Steam Inhalation: Benefits, Burns and Safer Habits

What steam actually does

Warm, moist air can loosen mucus a little and make a blocked nose feel more comfortable for a short while. Many people simply enjoy the warmth. But steam does not kill viruses or bacteria in the body, does not clear a chest infection, does not treat pneumonia, COVID-19 or influenza, and does not substitute for medicines or oxygen. Reviews of heated, humidified air for the common cold have found no clear benefit in shortening illness, and have recorded burns, mostly from hot water spills. During the pandemic many families used steam in the belief that it protects against infection, but health authorities do not support this as a treatment or prevention.

Steam can also make some conditions worse. Hot, moist air may trigger coughing, wheeze or tightness in people with asthma or COPD, and heavy steam can irritate already inflamed airways. So steam is at best a comfort measure and, for some people, a hazard.

Who should avoid steam or ask first

Do not use steam inhalation, or ask the doctor first, if your parent:

• Has asthma, COPD, bronchiectasis or other chronic lung disease; steam can trigger bronchospasm.
• Is on oxygen at any time. See the fire warning below.
• Has dementia, confusion, tremor, severe weakness, dizziness, poor eyesight or poor balance, since spills are likely.
• Has numb skin or neuropathy (diabetes, stroke), which can hide a burn.
• Has heart disease or low blood pressure and may feel faint in a hot, steamy atmosphere.
• Has thin, fragile skin or a skin condition on the face.
• Has a fever, breathlessness or chest pain. These need medical assessment, not steam.
• Is drowsy or sedated by medicines.
• Is a child in the home who might get hold of the pot.

The dangers

Scalds and burns. The classic injury is a bowl of boiling water tipping over onto the lap, thighs or chest. In older adults, burns are deeper, heal slowly and can become infected. Hot steam can also burn the face, eyes, lips, nose and throat.

Airway burns. Very hot vapour can injure the lining of the nose, throat and lungs, causing swelling and breathing difficulty.

Eye problems. Steam can irritate or damage eyes, especially when strong additives are used.

Falls. Leaning over a table or getting up quickly with hot water around can lead to a fall.

Additives. Some people add camphor, menthol, eucalyptus, medicated balms, herbal oils, salt, turmeric or other substances. These can irritate airways, trigger asthma, burn skin and, in the case of strong oils, be unsafe for some people with lung conditions. Do not add them unless a doctor agrees.

Fire. Electric steamers and heaters create a heat source. Steam and oxygen do not mix: a heated element near oxygen is a fire hazard, and a person on oxygen should not use a steamer at all unless a doctor and the equipment supplier say it is safe. Never take a bowl of boiling water near a running oxygen concentrator or cylinder, and never use a lit flame to heat water in the room with oxygen. See safe use of oxygen and electrical equipment.

Mould and germs. Frequent steaming in a closed room raises humidity and can feed mould, which affects people with lung disease; see indoor air quality for older lungs: dust, smoke and damp.

If you still choose steam: harm-reduction rules

Only after checking that it is suitable, and not if your parent is on oxygen or has any of the conditions above without a doctor's agreement:

1. Prefer a safer set-up: a steam inhaler device with a stable base, a built-in safety cut-off and a mask or nozzle that keeps the water enclosed, rather than an open pot. A product designed for the purpose is safer than a pan or kettle, and should be used according to the maker's instructions. 2. Never use an open pot of boiling water on the lap or with a towel tent over an unsteady person. 3. Use warm, not boiling, water. Let boiled water cool for a few minutes first, so that vapour is warm and not scalding. 4. Place it on a stable, hard table, away from the edge, where it cannot tip, with the cord away from walkways. 5. Sit upright in a firm chair, with feet flat, and not in bed, on a sofa or a reclining chair. 6. Keep a safe distance: hold the face well away, at least 30 cm, and do not put the face inside a towel tent. 7. Limit sessions to a few minutes and stop if your parent feels hot, dizzy, short of breath, wheezy or uncomfortable. 8. Have a helper stay with the person, especially if they are weak or forgetful. Never leave them alone. 9. Keep children and pets out of the room. 10. No additives unless the doctor approves. 11. Cool down afterwards: wipe the face, sip water and rest. 12. Empty and clean the device after use; see a cleaning schedule for breathing equipment.

First aid for a scald

• Cool the burn with cool, clean running water for at least 20 minutes, as soon as possible. Do not use ice, butter, toothpaste, ghee, turmeric or home remedies.
• Remove rings, watches and clothing near the burn, unless stuck to the skin.
• Cover loosely with a clean, non-fluffy dressing or cling film.
• Seek medical help for any burn on the face, hands, feet, groin or over a joint, any burn larger than a small coin, blistering, burns in a person with diabetes or poor circulation, or any burn that is white, leathery or very painful or painless.
• Call 112 for burns with breathing difficulty, burns to the mouth or airway, or large burns.
• Tell the doctor about tetanus vaccination status.

Safer ways to ease congestion and cough

Ask the doctor or pharmacist about the options that suit your parent, which may include:

• A warm, humid bathroom after a shower, with the person seated safely and the shower not scalding.
• Warm fluids, such as water, clear soup or herbal tea, if fluid is not restricted, which help keep mucus thin. See hydration for older adults.
• Saline nasal sprays or rinses, if the doctor agrees, using clean, boiled and cooled or distilled water for any rinse.
• Resting upright with extra pillows to ease breathing and mucus drainage.
• A cool-mist or room humidifier kept clean, if the air is very dry. Dirty humidifiers spread germs and mould, so clean as the maker says.
• Avoiding smoke, dust and strong smells, and keeping the room comfortably warm with fresh air; see temperature and ventilation at home.
• Prescribed or recommended medicines only.
• Honey in warm water for cough, for adults without diabetes concerns or allergies, if the doctor agrees; check with the doctor if your parent has diabetes.
• Nebulised or inhaled medicines prescribed for lung conditions; see nebulisers: types, use and cleaning and nebuliser or inhaler: understanding the difference.
• Treating the cause, such as allergies, reflux, infections or medicines that cause cough, which the doctor can identify.

For more general guidance on cough and cold remedies, the library includes older posts, but treat any remedy as a comfort measure, not as treatment.

When congestion is not simple

Seek medical advice rather than relying on steam if your parent has:

• Breathlessness, wheeze or chest tightness.
• Fever or a temperature that is rising; see fever in older adults: why it can be subtle and when to call.
• Cough lasting more than two to three weeks, blood in sputum, weight loss or night sweats.
• Green, yellow or foul-smelling sputum with a fever.
• New confusion, drowsiness or a fall.
• Low oxygen readings; see when oxygen saturation is low: what to do.
• Facial pain or swelling, severe headache or stiff neck.
• Any COPD or asthma flare-up according to the action plan; see building a COPD action plan with your doctor.

When to ask a professional

Ask the doctor whether steam is suitable for your parent, especially with asthma, COPD, heart disease or if oxygen is used. Ask a pharmacist about safe, evidence-based remedies for cough and congestion. Ask a nurse about burn first aid. Call the doctor if symptoms last or worsen. Call 112 for severe breathlessness, blue lips, confusion, chest pain, collapse, a significant burn or any burn affecting the face or airway.