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Allergies Health Center

Nasal Spray: Are You Overdoing It?

Why overusing your nasal spray may backfire.
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Consequences of Overuse continued...

The issue is overuse, not the products themselves.

"Many consumers turn to topical nasal sprays because they are safe and effective when used as directed," says Elizabeth A. Funderburk, a spokeswoman for the Consumer Healthcare Products Association. "We know that people demand a range of options and different delivery forms work for different people. As with all OTC medicines, it is important that consumers always read and follow the label. The labeled directions state that you should not use topical nasal decongestants (nasal sprays or gels) for more than three days, because frequent or prolonged use may cause nasal congestion to recur or worsen."

Alternative Treatments

OTC decongestant nasal sprays are "my least recommended interventions for nasal congestion," says Anne L.  Maitland, MD, PhD, assistant professor of medicine and clinical immunology at Mount Sinai School of Medicine in New York City. Nasal corticosteroids, such as Flonase and Nasonex, "are the gold standard of medications for allergic rhinitis," Maitland tells WebMD.

Prescription nasal sprays are longer-lasting, more targeted treatments that work in several ways.

  • Nasal corticosteroids are anti-inflammatory sprays that control the allergic immune response at the site of the problem; one dose typically provides relief for the day. Only two steroid sprays, Nasacort and Flonase, are available over the counter.
  • Nasal antihistamine sprays work by blocking histamine, what causes the inflammation, and one dose typically lasts for 12 hours. But  antihistamines do not "calm down the immune cells responsible for the symptoms," Maitland says.

Maitland says patients may prefer a nonpharmacological approach, such as Neti pots, to treat their congestion, but this, too, comes with some risks.

"Washing the allergens and irritants out of your nose is very safe, but surprisingly, you can use this too much," Maitland says. "Imagine washing your hands frequently every day. You will end up with dry, irritated skin. The same for your [nasal] passages."

The Only Way to Quit Is to Quit

If chronic nasal spray overuse occurs, doctors recommend patients stop using the product altogether.

"The only real way to fix the problem [of rhinitis medicamentosa] is to stop cold turkey," says James N. Palmer, MD, director of the division of rhinology in the department of otolaryngology: head and neck surgery at the University of Pennsylvania in Philadelphia. "It's kind of like smoking. What's the way to stop smoking? It's to stop smoking."

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