Nasal steroids can help inflammation of the nasal passageway, in particular to the inferior turbinates. Inflammation is usually a result of allergic rhinitis, a condition affecting more than 40% of the population. Allergens, such as pollen or ragweed, will irritate the nose, causing the inferior turbinates to swell.
Nasal steroids work gradually, often taking up to two weeks until the patient will notice a difference in breathing.
Some nasal sprays such as Afrin, work by a different mechanism and provide immediate change in breathing. Unfortunately, Afrin and sprays similar to Afrin, can lead to a condition known as rhinitis medicamentosa, where an addiction to nasal sprays can occur.
One of the biggest drawbacks of nasal steroid are irritation to the nose and the potential for nose bleeds. The key to maximizing comfort and minimization of nose bleeds is proper use of the spray (See below) and close monitoring by a physician.
Directions for nasal steroid use:
- Blow your nose prior to use of nasal steroids. If using nasal saline along with nasal steroids, use nasal saline and irrigate nose prior to use of nasal steroid.
- Aiming: It is important to utilize nasal steroids correctly in order to maximize their effectiveness. Spraying steroid sprays straight up will irritate the nasal septum, leading to potential for nose bleeds. Aiming out towards the ear, will direct the nasal steroid towards the inferior turbinate, which will maximize the breathing of the nose.
- Try not to blow your nose or sneeze for at least 5 minutes after application of nasal steroid.
Using Nasal Steroid Sprays
Nasal steroid sprays are used to reduce edema and swelling of the turbinates of the nose. Swelling can occur with allergic reactions or can even occur temporarily after surgery. The main advantage of nasal steroid spray is that they decrease swelling by acting locally. What that means is that the steroid stays in the nose and only small amounts are absorbed by the body, drastically limiting side effects.
Nasal steroids take about a week before any change in breathing will occur. We recommend that patients use the spray for about six weeks prior to declaring it ineffective.
The problem with nasal steroids is that they can be ineffective for structural changes in the nose. In addition, nasal steroids can cause local irritation and nose bleeds and rarely septal perforation.
In an effort to minimize complication, we recommend patients who use nasal steroids use it correctly to decrease the chance of nose bleeds. (See Video) Nasal steroids should be aimed toward the turbinate rather than at the septum. After spraying the steroid, the patient should not blow their nose or use nasal saline for at least five minutes after spraying.