Steam Inhalation and Gargles – An all round view

since ages. Camphor, eucalyptus oil drops, etc are traditionally added in the steam for relief of blocked nose, choked sinuses, irritated throat, and so on. Ever since the appearance of corona pandemic, these traditional therapies have gained a lot of traction in masses. There are views and counter views on these household therapies, regarding their usefulness (or lack thereof). Let’s see some of the established facts first.

The steam or water vapor itself is known to cause the following ~

(1) Warms the airways,

(2) Clears the airways,

(3) Loosens or liquefies the mucus in the respiratory tract.

Additional benefits have been shown by addition of menthol or eucalyptus oil (or, essential oils). Eucalyptus oil has been shown to have some antiviral properties. Gargles with warm saline water or with povidone iodine have been shown to have similar benefits, on a different region, though. Gargles are more useful for the throat/larynx region. Povidone iodine is known to cause oxidation of cell surface receptors, thereby preventing the attachment of the virus to the cell membranes. It has also been shown to have viricidal properties. Now, let’s discuss the corona virus and steam inhalation. Studies published in Lancet and other publications indicate that the corona virus is inactivated or destroyed when exposed to 70 0 C for 2.5-5 minutes. What is the usefulness of steam inhalation in the current pandemic? A major proportion of population is taking steam very regularly; some are taking it daily, or even 3 to 5 times a day! Every time one is taking a steam inhalation, it will have to be assumed that he/she is already exposed to the corona virus; the virus has already attached to the respiratory mucosa. The heat of the steam is likely to destroy the envelop of the virus. Ditto with betadine gargles. However, there are two things that need further exploration. If there is no corona virus colonizing one’s respiratory tract, what can be the possible (unwanted) effects of excessive steam and gargles? (1)Will the steam and gargles destroy the commensals in the throat and other regions? Those friendly bacteria could have been useful in fighting off the corona virus. (2) What will be the effect on the mucosa-associated lymphoid tissue (MALT)? There are local defense mechanisms (antibodies, macrophages); will they be destroyed by excessive steam or gargles? In addition, some recent articles implicated the steam in development of mucormycosis. It is already known that the fungus grows in a moisturized milieu. (Of course, it’s not the steam alone; the concomitant use of steroids, immunocompromised state of the host, uncontrolled diabetes are the factors responsible for the dreaded mucormycosis.) Hence, a balanced approach needs to be taken for steam inhalation and gargles. Steam and betadine gargles could be done once or twice a day, for not more than 3 to 5 minutes each. This is particularly applicable if exposure to the virus is suspected. Adequate care should be taken during steam inhalation. Face shouldn’t be too close to the vaporizer. Burning of the nasal mucosa is an unwanted effect rather avoided. Finally, about the corona pandemic. Hardly any virus has been eradicated once it came into being on this planet (small pox comes to mind as an exception). Hence, the pandemic will eventually subside but the virus will stay. After certain number of mutations, its virulence will wane; that’s the traditional wisdom. However, till then, all the precautions must be taken, including the steam and gargles.

- DR VIVEK NALGIRKAR