Medical question: affects of abuse of nasal spray

Are there health hazards to the long term (chronic) use of nasal sprays? Other than dependance on them? Cancer? Destruction of nasal passages?

What happens is that you get to a point where your nasal passages can’t stay open without the spray. The spray is an irritant and possibly a route of introduction of bacteria, so you are more susceptible to infection.

I highly advise you to seek medical help if you find yourself depending on nasal spray to keep your nose open for more than a week or so. The dependency is not always reversible. If yours can’t be reversed, you might be looking at painful nasal surgery to fix it. I’m speaking from experience… my left nostril is mostly OK now, but my right nostril will probably never have more than 15% airflow unless I get some very painful surgery.

Ah, Rhinitis Medicamentosa!

Dependence on them, in higher and higher doses, to keep the nasal passageways open is the chief complication. However, they can cause mucosal erosions (from overconstriction of capillaries) and give chronic intermittent nosebleeds as a result. I’ve not seen any studies suggesting infection is a common problem with abuse. Nor should it distort otherwise normal bony or cartilaginous architecture. If your septum was straight before, it will be after abusing the spray.

I’ve treated a number of patients in this situation. Usually I “cold turkey” them from the nasal spray (usually the spray they’re using is Oxymetazoline) and have them use saline nasal sprays as long and as often as they like, along with some oral pseudoephedrine if appropriate. But most important is a nasal steroid, to start overcoming the over-reactive nasal mucosa.

On occasion I’ve used systemic steroids to try to get things calmed down in severe cases.

If all that doesn’t work, I send 'em to the ENT doc.

Here’s an excellent summary of the condition:


THanks for the replies. I used the nasal spray, daily, for at least 6 months, starting with a cold I had. I use a CPAP, which requires open nasal passages. And the darn spray just works so good…

Today, I have not used the OTC spray for a week. I have been using a prescription steroid spray ‘Flonaze’, which doesn’t work well at all.

I have no nasal passage issue during the day. I only notice the problem when I put on the CPAP and feel like I’m very slowly being suffocated (which was why I started using the OTC nasal spray. Catch-22)

FTR, I only used them (OTC 12 hour spray, usually Nafrin) just before bed. I never needed more than one blast per nostril. I never experienced nosebleeds.

Guess I’m lucky.

Do you have a humidifier and a heater? Those work wonders for some people.

I suspect you mean Flonase, or fluticasone.

It won’t work like Afrin. That’s not how it goes. It is not designed to give relief within minutes, or hours. Used as directed, within 10-14 days, the swelling in the nose should diminish, and the passages should stay open and uninflamed.

How would these help?

Brilliant, just the kind of topic I was looking for.
My nasal spray seems as if it’s slowly not working… am I in trouble?

I use rhinocort, or 32mg/spray of budenoside.

How long have you been using it?

The main reason I opened this thread was because my nasal spray never stopped working. Yes, I couldn’t do without it. But if that was the worst that could happen, what was the harm in keeping using it? That thought was probably inspired by the detoxing from the chronic use.

On and off for about a year. I normally would rarely use it until I started getting disequilibria when I’d try to lie down, aparently from my sinuses. So she (doctor) said to just start using it again, and it should clear up. That was about a month or so ago. And the disequilibria has started coming back. And I’ve started using more and more, because my nose just seems to be getting worse, and it feels like I am never breathing properly.

Be really careful. I got a hole in my septum from using steroid spray.

Dry air under pressure can dry out the tissues in your nose lickety-split. That causes irritation and swelling, which in turn makes it harder to breath. Some people are much more sensitive to this effect than others.
Cold air also tends to narrow the nasal passages, so if you use an unheated humidifier, or the air temperature in the bedroom gets too low for a heated humidifier to handle, you end up breathing poorly.
Here’s a sleepnet thread on humidifiers, and of course google provides much more info.

That’s not what happens. The spray will always work, and work well. What stops working is your nose’s natural ability to stay open without the spray. If you keep using the spray, you can irreversably damage your nose’s ability to stay open without the spray.