Hyposmia

What is hyposmia?

Hyposmia (pronounced “hi-POSE-mee-uh”) refers to a decreased sense of smell. People with the condition have difficulty detecting and identifying odors and scents. Hyposmia is a smell disorder, but it’s different from anosmia, which refers to a total loss of sense of smell, and parosmia, which refers to an abnormal sense of smell.

How rare is hyposmia?

While over 12% of the U.S. population has some form of smell dysfunction, about 3% of Americans have hyposmia.

Your risk for hyposmia and other types of smell disorders increases with age.

What are the symptoms of hyposmia?

Hyposmia symptoms can develop suddenly or gradually over time and may include:

• A diminished sense of smell overall.
• Trouble detecting certain odors.
• Difficulty distinguishing between certain smells.

Up to 80% of taste is due to the sense of smell. As a result, you may also notice changes to your sense of taste (dysgeusia) in addition to a decreased sense of smell.

What causes hyposmia?

Hyposmia causes include certain health conditions, environmental factors and neurological issues. The most common cause of hyposmia is inflammation inside your nose. Additionally, neurological issues can affect the part of your brain responsible for your sense of smell.

Health conditions that may contribute to hyposmia include:

• Allergies.
• Bacterial infections, including rhinosinusitis, nasal vestibulitis or chronic sinus infections.
• Viral infections, including COVID, flu or the common cold.
• Nasal polyps.
• Deviated septum.
• Hormonal imbalances.
• Type 1 diabetes.
• Malnutrition.
• Dental issues like extensive tooth decay or gum disease.

Environmental factors that can cause hyposmia include:

• Smoking.
• Certain medications, including some antibiotics, antihistamines and antidepressants.
• Long-term exposure to certain chemicals, like lead and other heavy metals.
• Head and neck radiation therapy.
• Using cocaine.

Neurological issues linked to hyposmia include:

• Parkinson’s disease.
• Alzheimer’s disease.
• Multiple sclerosis (MS).

Hyposmia and COVID-19

Hyposmia is a common symptom of COVID-19. In many cases, it’s one of the first noticeable warning signs.

Having hyposmia doesn’t necessarily mean you have COVID-19. But if you develop a sudden decrease in your sense of smell, let a healthcare provider know.

What are the complications of hyposmia?

Hyposmia can have a significant negative impact on your quality of life. Most notably, it can prevent you from detecting odors that tell you you’re in danger, like:

• Fire or smoke.
• Gas leaks.
• Spoiled food.
• Poisonous chemicals.

How do healthcare providers diagnose hyposmia?

Apart from a multidimensional assessment ruling out neurological causes and COVID-19, a consultation with an ear, nose and throat specialist will examine your sinuses and the inside of your nose to check for infection, growths or polyps. They may also recommend diagnostic tests, including:

• Nasal endoscopy.
• Imaging tests, including CT (computed tomography) scans and MRI (magnetic resonance imaging).
• Sense of smell tests.

How do healthcare providers treat hyposmia?

Hyposmia treatment involves identifying and addressing the underlying cause. Treatments may include:

• Lifestyle changes.
• Sense of smell training.
• Medication.
• Surgery.

Every case is unique, so treatments vary widely. For neurological causes and COVID-19-related smell loss, ask your healthcare provider which options are right for you.

Lifestyle changes

People who develop hyposmia because of environmental factors may be able to reverse their symptoms by removing the trigger. For example, if smoking causes hyposmia, you might regain your sense of smell if you quit. Occasionally, occupational exposure could result in an irreversible sense of smell loss, so avoidance of these may be of value to avoid a further decrease in the sense of smell.

Medication

Prescribing medication to treat the underlying cause can also reduce hyposmia symptoms. For example, if you developed hyposmia because of allergies, your provider may recommend antihistamines or corticosteroids. Or they may prescribe antibiotics for sinusitis-related hyposmia.

Surgery

In severe cases, you may need surgery to treat hyposmia. But the type of surgery you need depends on the condition that caused it. If you have a deviated septum that caused hyposmia, you may need septoplasty. Or if you have nasal polyps, a surgeon may need to remove them.

Can I prevent hyposmia?

You can’t always prevent hyposmia because many of the underlying causes are unavoidable. But there are things you can do to reduce your risk:

• Wear proper protective gear if you work in an environment with harmful chemicals.
• Keep existing health conditions in check.
• Practice good oral hygiene.
• Eat a well-balanced diet.
• If you smoke, consider quitting.
• Avoid insufflating (snorting) cocaine, opioids or other substances.

How long does hyposmia last?

It depends on what caused it. Some people only notice a reduced sense of smell for a few days. Others may notice lingering symptoms for months or years. In some cases, hyposmia can be permanent.

To ease hyposmia symptoms as quickly as possible, schedule an appointment with a healthcare provider. Once they determine the cause, they can recommend appropriate treatment.

When should I see my healthcare provider?

A decreased sense of smell usually goes away on its own when it results from allergies, colds or infections. But if you have hyposmia symptoms that linger for more than a couple of weeks, tell a healthcare provider.

In addition, if you develop sudden and severe hyposmia for no apparent reason, seek medical care right away. It could indicate a more serious health concern.

What questions should I ask my healthcare provider?

Changes in your sense of smell can be scary. Here are some questions to ask your healthcare provider if you develop hyposmia:

• Why did my sense of smell change?
• What’s the underlying cause?
• What tests do you recommend?
• Do I have another health condition causing this?

A note from Cleveland Clinic

Our sense of smell is one of many ways we connect to the world around us. It gives us pleasure, like smelling the aroma of flowers or freshly baked bread. It also warns us of danger and helps keep us safe. Hyposmia can negatively impact your quality of life. The only way to treat it is to address the underlying cause or condition. If you have a decrease in your sense of smell, talk to your healthcare provider. They can determine the cause and recommend treatment to ease your symptoms.