Several of my patients have come to me with fears that they may be addicted to their over-the-counter nasal spray. Their sinuses are chronically blocked and they keep using a nasal spray to clear them! They are not alone either. In fact, researchers claim that there are 10 million Americans who are chronically dependent on the use of nasal sprays.

There was even a funny parody about nasal spray addiction on the TV sitcom King of Queens. When everyone’s gone, the father-in-law pulls out a concealed bottle of nasal spray, sprays some into his nostrils, and lies back on the couch in an amused daze, listening to jazz.

However, there is nothing funny about serious medical problems such as severely inflamed nasal tissues and holes in the nasal septum that can result from overuse of these chemical nasal sprays.

I’d like to talk to you about the safe use of nasal sprays and what you can do to stop your dependence on them. Then I’ll tell you about some natural alternative decongestants you can use to clear congested sinuses, heal inflamed nasal tissues, and stop swelling.

Nasal Sprays: Over-the-Counter vs. Prescription

Even though their labels clearly state they should not be used for more than 3-4 days at a time, people enjoy the quick congestion clearance they allow and continue to use nasal sprays well past their expiration dates. From this frequent use, the natural sinus clearing mechanisms slow down, or even stop, and using the spray is the only thing that clears blocked sinuses.

This is called the rebound effect, and it can happen if you overuse them. The rebound effect is really the addiction to these sprays that people experience, as they do not contain any actual addictive chemicals.

Two of the most popular OTC nasal decongestants are Afrin and Neo-Synephrine. Both work very well to clear up what is supposed to be occasional sinus congestion, like the one that comes with a bad cold. Both contain chemicals such as xylometazoline, oxymetazoline, and phenylephrine that work quickly to clear congestion and are intended for self-limited use.

Rhinostat, RhinoCort, Flonase – are some Rx nasal sprays that doctors prescribe to their patients to get them to stop using over-the-counter nasal sprays. They contain cortisone which decreases inflammation and swelling of the nasal tissues and does not have the rebound effect of over-the-counter sprays.

Why are you using so much nasal spray?

Most people start using these sprays for a good reason. Like my patients, most sought them out for relief from congested sinuses. However, what many people may not realize is that their constant nasal congestion could be due to an allergy and a condition called allergic rhinitis.

When patients tell me they use nasal congestion sprays, I like to first find out what is causing the congestion in the first place. Most of the time, they have a seasonal allergy, for example, to pollen or mold in the spring or fall air; or year-round allergies to dust mites, pet dander, and mold. Treating the allergy first can prevent overuse of nasal sprays.

To determine if an allergy is the cause of congestion, I refer my patients to a specialist in the field of Allergy and Immunology who deals specifically with people’s allergies. There, they will be given a skin test that involves placing around 100 of the most common allergens, such as dust mites, ragweed, mold, pollen and animal dander, on patches to determine the reaction.

If any of the allergen patches are positive, then you are allergic to that substance and should stay away from it to avoid allergic symptoms. Dust mites, mold and animal dander are year-round allergens that can cause chronic nasal congestion.

If you have dust or a pet in your home, you are constantly breathing dust mites and pet dander into your nasal airways, causing them to become inflamed, swollen, and congested. Dust mites are microscopic bugs that like to burrow into carpets and bedding and can be anywhere. You may need to remove rugs and be sure to wash bedding regularly. Using a medical grade HEPA filter air filter can collect about 99% of allergens.

Pollen and mold are more seasonally dispersed outdoors in the spring and fall. When you breathe them in, they irritate the nasal passages. All types of upper respiratory allergens can also cause chronic inflammation of the lungs and/or asthma if the allergen is not treated or removed.

Sometimes nasal polyps or other sinus diseases can be to blame for congestion. A visit to an ear, nose and throat doctor, who can examine your sinuses with an endoscope and/or X-rays, can determine if there is a physical obstruction in your sinuses causing the congestion. Less common food allergies can also be to blame for chronic sinus congestion, such as a sensitivity to dairy, which can cause a lot of phlegm to build up in your sinuses. Even gastric reflux disease can be responsible for constantly inflamed and congested sinuses.

What are the alternatives to over-the-counter nasal sprays?

As you know, I am in favor of natural food treatments whenever possible. Even though your particular reliance on over-the-counter nasal sprays may require a brief weaning off of a prescription nasal spray as mentioned above, there are some great alternatives that can help you deal with allergens and keep your sinuses open once you’re done. put down the over-the-counter spray.

Neti Pot: Fill with salt water made with 1 tablespoon of sea salt and warm water. Tilt your head to the side and feel for the solution inside one nostril. The water flows into the nasal cavity and out the other side. Repeat on the other side. This removes allergens and breaks up congestion.

External Strips – There are over-the-counter nasal strips that are applied to the bridge of the nose and manually open the nostrils to help you breathe easier. These can also be used to stop using over-the-counter nasal sprays until you can determine an allergy or what else may be causing the congestion.

oregano tincture – Found in health food stores where vitamins and other supplements are sold, a drop on the tongue can clear the sinuses very effectively.

Aloe Vera and Saline Nasal Spray – Also found in health food stores, this is a small bottle of salt water with added aloe vera. It can be used as a nasal spray to clear allergens from the nasal passages. It is very safe and does not cause the damage that other over-the-counter sprays can.

sinus destroyer – Contains capsaicin (cayenne) that decreases inflammation, swelling, congestion. It is also a very safe alternative spray that uses the natural ingredient of hot peppers to clear the nasal passages.

Fenugreek and Myrtle – An old herbal remedy for sinusitis and congestion, mixed in a capsule, it opens up the sinuses and decreases inflammation.

bromelain – An enzyme from the pineapple plant that decreases inflammation in conditions of the upper respiratory tract (lungs and sinuses).

Nasal congestion can be very uncomfortable to live with, especially if you find yourself doing a lot of mouth breathing. This can cause a chronic dry mouth and sore throat. You might be tempted to do some quick fixes with over-the-counter nasal sprays. While these products are fine for very short-term use if you have a bad cold, constant use can create more trouble than they’re worth. Try some of the natural decongestant remedies I’ve listed here and/or see your doctor if chronic sinus congestion is a problem and get to the bottom of what’s causing it.