Is it bad to hold in a sneeze?

What the evidence says

A sneeze is your body's way of blasting irritants out of your nose at high speed and pressure. When you pinch your nose and clamp your mouth shut to stop a sneeze, that pressure has nowhere to go, so it gets pushed back into your head, throat, chest, ears, or eyes instead.

A review that gathered 52 published cases of sneeze-related injury found problems in the chest, throat, eyes, brain, and ears, and it specifically warned that these problems happen especially when someone tries to hold in a sneeze with the airway closed. Most of the people affected were otherwise healthy adults, and men seemed to be at higher risk.

Documented cases include a torn windpipe, air leaking into the tissue around the throat and chest, a ruptured blood vessel in the skull, and even a facial bone fracture, all triggered by pinching the nose shut during a sneeze. These are rare, serious complications, not something that happens to most people who occasionally stifle a sneeze.

Because of this, the researchers who reviewed these cases recommended letting a sneeze happen naturally rather than forcing it shut. If you can, it is safer to sneeze into your elbow or a tissue instead of holding it in.

There is no specific Canadian guideline on sneeze suppression, since this is such an uncommon event; the available evidence comes from case reports and a review article rather than large studies or clinical guidelines.