You may want to avoid flying while congested to not risk additional discomfort and complications. But if you can’t skip the flight, a few strategies — like staying hydrated and taking medication — may help.

Infections, allergies, irritants, and factors like the weather can all contribute to congestion. This buildup of mucus and inflammation in your sinuses and eustachian tubes can create intense pressure or pain in your head.

When you fly, changes in air pressure require your ears and sinuses to adjust quickly. However, fluid and swollen tissues can prevent pressure regulation when congested.

For some people, this means increased sinus or ear pain, headaches, and even ear barotrauma, an injury to the ear that could result in permanent hearing loss.

General recommendations are to avoid flying if you’re severely congested. Specific strategies might make your journey more comfortable if you have mild to moderate congestion and can’t miss the flight.

Consider asking a healthcare professional about medication options for your needs. If you have a sinus infection or other condition that causes congestion, they can also advise you on any potential risks of flying while congested.

Correctly timing a pre-flight oral decongestant or allergy medication can help manage congestion when you step on the plane.

You may want to keep additional medication doses in your carry-on for longer trips, as long as they’re cleared by the Transportation Security Administration (TSA).

Keeping medications in their original packaging allows TSA officers to identify and clear them quickly. It’s also important to keep a copy of your written prescriptions.

Staying hydrated may help thin mucus and allow your body to expel it efficiently. Warm water is ideal: The warmth may boost circulation to clear out inflammation. Any water intake will do, though.

You can also use an irrigating nasal spray to moisten your sinus tissue, soothe irritation, and aid in thinning mucus. Most flights allow carry-on nasal spray if the bottle is 3.4 ounces or less.

Avoiding alcohol is also a good idea to stay hydrated.

Sinus pressure and stuffiness may feel worse if you’re leaning forward. Reclining with your head tilted slightly back can help if you’re congested while flying.

For maximum comfort, consider bringing a neck pillow to provide stability, or request a blanket from a flight attendant to roll behind your neck.

If you’re congested, you can ask a flight attendant for a hot towel regardless of which class you’re traveling in. Applying heat to your face promotes circulation, which may reduce inflammation and soothe congested areas.

If you’re not sure a hot towel will be available, TSA allows instant hot packs in your carry-on.

When ear pressure is a concern, pressure-regulating earplugs slow the pressure change in your ears by filtering the air entering your ear cavity.

However, pressure-regulating earplugs are not for everyone. If you have a history of ear conditions, you may want to discuss using these devices with a healthcare professional before flying, especially if you’re congested.

The Valsalva maneuver is a technique of exhaling against closed airways. By closing your mouth, plugging your nose, and attempting to exhale, you can equalize the pressure in your eustachian tubes by increasing the pressure in your upper respiratory tract.

Some eye, heart, and ear conditions may worsen using the Valsalva maneuver. To avoid adverse effects, discuss this technique with a healthcare professional before you try it.

Yawning and swallowing contract the muscles attached to your eustachian tubes, allowing them to open and drain. While you can’t always force a yawn, you can promote swallowing by chewing gum or having some hard candy throughout your flight.

You may want to anticipate symptoms and start chewing gum before you get on the plane. Taking small sips from a water or soda bottle during the flight may also help.

Like sinus irrigating sprays, decongestant sprays are allowed in your carry-on if they don’t exceed 3.4 ounces. If your congestion is severe, having a nasal spray on hand can provide relief when other options aren’t working during your flight.

Saving this as a last resort can decrease the chance of worsening your congestion from medication-induced rebound inflammation, a condition known as rhinitis medicamentosa.

Even if your congestion is mild on the ground, there’s no way to predict how you’ll feel once the plane takes off. For example, even a minor sinus infection may worsen when exposed to flight-related pressure changes.

Discussing your symptoms with a healthcare professional before you depart can help ensure your flight is as safe as possible.

Some reasons a doctor may recommend canceling a flight due to congestion include:

  • congestion is severe, or your eustachian tubes are significantly blocked
  • you have an active infection causing congestion
  • medication or other strategies do not significantly improve your congestion
  • you have a high risk of barotrauma
  • symptoms like headaches, earaches, or facial pain are already present
  • underlying health conditions (like respiratory conditions) could worsen
  • you have a history of sinus or eustachian tube conditions
  • you’ve recently had a face and/or ear-related surgery

General recommendations are to avoid flying if you have severe congestion. Rapid air pressure changes during flights can lead to increased discomfort and complications for some people.

If a healthcare professional says it’s OK to fly, taking before-flight decongestants, staying hydrated, and reclining comfortably are just a few tips that might make your trip more comfortable.