Not all nasal sprays may be effective in relieving nasal congestion.

Do you regularly use a nasal spray to relieve your symptoms of sinusitis or allergic rhinitis? If so, do you use a prescription nasal spray or an over-the-counter one? While there are many different types of nasal sprays available to relieve nasal congestion, not all of them are effective.

The most common nasal sprays are over-the-counter ones, which are easy to obtain and provide immediate relief from nasal congestion. Over-the-counter nasal sprays contain chemicals such as oxymetazoline, phenylephrine, xylometazoline and naphazoline. A squirt of this nasal spray helps to quickly decongest the nose by constricting the swollen blood vessels in the nasal lining.

While an over-the-counter nasal spray can provide relief for a few days, it can have a rebound effect if used for a longer period of time – it can actually worsen your nasal congestion instead of alleviating it. Furthermore, excessive use can even damage your nasal membrane.​

What happens under this rebound effect is that the swelling inside your nose returns after the effect of the nasal spray wears off, and your congestion will appear to be worse than before. This rebound congestion, known as rhinitis medicamentosa, forces you to use even more nasal spray to relieve your symptoms. This way you get trapped in a never-ending cycle of having nasal congestion and temporary relief from it, if you continue its use.

Can an over-the-counter nasal spray be​ addictive?

Rebound congestion can cause a dependency on an over-the-counter nasal spray. This dependency may appear to be an addiction but it actually isn’t. It is a psychological need and not a physiological need, and therefore, does not count as an addiction.

“For adults, the general rule of thumb for over-the-counter nasal spray is no more than five days of continuous use. For children, some doctors may recommend an even shorter duration,” says doctors from the​ Department of Otolaryngology, Singapore General Hospital (SGH), a member of the SingHealth​ group. “It is also important to note that the dosage of oxymetazoline, especially in infants and children, is different from the adult dose.”

Ref: Q15