Neti pots are small, teapot-like devices that people use to rinse out their sinuses. Although they can be helpful, they must be used correctly to avoid health issues.
The United States Food and Drug Administration (FDA) warns that if they are not used correctly, the user runs a risk of developing serious infections, even potentially fatal ones.
The FDA says that neti pots do not pose a problem on their own. However, they also maintain that the way neti pots are being used poses a health risk.
- Neti pots can relieve the symptoms of rhinosinusitis if used properly.
- The earliest record of nasal irrigation comes from the ancient practice of Ayurveda.
- Neti pots must be thoroughly cleaned before and after each use and never shared.
- If an individual is in any doubt about how to use their neti pot, they should speak with a doctor or pharmacist.
What is a neti pot?
Neti pots are safe when used correctly.
The neti pot is a home remedy for congested noses and sinuses that is available as an over-the-counter (OTC) treatment at most drugstores. It is a type of saline nasal irrigation (SNI) treatment.
The user fills a neti pot with a saltwater solution, tilts their head back, and pours the solution into one nostril. The liquid goes into one nostril and out of the other one.
With its roots in Indian Ayurvedic medicine, nasal irrigation and possible devices for administering the treatment were first introduced to Western medicine by The Lancet journal in 1902. In a survey of 330 primary care physicians, 87 percent advised that they recommend SNI to people that visit for one or more conditions.
The FDA, however, warns that the incorrect use of neti pots and other devices for rinsing out the sinuses, including squeeze bottles, battery-operated pulsed water devices, and bulb syringes, have been linked to a higher risk of infection.
The FDA says it is informing doctors, other healthcare professionals, device makers, and users about safe practices when using these devices.
Users must ensure that the liquid is a dedicated saline nasal rinse. Do not use tap water or any form of unsterilized liquid.
Tap water generally has small amounts of bacteria, protozoa, and other microorganisms, including amebae. These are fine to swallow because stomach acid kills them, but they should not go into the nasal passages. If they do, they can remain alive and eventually cause serious infections.
In 2011, two neti pot users in Louisiana lost their lives after using water tainted with Naegleria fowleri (N. fowleri), a type of ameba. This happened to another individual in 2013.
N. fowleri is naturally found in warm, freshwater lakes and rivers. If the bacteria enter the nose, which most often happens while swimming, they can migrate to the brain through the olfactory nerve. This can cause primary amebic meningoencephalitis (PAM), which is fatal for almost every person with the condition.
Commenting on the tragic deaths, Louisiana State Epidemiologist, Dr. Raoult Ratard, advised:
"If you are irrigating, flushing, or rinsing your sinuses, for example, by using a neti pot, use distilled, sterile, or previously boiled water to make up the irrigation solution. Tap water is safe for drinking, but not for irrigating your nose."
Click here to choose from a range of neti pots. Following the link will open an external page.
According to the FDA, some makers of neti pots provide misleading and contradictory data. Some have no guidelines at all. The agency added that neti pots made by artists commonly have no instructions on their use.
A number of instructions have pictures or videos of people using plain tap water, while at the same time, write in the instructions that tap water should not be used.
Below are some details of how to go about rinsing the nasal passage with one of these devices. The exact method might vary, depending on which product is being used:
- Lean over a sink.
- Tilt the head to one side so that the forehead and chin are at approximately the same level. This prevents the sterile water or saline solution from getting into the mouth.
- From this point, breathe through the mouth.
- Place the spout into the upper nostril.
- Pour the solution so that it drains through the lower nostril.
- Clear your nostrils by blowing your nose, and perform the same action again on the other side.
Rinsing the nasal passage helps clear out pollen, dirt, and other trapped debris. The saline solution does not irritate or burn the nasal membranes, which are extremely sensitive and delicate.
Here a video demonstrating how to safely use a neti pot.
If the instructions on a neti pot are not clear, individuals should check how to use it with a pharmacist or doctor. The potential consequences are not worth the risk.
Only use the following types of water for nasal rinses:
- Sterile or distilled water: When purchasing, check the label says "sterile" or "distilled."
- Boiled tap water: It must be boiled for 3 to 5 minutes then allowed to cool down. If it is stored in a clean, closed container, it will be safe to use for no more than 24 hours.
- Filtered water: Water that has gone through a filter with an absolute maximum pore size of 1 micron.
It is very important to clean the neti pot after each use, paying particular attention to the region of the neti pot at which the spout connects to the pot. Salts can build up in this part of the device.
For the same reasons people do not share toothbrushes, do not share neti pots with others. Even if the device is cleaned, certain bacteria from the upper regions of the nostril can sometimes survive and be passed on to the next user.
Overuse of neti pots might also be detrimental to overall health. Long-term users may be more prone to attacks of rhinosinusitis, an infection in the lining of the sinuses. This is thought to be because the salt gradually depletes the mucus that acts as a protective covering on the membranes of the nose.
As a general rule, a neti pot should not be used for more than 1 to 3 weeks at a time. The individual should visit a doctor if congestion continues.
Nasal rinsing and children
After the age of 2 years, children with nasal allergies may benefit from using nasal-rinsing devices only when recommended by a doctor.