Allergies, colds: Nasal sprays can provide relief if used properly

Jeffrey Adam, MD, an otolaryngologist with Upper Valley ENT Associates, said the first important step is to determine the underlying issue causing the congestion.

“Having a proper diagnosis to work with is very, very important,” said Adam, who practices with Premier Health Specialists. “A patient can start with basic saline solution, but if they aren’t seeing an improvement, then they need to see a physician to get a proper diagnosis.”

Leelmohan Ravikumar, MD, a primary care physician with Troy Primary Care Physicians, said nasal congestion can be caused by many different issues such as seasonal allergies, sinus infections, the common cold and even the flu.

“Understanding the cause can help determine the most effective nasal spray, and whether it is something for which they need temporary relief or chronic care,” said Dr. Ravikumar, who practices with Premier HealthNet.

Here’s a look at the type of nasal sprays available including the safest way they should be used:

Saline spray: Saline sprays are a good moisturizer for the nasal passages — a problem that often occurs during cold, dry winters. This type of spray can also work as a decongestant. Saline can be used as often and as long as needed.

“This is the safest type of spray,” Dr. Adam said. “There is no limit to its use. A person could use it every day for the rest of their life and not hurt their nasal passages.”

Intranasal steroids: This type of spray is good for individuals who experience chronic sinusitis symptoms that aren't related to allergies. They may have pressure and pain over their sinuses and anterior and posterior nasal drainage. This steroid spray is safe for on-going use, but he said it is important that patients are correctly counseled on how to use it.

“I counsel patients to aim for the corner of their eye when they spray,” he said. “If they don’t, pressure from the spray over time can actually perforate their septum.”

Intranasal antihistamines: These work similarly to antihistamines taken by the mouth, but are delivered through a spray right to the nasal passages. They offer relief for seasonal rhinitis and allergies without making a person drowsy.

Vasoconstrictors: This type of spray is often marketed under names Afrin or Neo-Synephrine. These medications are good for instant relief of nasal congestion often associated with the common cold or infections. However, vasoconstrictors pose a risk to patients who misuse it.

“Patients need to be careful that they do not use them for more than 72 hours,” Dr. Adam said. “Patients who use this type of medication for a long period of time or several times a day will experience irreversible changes in their nasal mucus membrane lining.”

Dr. Ravikumar agrees and said many nasal sprays are over-the-counter, but that doesn’t mean patients shouldn’t be careful to properly diagnose their underlying problem before deciding on which spray is right for them.

For more information on nasal sprays or to find a Premier Health Specialists physician near you, visit www.premierhealthspecialists.org/ent.