Dear Reader,

Two squirts up each nostril might seem like all that is standing between you and mucho mucus and swelling, but when used over the long haul, nasal sprays can actually make runny noses and congestion worse. Over-the-counter nasal sprays — the nasal decongestant or medicated kind — work by constricting the blood vessels in the nose, reducing swelling, irritation, and sniffling. As swelling in the nasal passages decreases, you have more room to get air in, and quick as a sniff, that uncomfortable stuffy head feeling is gone. But, when the spray wears off, blood vessels dilate again, bringing swelling and congestion with the extra blood flow. This is when most folks reach for the spray bottle again... and again. However, with continuous use, nasal sprays can cause "rebound rhinitis," a condition in which nasal passages become even more swollen than they were originally. Long-term use can lead to around-the-clock congestion (it sounds as though this might be what has happened to you). Overuse of nasal sprays can also raise heart rate and blood pressure levels. For these reasons, the American Academy of Allergy, Asthma, and Immunology advises against using over-the-counter nasal sprays for more than three or four days in a row.

Since you've been using nasal sprays for several years, you'll probably want to get help in finding a spray-free solution to what you have. Explain your situation to your health care provider; s/he may be able to prescribe another prescription decongestant, such as steroids, to keep your head clear while you wean yourself off of nasal sprays. S/he may also want to refer you to an Ear, Nose, and Throat specialist (a.k.a., an Otolaryngologist or E.N.T.), who can address any underlying issues causing your congestion, or the damage you may have done to your nasal passages from overusing the nasal spray.

For people trying to deal with a fresh case of marathon nose (one that can run all day without stopping), try using a saline (non-medicated) nasal spray that can moisturize and shrink nasal passages (and is not addictive), a steam bath and/or shower that will loosen mucus and allow it to drain from nasal passages, and/or an over-the-counter decongestant and/or antihistamine pill. Remember, it's the only nose you're gonna get, so don't blow it!

Alice

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