When sinus conditions occur, there are different topical treatments, or therapies that can be applied directly to the affected area of the nose. Some of the most common are corticosteroid nasal sprays, saline nasal sprays, and nasal rinses.
Medicated corticosteroid nasal sprays, such as Flonase®, Afrin® and RHINOCORT®, can be purchased over-the-counter or with a doctor’s prescription. Prescription sprays are usually stronger or contain more active ingredients than the over-the-counter sprays. When the applicator is activated, the mist settles on the mucus membrane inside the nose and sinuses. The chemicals mimic the body’s natural hormones which help to fight inflammation. When the sinus tissue is inflamed and causing blockage, steroids can help reduce swelling, enabling the patient to breathe better.
Saline sprays can come in similar-looking bottles as corticosteroid sprays. However, saline sprays do not include corticosteroids. It does not have any medicated ingredients. In fact, it only contains saltwater. Washing the nasal passageways out with water is a common practice and is used to treat disorders of the nose. Saline nasal sprays are an application of this technique.
Saline nasal sprays usually get into the nose just fine, but because only a small amount of saline is expelled, it may not reach all the way into the sinuses. This is a drawback of all sinus irrigation methods, but methods that use higher volumes of water may be more effective at rinsing deeper inside the sinus cavities. Still, saline sprays have some effect in re-hydrating and rinsing the nostrils.
The American Rhinologic Society points out that when a nasal rinse method delivers more water, it also stands a better chance of penetrating deep into the network of sinuses.
Nasal rinsing involves pouring saltwater through one nostril and letting it drain the sinuses and exit the other nostril. Most people will lean over the sink or rinse in the shower for convenience.
Several variations of sinus rinse devices are available without a prescription. They may be referred to as “Sinus Rinse”, “Neti Pot”, “Sinus Irrigation” or “Nasal Lavage” among other names. The delivery device is something that resembles either a small plastic teapot or a squeezable nasal rinse bottle.
For those who don’t need the convenience of purchasing the store bought pre-mixed saline packets, the American Academy of Allergy Asthma and Immunology (AAAAI) website provides a make-at-home recipe, along with guidelines for use and precautions to follow.
The American Rhinologic Society states that while rinses help to clear the nose of mucus, they may also help to reduce inflammation. This may result from helping the nose to remove small particles, bacteria, and viruses which can cause allergy and inflammation.
The AAAAI advises patients that a doctor with specialized training and experience can accurately diagnose conditions and suggest helpful treatments.
Over-the-counter decongestant nasal sprays, like Afrin®, can shrink blood vessels and tissues and decrease mucus production. They can be used temporarily to relieve short-term congestion symptoms. The inflammation-reducing effect of the spray typically lasts a few hours, after which the mucous membranes begin to swell again.
The recurrence of swelling may become stronger if the decongestant nasal spray is used continuously for more than a few days. Physicians may refer to this as “the rebound effect.” Therefore, this treatment is not intended for long-term use.
Which methods are right for you?
Even though these methods seem to have many similarities, it is important to understand the differences. Saline and corticosteroid sprays are not the same thing—even though they come in similar looking bottles. Corticosteroid sprays are medicated, while saline sprays are not. Nasal rinsing is similar to saline spray, but it rinses the nasal passages with more water than a spray. As such, it may be more effective in clearing mucus, flushing the sinuses, and helping address sinus symptoms. Before you attempt to treat your sinus condition with any of these methods, it is important that you consult a doctor to determine what’s best for you.
Afrin is a registered trademark of Bayer. Flonase is a registered trademark of GSK. RHINOCORT is a registered trademark of AstraZeneca.