Signs You Should Seek Medical Advice When OTC Solutions Aren't Working

Many common ailments do not require a visit to the doctor. You can usually find over-the-counter (OTC) solutions you need to feel better at your nearby pharmacy. But when your symptoms continue, you may wonder if you should seek medical advice, or even make a trip to urgent care.

Fevers in Adults

For adults, a fever is generally considered any temperature above 100.4°F, measured orally. Most germs that cause illness cannot survive in higher temperatures, so fevers are one of the immune system's ways of fighting infection. However, you should seek medical evaluation if you have a fever that is above 103°F, that lasts more than three days, or is accompanied by symptoms such as headache, confusion or difficulty breathing.

Fevers in Children

Children may run higher temperatures than adults, so a fever in a child is not an automatic cause for alarm. It's unlikely to be concerning if OTC solutions are controlling the fever and your child is alert, eating and drinking, and does not seem distressed.

That said, any infant under 12 weeks of age with a fever of 100.4°F or above should see a doctor. For children older than three months, seek medical advice if their temperature rises above 104°F. Contact your pediatrician if your child also experiences symptoms such as unusual tiredness or fussiness, unexplained rash, vomiting or diarrhea with their fever.

Cough and Cold Symptoms

Coughs associated with colds and the flu can be irritating, but they do not usually require medical attention. Viruses cause most seasonal respiratory illnesses. OTC products can reduce your cough and provide comfort while your body fights the infection. However, a prolonged viral respiratory infection can lead to bronchitis or pneumonia, which may require steroids or antibiotics (prescription necessary). See a provider if your cough lasts more than three to four weeks and you're experiencing fever, chills, wheezing or phlegm — especially green, yellow or bloody phlegm.

Cough in Children

Young children are highly susceptible to respiratory infections, especially during flu season. Respiratory illnesses can be especially dangerous to infants with developing immune systems who are not yet fully vaccinated.

As a rule, children under the age of four should not use OTC cough medicines. Children between four and six should only use OTC cough remedies under their provider's direction.

A croup cough occurs most often at night and has a distinct, coarse sound that is often described as "barking." A croup cough can alarm parents, but in many cases, it will settle down in a few moments. However, if your child begins to make a whistling sound that becomes louder with each breath, cannot catch their breath, speak or swallow, or their lips and fingertips start to turn blue, call 911.

Respiratory syncytial virus, or RSV, is another common seasonal respiratory illness in children. Healthy children may appear to have a cold, but susceptible children may require hospitalization in some cases. Retractions, or the chest caving in with each breath, are a hallmark sign of RSV. Seek medical attention if your child does not have at least one wet diaper every eight hours, develops difficulty breathing, makes wheezing or grunting noises with each breath, turns gray or blue around the lips, or becomes less active and alert.

Whooping cough, or pertussis, first presents with cold symptoms, then progresses with a distinct, high-pitched sound (whooping breaths) on inhalation. Infants typically receive vaccinations against whooping cough. However, they can contract the illness if they're in close proximity to unvaccinated individuals before they are fully protected. While older children may be able to stay home if they are not experiencing respiratory distress, infants under six months of age need to be hospitalized for whooping cough.

Sore Throat

Most sore throats are caused by viral infections and will not respond to antibiotics. Therefore, you can usually wait a couple days to see your doctor. However, a sore throat requires medical care if it does not improve in a few days or is accompanied by a rash, joint pain, fever above 101°F for more than a day or two, difficulty swallowing liquids or trouble breathing.

Headache

Headaches often accompany stress or dehydration. If they occur infrequently and respond to OTC medications like Tylenol or Excedrin, they're not likely concerning.

See your primary care provider if you experience:

• Headaches that do not respond to OTC medications. (Some headaches, such as migraine or cluster headaches, require other treatments.)

• Headaches that impact daily activities, work, school or sleep.

• Headaches that are recurrent, and you cannot identify a trigger.

• Headaches that are becoming more frequent or more severe.

Headaches that occur with the following symptoms warrant immediate attention, as they could indicate a stroke or other severe neurological condition:

• A sudden and very severe headache, often described as "the worst headache of my life."

• Headaches accompanied by a stiff neck, fever, seizure, fainting, confusion, personality changes, weakness, numbness or vision changes.

• Any headache that occurs after a head injury.

Earaches and Swimmer's Ear

Earache is another common ailment that often accompanies other illnesses. Most viral ear infections will resolve on their own; however, if the drainage persists, bacteria can grow in the inner or middle ear, and in this case, antibiotics become necessary to treat the infection.

Swimmer's ear is another condition that causes ear pain. This is an infection of the outer ear (the ear canal leading to the eardrum), usually due to excessive submersion in water, like a pool, lake or pond.

Any ear pain due to trauma needs emergency care. However, seek medical care if you have an earache with any of the following symptoms:

• Severe pain in an ear with or without fever.

• Itching of the ear or ear canal.

• Loss of hearing or difficulty hearing in one or both ears.

• Pus or discharge from an ear, especially if it's thick, yellow, bloody or foul-smelling.

Wounds and Bites

Bruises, scrapes and bug bites are common when spending time outside in summer. However, wounds that do not stop bleeding with pressure need immediate attention. Beware of signs of infection that warrant medical attention, including yellow or green discharge around the wound, warmth and redness at the wound site, and a streaking appearance extending from the wound. Cellulitis, a bacterial infection under the surface of a wound, requires antibiotics. Ultimately, an untreated wound infection can advance to fever, chills, aches, pains and nausea.

When it comes to minor mosquito and bug bites, medical intervention is usually not required. However, some bites should receive medical treatment:

• Any bite from a dog, cat or another human that breaks the skin needs medical treatment.

• Even a minor cat scratch can become infected if left untreated, so see a provider if you notice any signs of wound infection.

• Livestock, feral creatures and wild animals such as raccoons can transmit diseases like rabies, so seek urgent medical advice for these types of bites.

• Bites to the hands, face or joints may cause infection or damage to underlying tissue, so medical care may be needed.

• Venomous snake bites need urgent medical care. If you're unsure whether or not a venomous snake bit you, seek medical care anyway. Take a picture of the snake (if possible), or be prepared to describe the snake to medical providers.

• Spider bites do not always require medical attention, but you should be concerned if you notice redness and warmth, drainage, severe pain, cramping or vomiting.

• Some individuals are allergic to bee and wasp stings. Seek immediate medical care if you experience any signs of anaphylaxis, including difficulty breathing, swelling of the throat or face, throat tightness, dizziness or fainting.

You can treat many minor ailments with OTC remedies, and it's often suggested you do so. However, a healthcare provider should evaluate any condition that does not improve promptly with OTC treatment. When it comes to your health, it's best to err on the side of caution.

Clinically reviewed on Oct. 2, 2023.