Nasal Saline Irrigation and Neti Pots

Medically Reviewed by Zilpah Sheikh, MD on May 21, 2024
8 min read

If you're one of the millions of people dealing with sinus problems, you know how uncomfortable facial pain and clogged nasal passages can be. In their search for relief, many have turned to nasal saline irrigation, a therapy that uses a saltwater solution to flush out the nasal passages.

Although several methods of nasal irrigation exist, one of the most popular is the neti pot. The neti pot is a ceramic or plastic pot that looks like a cross between a small teapot and Aladdin's magic lamp. Although nasal irrigation using a neti pot has been around for centuries, originally from the Ayurvedic/yoga tradition, its use is on the rise in the U.S.

Where to find a neti pot

Neti pots are available over the counter at many drugstores, health food stores, and online retailers. They usually cost between $10 and $30.

You can use a neti pot to manage symptoms of sinus infections (sinusitis), colds, the flu, COVID-19, and allergies involving the nose. You can also use it to push out mucus and allergens, prevent your nostrils from irritation, help you breathe more freely, moisturize your nostrils in dry indoor air, and relieve a stuffy or blocked nose. 

Wudu nasal rinsing

The Islamic faith practices nasal rinsing in wudu or ablution, a ritual performed before prayers that happen five times a day.

Ritual nasal rinsing is also practiced in yogic, Ayurvedic, and other traditions.

Ear, nose, and throat surgeons may recommend nasal irrigation for patients who've had sinus surgery to clear away crusting in the nasal passages. 

Many people with sinus symptoms due to allergies and irritants in the environment also use neti pots or other nasal irrigation devices, saying they ease congestion and help with facial pain and pressure. 

Nasal irrigation can be an effective way to relieve sinus symptoms when used along with standard treatments. For some people, nasal irrigation relieves sinus symptoms without medications.

Some benefits you may get from using a neti pot include:

  • A rinsed nasal passage
  • Cleared mucus / crusting
  • Reduced stuffy nose 
  • Improved breathing 
  • Relief from sinus pain and pressure

At its most basic level, a neti pot thins mucus and helps flush it out of the nasal passages.

A more biological explanation has to do with tiny, hairlike structures called cilia that line the inside of your nasal and sinus cavities. These cilia wave back and forth to push mucus either to the back of the throat, where it can be swallowed, or to the nose to be blown out. Saline solution can help increase the speed of the cilia and improve their coordination. This allows them to better remove allergens and other irritants that cause sinus problems.

You can buy premade solutions meant for use in the neti pot or other nasal irrigation devices. But you can also make a saline solution at home. 

Neti pot solution recipe

Mix 3 teaspoons of iodide-free and preservative-free salt with 1 teaspoon of baking soda. Store in a small, clean container. When you're ready to use the neti pot, mix 1 teaspoon of this mixture into 8 ounces of distilled, sterile, or boiled and cooled water. 

For children, use a half-teaspoon of salt with 4 ounces of water.

Neti pots usually come with an insert that explains how to use them. Be sure to follow these directions carefully. You might want to ask your primary care doctor or an ear, nose, and throat specialist to talk you through the process before trying a neti pot on your own.

Neti pot instructions

  1. Wash your hands before picking up the neti pot.
  2. Fill the neti pot with the saline solution. 
  3. Lean over a sink and tilt your head over it at about a 45-degree angle so that the liquid doesn't flow into your mouth when you start. 
  4. Breathe through your mouth as you place the spout into your top nostril
  5. Gently pour the solution into that top nostril. 
  6. The fluid will flow through your nasal cavity and out the other nostril. It may also run into your throat. If this happens, just spit it out. 
  7. Blow your nose to remove any remaining liquid, refill the neti pot, and repeat the process on the other side. 
  8. After each use, clean and rinse your neti pot or other irrigation device following the manufacturer's instructions, and leave it open to air-dry.

If you notice burning or stinging when you use the saline solution, reduce the amounts of dry ingredients to make it weaker.

Best time of day to use a neti pot

You can use a neti pot any time of the day, once or twice a day.

How often can you use a neti pot?

In studies, people with daily sinus symptoms got relief from using a neti pot or other nasal irrigation system daily. Three times a week was often enough once their symptoms eased. 

But using it too often can irritate your nasal passages. And it might be counterproductive to use it daily for a long time. 

The mucus in our nasal passages helps to protect us against infection. It captures germs and irritants before they enter our bodies and can even kill some bacteria. Some experts think that when you flush out mucus with nasal irrigation, you lose some of that protection. 

That's why it might not be a good idea to use nasal irrigation as a preventive measure when you don't have any sinus symptoms. Some experts say you should use it for no more than 1-3 weeks at a time. 

If your symptoms don't improve, see your doctor. They can figure out what's causing the problem and find the right treatment.

Research has found that a neti pot, used as directed, is generally safe. A few regular users experience mild side effects that go away, such as:

  • Nasal irritation
  • Stinging
  • Burning 

You can also get nosebleeds, but they're rare. 

If you experience these side effects, try to reduce the amount of salt in the solution, adjust the frequency of neti pot use, or change the temperature of the water to get relief. 

Congestion worse after sinus rinse

Your congestion can feel worse after a sinus rinse if you use only water rather than the saline solution. It can cause swelling in the nasal passages, making symptoms worse. 

Neti pot water stuck in sinuses

Water from the neti pot can get stuck in your sinuses if you don't tilt your head correctly. You can tilt your head properly, ensuring it's at a 45-degree angle, so the saline rinse doesn't get stuck or flow into your mouth.

If you feel like some of the solution is still in your nasal passages, tilt your head forward and to the opposite side of the nostril you just rinsed, and blow your nose gently. 

If you experience side effects or develop an infection after using a neti pot or nasal irrigation device, talk to your doctor.

A potentially serious infection from nasal irrigation, like a Naegleria fowleri infection, is possible with a sinus rinse. Naegleria fowleri is an amoeba that lives in pipes linked to tap water, ponds, lakes, and rivers. If you use water with this amoeba in your sinus rinse, it can go to your brain and cause primary amebic meningoencephalitis (PAM). 

PAM can destroy brain tissue and cause brain swelling and death. It's called a brain-eating amoeba for this reason. With a PAM infection, you may have symptoms like:

  • Headache
  • Fever
  • Nausea
  • Vomiting

As the condition progresses, symptoms may include:

  • Seizures
  • Stiff neck
  • Changes in mental state
  • Hallucinations
  • Coma

However, Naegleria fowleri infections are rare, with only 157 reported cases from 1962 to 2022.

To prevent a serious infection from happening during a sinus rinse, take these precautions:

Never use unboiled tap water for nasal irrigation. Some tap water contains bacteria or other harmful organisms. It's safe to drink since your stomach acid kills them. But they can live in your nasal passages. You can use distilled, sterile, or filtered water if you don't have boiled water.

Take proper care of your device. Nasal irrigation devices can harbor bacteria, too. Before you use it, wash your hands and make sure the device is clean and dry. After using it, always wash it thoroughly. You can wash it by hand or put it in the dishwasher if it's dishwasher-safe. Let your device air-dry entirely between uses. Replace your neti pot every few months or as recommended by its directions. 

See a doctor if you have symptoms of an infection, like fever, nausea, vomiting, chills, or tiredness.

Always clean and air dry your neti pot after using it to prevent it from harboring bacteria or other harmful organisms that can enter your nasal passages during your next use. Also, don't share your neti pot with anyone to prevent spreading germs. 

Replace your neti pot every few months as directed by the manufacturer.

How to clean neti pots

Here's how to clean your neti pot: 

  • Wash your hands first before picking up the neti pot
  • Add boiled, distilled, sterile, or filtered water mixed with dish soap to the neti pot
  • Replace the lid with your finger and shake it 
  • Pour out the soapy water
  • Rinse the neti pot with boiled, distilled, sterile, or filtered water
  • Air-dry before closing it with the lid

You'll also find the manufacturer's cleaning instructions on the package with the neti pot. It's best to follow the manufacturer's instructions for cleaning it. 

Other nasal irrigation devices you can use to relieve your nasal passages include: 

  • Bulb syringes
  • Squeeze bottles
  • Battery-operated pulsed water devices
  • Saline nasal sprays

Neti pots are a popular nasal irrigation device that can help relieve stuffy or irritated nasal passages. It's generally safe to use and may only cause minor side effects like stinging and burning. However, only use boiled water left to cool, sterile, distilled, or filtered water for your nasal saline irrigation. Be sure to wash the neti pot after every use. Change it every few months, and don't share it with others.

Where can I find a neti pot?

You can find a neti pot over the counter at drugstores, health food stores, and online retailers. 

Are there any downsides to neti pots?

Using neti pots when you don't need them can put you at risk of developing an infection. Other than that, using a neti pot and cleaning it appropriately may only come with mild side effects like stinging or burning.

What's the difference between the neti pot and sinus rinse?

Sinus rinse involves rinsing your nasal passages with a saline solution and a device like a neti pot. It can help clear out congestion, mucus, crust, and irritants from the nose and help you breathe more freely.