Can Steroids Change Your Smell? What the Science Says

October 7, 2025 •

5 min read

According to reports submitted to the FDA Adverse Events Reporting System, certain corticosteroids like fluticasone propionate are associated with olfactory adverse reactions, including altered smell. However, the effect of steroids on a person's sense of smell is complex and can be both therapeutic and, in rare cases, a negative side effect, so can steroids change your smell? It depends heavily on the specific medication, dosage, and underlying condition being treated.

Quick Summary

Steroids can either improve a compromised sense of smell by reducing inflammation or, less commonly, cause adverse effects like altered or reduced olfaction. The outcome depends on the type of steroid and the root cause of the smell disorder.

Key Points

Positive Effect for Inflammation: Steroids, especially nasal sprays, are highly effective in restoring or improving smell compromised by nasal polyps or chronic inflammation.
Adverse Reactions are Possible: While less common, some individuals experience a negative change in their sense of smell (dysosmia or parosmia) while taking steroids.
Mechanism Matters: The primary mechanism involves reducing inflammation to clear nasal passages, allowing odor molecules to reach the olfactory nerve. Adverse effects may involve direct neuronal impact or central nervous system effects.
Topical vs. Systemic: Topical nasal steroids have minimal systemic side effects, while systemic (oral/injected) steroids carry a higher risk of broader adverse reactions.
Long-term vs. Short-term Use: The risks and benefits vary with the duration of use. Chronic use of some intranasal corticosteroids has been linked to potential neuronal degeneration in animal models.
Consult a Professional: Any persistent changes in smell while on steroids should be discussed with a healthcare provider to rule out other causes or adjust treatment.

Steroids and Smell: A Complex Relationship

The relationship between steroid use and a person's sense of smell is multifaceted. Rather than a single outcome, the effect of steroids on olfaction can be categorized into two primary scenarios: therapeutic restoration of smell and potential adverse reactions. The distinction lies in the type of steroid (topical vs. systemic), the dosage, the duration of use, and the underlying medical condition causing the olfactory issue.

How Steroids Can Improve a Compromised Sense of Smell

For many patients suffering from smell loss (anosmia) or a reduced sense of smell (hyposmia) due to inflammation, corticosteroids are a cornerstone of treatment. Their powerful anti-inflammatory properties can directly address the root cause of the problem, particularly in conditions affecting the nasal passages and the olfactory nerve.

Chronic Rhinosinusitis with Nasal Polyps (CRSwNP): This is one of the most common applications. In patients with CRSwNP, chronic inflammation and growths (polyps) in the nasal cavity obstruct the airflow, preventing odor molecules from reaching the olfactory nerve in the upper part of the nose. Steroids, especially nasal corticosteroids, reduce the size of the polyps and decrease inflammation, effectively clearing the pathway and restoring the sense of smell.
Postviral Olfactory Dysfunction: Following viral infections like COVID-19, some individuals experience a persistent loss of smell due to inflammation and damage to the olfactory neuroepithelium. In some cases, steroids have been used to reduce this inflammation and support the regeneration of olfactory neurons, with topical forms showing more consistent benefits than oral steroids in recent studies.
Allergic Rhinitis: For those with allergies, nasal corticosteroids can alleviate symptoms like congestion and inflammation that interfere with olfaction, thereby improving the ability to perceive odors.

The Potential for Adverse Olfactory Effects

While often beneficial, steroids can, in some cases, have a negative impact on the sense of smell. This can manifest as a diminished sense of smell (hyposmia), a complete loss of smell (anosmia), or a distorted sense of smell (parosmia), where smells are perceived incorrectly or unpleasantly. These adverse effects are generally less common than the therapeutic benefits, but they are documented.

Some reported adverse effects on olfaction include:

Dysosmia/Parosmia: Distortion of the sense of smell is possible with certain medications. For example, some corticosteroids, including topical ones like fluticasone propionate, have been reported in adverse event databases to cause parosmia, though this is a relatively rare occurrence.
Delayed Recovery: In cases of post-viral smell loss, some studies have shown conflicting results regarding the efficacy of oral steroids, suggesting they might not significantly shorten the recovery duration compared to placebo.
Chronic Use Concerns: Long-term, high-dose use of corticosteroids, particularly certain intranasal forms, has been associated with potential degeneration of olfactory sensory neurons in animal studies. While direct human evidence is limited, it raises questions about long-term topical use for olfactory loss, particularly without addressing the root cause.

How Do Steroids Influence the Sense of Smell?

The mechanisms by which steroids influence olfaction are varied and depend on the administration method and underlying condition.

Anti-inflammatory Action: The most common and beneficial mechanism is reducing inflammation. By suppressing the immune response in the nasal cavity, corticosteroids can:

Decrease swelling of the nasal mucosa, improving airflow to the olfactory cleft.
Reduce the size of nasal polyps.
Allow for better regeneration of olfactory neurons following inflammatory damage, such as from viral infections.

Local Cellular Effects: Some theories suggest corticosteroids may directly affect the sensory neurons themselves or the supporting cells. For example, some studies suggest certain intranasal corticosteroids could disrupt the normal turnover of olfactory sensory neurons, especially with chronic use. Additionally, systemic effects of oral steroids could theoretically influence central nervous system processing of olfactory information, though research in this area is limited.

Comparison of Topical vs. Systemic Corticosteroids

The impact of corticosteroids on smell varies significantly based on how they are administered. Topical (nasal) and systemic (oral) steroids have different side effect profiles and mechanisms of action related to olfaction.


Feature	Topical (Nasal) Corticosteroids	Systemic (Oral/Injected) Corticosteroids
Effect on Smell	Highly effective for improving smell in cases of localized nasal inflammation or polyps.	Can temporarily improve smell in severe inflammatory conditions, but overall efficacy for isolated smell loss is less clear.
Mechanism	Directly targets inflammation in the nasal mucosa and olfactory region.	Reduces inflammation throughout the entire body. Its effect on smell is a side benefit of its broad anti-inflammatory action.
Side Effects (Local)	Nasal irritation, dryness, burning, nosebleeds, and crusting are common local side effects.	Not applicable. Local side effects are associated with the nasal delivery route.
Side Effects (Systemic)	Low risk due to minimal systemic absorption.	Higher risk, especially with long-term use, including metabolic changes, mood disturbances, and risk of infection.
Typical Duration	Often prescribed for longer-term management of chronic conditions like allergies or polyps.	Typically prescribed for a short course to address acute, severe inflammatory episodes.
Known Olfactory Risks	Rare association with altered smell (parosmia) reported in adverse event databases.	Conflicting evidence on effectiveness for persistent smell loss, with some studies showing no significant benefit over placebo.

Conclusion

In summary, steroids can change your smell, but whether that change is beneficial or adverse is highly dependent on the circumstances. For many inflammatory conditions of the nose and sinuses, such as nasal polyps or allergic rhinitis, corticosteroids are a well-established and effective treatment for restoring or improving the sense of smell. Topical nasal sprays are the most common approach and carry minimal systemic risk. Conversely, for other conditions, such as post-viral olfactory dysfunction, the role of systemic steroids is more debated, and some adverse event reports suggest a rare risk of altered smell, or parosmia, with certain medications. Patients should always discuss any concerns about changes to their sense of smell with their healthcare provider. It is important never to discontinue a prescribed medication without medical advice, as stopping prematurely could worsen the underlying condition.

Further research is ongoing to better understand the long-term effects and precise mechanisms of corticosteroids on the complex sense of smell. You can explore more studies on the topic by visiting the National Institutes of Health's PubMed Central database.

Frequently Asked Questions

Nasal steroids are typically used to treat conditions like nasal polyps that cause smell loss. While rare, some adverse event reports have associated nasal steroids like fluticasone with reduced or altered smell, but this is not their primary effect.

Parosmia is a distorted sense of smell, where familiar odors smell unpleasant or different. There are reports linking corticosteroids to parosmia, though it is not a common side effect.

In some cases, high doses of oral steroids can temporarily restore smell in individuals with inflammatory conditions like nasal polyps. However, their efficacy for persistent smell loss, such as after a viral infection, is inconsistent across studies.

Steroids work by reducing the inflammation and swelling caused by nasal polyps. This clears the physical obstruction in the nasal passages, allowing odor molecules to reach the olfactory receptors.

The timeline varies depending on the condition and individual response. Some people notice improvement within a few weeks of treatment for nasal polyps, while others may require a longer course.

For changes related to resolving inflammation, the effect is typically a temporary improvement. Adverse changes like parosmia are also often temporary and may resolve after stopping the medication. However, any persistent changes should be evaluated by a doctor.

If you experience a worsening or alteration of your sense of smell, you should consult your healthcare provider. Do not stop taking a prescribed medication without medical guidance, as they may need to adjust your dosage or investigate alternative causes.