What Is Phantosmia?

If you’re constantly smelling something nobody around you seems to be able to smell, you may have a condition called phantosmia. It’s a term used to describe olfactory hallucinations -- that means the organs related to your sense of smell are sensing odors that aren’t really there.

If you have phantosmia, the odors can vary from smells that almost make you sick to really pleasant scents. But most people with phantosmia tend to detect bad smells. The odors have been described as “burned," "foul," "rotten," "sewage," or "chemical." You may be smelling it from one or both of your nostrils. But it isn’t constant. The smells usually come and go.

What Causes It?

Experts say there are a few things that may lead to these nasal “hallucinations.” They can include:

If you notice phantom smells, talk to your doctor about it. They may do a thorough physical exam and ask about your medical history to make sure you don’t have another underlying cause, like a brain tumor.

Doctors may also have to rule out another similar smell disorder called parosmia. In this condition, your nose detects odors that are different from what’s actually there. For example, you might see a banana but smell rotting flesh. Parosmia usually happens when an upper respiratory infection damages tissues in your nose and nasal cavity.

COVID-19 and Phantosmia

Many people infected by SARS-CoV-2, the virus that causes COVID-19, lose their sense of smell and sense of taste. Reports also link COVID-19 infections to phantom smells like “burned toast” or unique scents that are hard to describe.

Some people’s senses of smell and taste return to normal after the infection clears up. But others’ symptoms may linger for a longer period of time. Scientists don’t have clear answers as to why this happens.

One study found that a little over 6% of the people with COVID-19 reported phantosmia. But experts say they need more information and larger studies done to see how COVID-19 affects your sense of smell in the short term and long term.

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Problems Phantosmia Can Cause

Smells and tastes have a huge effect on your mood. Good aromas can boost your spirits. But constantly smelling foul odors because of phantosmia could reduce your quality of life. It might also cause:

And there are added dangers like not being able to smell spoiled foods or a gas leak.

If you work in a field that requires a strong sense of smell, like chefs, perfumers, or fire fighters, phantosmia may make it impossible to do your job properly for periods of time.

Treatment Options

To treat smell disorders like phantosmia, you may need to see several types of doctors, especially if the condition results from damage or a head injury. Your treatment team can include:

Your doctor may do several lab tests and a physical exam to check what’s causing the phantom smells. They can give you medications to treat it. If the drugs don’t work and the problem doesn’t go away, you may need surgery to fix it. But there is a chance it might not work, or that you could lose your sense of smell completely. So doctors recommend it only when it’s really necessary.

If you got phantosmia after a viral infection like COVID-19 or a head injury, there’s no treatment. But damaged nerves in your nose and nasal cavity do have the ability to grow back. It’s possible for your sense of smell to partially or fully come back without treatment.

WebMD Medical Reference Reviewed by Michael W. Smith, MD on March 23, 2021

Sources

SOURCES:

Mayo Clinic: “Phantosmia: What causes olfactory hallucinations (phantosmia)?”

Archives of Otolaryngology-Head & Neck Surgery: “Long-term Follow-up of Surgically Treated Phantosmia.”

East Carolina University: “Parosmia and Phantosmia.”

Fifth Sense: “Parosmia And Phantosmia.”

Oxford University Press: “More than smell – COVID-19 is associated with severe impairment of smell, taste, and chemesthesis.”

National Health Service UK: “Lost or changed sense of smell.”

UpToDate: “Evaluation and treatment of taste and smell disorders.”

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