When a stuffy nose strikes, the right nasal spray can provide much-needed relief. As they're sold over-the-counter, many people assume that they can use them as needed without problems. But is this true?
The answer depends on the type of nasal spray being used. Some are safe to be used daily for several months. However, others can cause what is known as "nasal spray addiction" if used for more than just a few days.
Nasal spray addiction is not a true "addiction," but it can cause damage to the inside of the nose. It can cause swelling and long-term stuffiness that leads to misuse and overuse of the spray.
In some cases, a person may need to undergo additional treatment - even surgery - to correct any damage.
To avoid this problem, it's important to become familiar with the different types of nasal sprays and how to use them safely.
Contents of this article:
Saline nasal sprays
Nasal spray addiction, while not a true "addiction," can cause damage to the inside of the nose.
Drug-free saline nasal sprays are generally regarded as safe for all ages. Saline sprays can help loosen and thin mucus in the nose. They allow easier breathing when the nose is congested due to colds or allergies. They contain no medication and have no side effects.
These sprays contain a small amount of salt and sterilized water. Some also contain preservatives that prevent the growth of mold or bacteria. Preservative-free formulas are available in aerosol cans that keep the liquid sterile.
Many saline sprays will specify "saline" and "drug-free" on the bottle. To be sure, people should look for sodium chloride (salt) and water as the main ingredients, with no "active" ingredients.
Are saline nasal sprays addictive?
No. Saline sprays have no side effects and can be used as needed.
Steroid nasal sprays
Many people link the term "steroids" with bodybuilders who want to improve muscle mass. These are known as anabolic steroids, and they work by promoting the development of male sex hormones like testosterone.
Steroid nasal sprays are not anabolic steroids. The ingredient in these products is known as a corticosteroid. Corticosteroids are useful for calming inflammation caused by an overactive immune system response. Conditions such as hives, skin rashes from allergies or bites, asthma, and nasal allergies can be treated with different types of corticosteroids.
Steroid nasal sprays apply a corticosteroid directly into the nose to treat nasal allergy symptoms such as sneezing and a runny nose. They can provide relief from hay fever or nasal allergies, and can often replace other allergy medications taken by mouth.
These sprays typically start working after several days of use. They must be used every day throughout allergy season to continue to provide relief. Side effects are uncommon, but may include nosebleeds, eye conditions such as cataracts, and headaches.
Some types of corticosteroids may slow growth in children, especially if used for a long time. A study in The Journal of Allergy and Clinical Immunology found a small reduction in growth in children who used a particular type of nasal spray that contained a type of corticosteroid called fluticasone furoate. Children should only use steroid nasal sprays under the guidance of a doctor for this reason.
Steroid nasal sprays are commonly available in stores, although some may require a doctor's prescription. The active ingredients may be listed as fluticasone propionate or triamcinolone acetonide.
Are steroid nasal sprays addictive?
No. Nasal sprays with corticosteroids are safe to use daily for most people. People who need to use steroid nose sprays for 6 months or more should talk with their physician.
Antihistamine nasal sprays
There are several types of nasal spray and it is important for users to know the correct usage and dosage.
Antihistamines have been used for years to treat seasonal allergies. Antihistamines block a chemical called histamine that is responsible for allergy symptoms such as sneezing, itching, and runny noses.
Antihistamine nasal sprays allow the medicine to be applied directly in the nose. This can help treat nasal allergy symptoms at the source and may cause fewer side effects than pills for some people.
Cromolyn sodium is an antihistamine spray available over the counter and can be used in ages 2 and up as directed. It may take a week or more of daily use before a person feels complete relief from allergy symptoms.
Are antihistamine nasal sprays addictive?
No. Cromolyn sodium sprays are nonaddictive and can be used daily for up to 12 weeks. Those who need to use them for longer should ask their doctor.
Decongestant nasal sprays
Decongestant sprays are available over the counter and are designed to temporarily shrink the blood vessels in the nose. This is known as vasoconstriction. Although this provides temporary relief from stiffness, it does not cure a cold or allergies.
These sprays are sold under different brand names, but the active ingredient is oxymetazoline.
Are decongestant nasal sprays addictive?
Yes. These sprays can cause what is often called "nasal spray addiction" in some people. This often occurs when a decongestant nasal spray is used too frequently or for too long. The correct term for this issue is rebound congestion.
With rebound congestion, a person may find that they need to use the spray more frequently over time, often several times a day or more. Each time the spray is used, the blood vessels in the nose narrow, causing the tissue inside the nose to shrink.
After the medicine wears off, the nasal tissue swells again, sometimes swelling even more than before. With continued use, this swelling can get more severe and lead to permanent swelling of the tissue. Long-term use of these sprays can also damage the tissue, causing infection and pain.
Symptoms of rebound congestion or dependency on nasal spray may include:
- Feeling congested again shortly after using a decongestant spray
- Using a decongestant spray regularly but feeling that it doesn't work anymore
- Feeling a strong urge to use the spray more often than directed
- Using the spray just to be able to breathe normally on a daily basis
To help avoid this problem, the American Academy of Asthma, Allergy and Immunology recommend using it for no more than twice a day for only 3 days.
Those who have been using the spray more frequently should see a doctor. The nasal tissue should be examined for damage or excess swelling.
Typically, a person will need to stop using the spray and may need a different medication to relieve the swelling, such as a steroid nasal spray.
Alternatives to nasal sprays
Because saline nasal spray is drug-free and considered safe, it is often the first choice for mild congestion due to allergies and colds. Neti pots are also an effective way to flush mucus and allergens out of the nose.
However, the United States Food and Drug Administration warn that neti pots must be used with sterilized water and cleaned properly to avoid rare but dangerous infections.
Neti pots are useful alternative to nasal sprays, but must be used with sterilized water and cleaned often.
Those who do not wish to use a steroid or decongestant nasal spray may opt for over-the-counter decongestant and allergy pills. It's important to use these medications as instructed on the label.
People should also ask a pediatrician before giving any medication to young children.
Decongestant nasal sprays should be used with caution to avoid rebound congestion and damage to the delicate nasal tissue.
Nasal sprays should be treated as medicines, and should never be used more frequently than directed on the label.