Tired of living with a stuffy nose, postnasal drip, sinus infections, facial pain, poor sense of smell, and the other symptoms that come with nasal polyps? It’s time to seek treatment.
“There are a full array of treatments available for nasal polyps,” says Cecelia Damask, DO, an ear, nose, and throat specialist in Lake Mary, FL.
Your doctor can create a treatment plan that aims to shrink or eliminate these noncancerous growths in your nostrils and sinus cavities, allowing you to breathe easier.
These are the most common medications used to treat nasal polyps:
Topical steroids: This is usually the first treatment doctors recommend for nasal polyps. These medications, delivered into your nasal passages via drops, sprays, nebulizers, and inhalers, reduce inflammation and shrink nasal polyps.
They're not only effective, but have fewer side effects than oral steroids, Damask says.
Your doctor can prescribe topical steroids, and you can buy over-the-counter versions as well. It's safe to use them long-term. Your symptoms will return when you stop using them.
Many people use them along with other treatments. Research shows that combining topical and oral steroids is more effective to shrink polyps and improve your sense of smell than topical steroids alone.
A newer tool called an exhalation delivery system (EDS) may work better than conventional nasal sprays to deliver the medication where you need it. An EDS connects to your nose and mouth. You blow into the device, sending the medication high into your nasal cavity.
Oral steroids: Oral steroids are among the most common treatments for nasal polyps. Doctors may prescribe them:
- When you have serious sinus disease
- If your nasal polyps tend to come back
- When sprays don't work to shrink your polyps or reduce symptoms
“Oral steroids do a great job,” Damask says.
Still, they come with some risks. Repeated use of oral steroids has been linked to serious side effects like high blood sugar, cataracts, glaucoma, osteoporosis, bone fractures, and heart problems, she says.
“As few as four lifetime bursts of oral steroids could result in these side effects,” Damask says.
Because of the risk of side effects, your doctor probably won't recommend using oral steroids long term. Their effects usually last for a few months.
Injectable steroids: Your doctor can inject steroid medication directly into nasal polyps, which helps more medication reach the site. The effects of injectable steroids should last for at least 3 months.
They're as effective as oral steroids for reducing inflammation, easing symptoms, and shrinking polyps, but tend to have fewer side effects. A few people have had short-term vision loss as a side effect, though.
Your doctor may recommend steroid injections if your polyps are serious. But if you have several large polyps, injections may not work to eliminate them.
Antibiotics: Nasal polyps and sinus infections often go hand in hand. Your doctor may prescribe antibiotics if you have a bacterial sinus infection along with nasal polyps. (Most sinus infections are caused by viruses, so antibiotics don't work to treat them.)
The antibiotics treat the infection, which causes inflammation. You'll get other medications, like steroids, to shrink the polyps.
Antihistamines and decongestants: While these medications don't actually treat nasal polyps, your doctor may recommend them in addition to other treatments to help control symptoms such as runny nose, congestion, and itchy eyes, says Yasmin Bhasin, MD, allergist and immunologist at Allergy Asthma Care in Middletown, NY.
“Antihistamines and decongestants can also reduce swelling in the nose,” she says.
Biologics: In 2019, the FDA approved the use of biologics for nasal polyps. These injectable medications target the proteins that cause inflammation and swelling. Bhasin calls biologics “the ultimate weapon” against nasal polyps.
You'll get the first few doses in your doctor's office so your doctor can watch for side effects, which can include pain, redness, and swelling at the injection site, she says. If you have no side effects, you can use a special pen to give yourself the injections at home.
Research has found that people who took biologics had less severe sinus infections, an improved sense of smell, and smaller nasal polyps.
Immunotherapy: Allergies cause inflammation that can trigger the growth of nasal polyps. So it makes sense that getting allergy shots could help.
One study found that people with nasal polyps who got immunotherapy injections every 2 weeks for a year had fewer symptoms and fewer polyps. They also had few side effects from the medication.
Treating your allergies can also lessen the risk that nasal polyps will return, Bhasin says.
Aspirin desensitization: People with an intolerance to aspirin intolerance are at higher risk for developing nasal polyps. Aspirin intolerance appears to increase the release of eosinophils, white blood cells that increase inflammation.
Aspirin desensitization involves taking aspirin in increasing doses, under medical supervision. The goal is to prevent nasal polyps from coming back and decrease your need to take steroid medications.
When Medications Aren't Enough
While there are many medications available to treat nasal polyps, you might need surgery if they don't work well enough.
But it’s not a cure. Nasal polyps tend to come back. Research found that 79% of people who had the surgery developed additional growths within 12 years. And more than one-third had additional surgeries.
Still, treatment is important to keep your symptoms under control and improve your quality of life.
“There is a lot that can be done that can really help,” Bhasin says.
Photo Credit: smartstock / Getty Images
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Cecelia Damask, DO, ear, nose and throat specialist, Lake Mary Ear, Nose, Throat & Allergy, Lake Mary, FL.
Yasmin Bhasin, MD, allergist and immunologist, Allergy Asthma Care, Middletown, NY.
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