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Air travel probably won’t make your cold worse. But landing with a cold can cause severe ear pain. The problem is air pressure. At high altitudes air pressure is low, but as you descend air pressure increases.

When you have a cold, the tiny tube (eustachian tube) that connects your throat and middle ear is often blocked. Normally, the eustachian tube equalizes air pressure in your middle ear with the increasing outside pressure. Blockage in the tube leaves a vacuum in your middle ear, leading to buildup of painful pressure on your eardrum. Your body’s attempt to fill the vacuum causes fluid and sometimes blood to enter the middle ear.

To prevent ear pain when you fly with a cold, take a decongestant at least an hour before landing. Also, use a decongestant nasal spray before descent. These over-the-counter medicines help keep your eustachian tubes open. Sipping a non-alcoholic drink on take-off and landing also helps keep these tubes open.

Drink plenty of non-alcoholic beverages whenever you fly, but especially when you have a cold. Liquids keep your throat and sinus membranes from drying, and they keep sinus secretions thin and easy to clear.