Nasal Disease Handbook

Nasal Steroids

Corticosteroids are hormones that are structurally similar to natural hormones in our bodies. In allergies, corticosteroids can be used to reduce the inflammation, mucus, and swelling in the nose and sinuses.

A nasal steroid is a topical medicine, which reduces inflammation in the nose, most commonly seen with allergic rhinitis. The doses are small and systemic absorption is also small. There is little to no effect on intrinsic steroid balance and complications associated with systemic steroids or anabolic steroids as are used by athletes and body builders. Nasal steroids can be taken over an extended period of time. Many people have used them for as long as 5 – 10 years with no known complications or side effects. Symptoms will typically begin to improve within 24 hours. Maximum relief generally takes up to 2 weeks to achieve. Once the maximum benefit is achieved, you can use the medications on a daily basis, as prescribed, or you may use them on a PRN or as needed basis if this provides satisfactory relief. Overall side effects of nasal steroids are minimal. People who sniff too vigorously may complain of a sore throat, and may not achieve the optimal benefit. Nosebleeds are no longer seen with today’s aqueous sprays. If you experience anything out of the ordinary or are concerned, you should consult your physician.

What about side effects?

Overall side effects of nasal steroids are minimal. The occurrence of nosebleed, nasal and throat irritation, and cough is similar to those seen with nonmedicated sprays. If you experience anything out of the ordinary, consult your doctor.

I’ve heard that steroids are “bad.” Is that true?

When most people hear the word “steroid”, they think of anabolic steroids that have been abused by some athletes and  bodybuilders. Anabolic steroids are from a different class of drugs and their misuse can lead to severe side effects.  Steroids used to treat allergies work very differently than anabolic steroids. In fact, when used properly in nasal inhalers, the medication goes directly into nasal passages and sinuses. Very little of the medication is absorbed in the body.
Nasal steroids are a safe and effective way to treat allergies.

You may notice your symptoms improving within 24 hours after beginning the nasal inhaler. Maximum relief generally takes 2 weeks to achieve. If you do not notice improvement in 2 weeks or you start to feel worse, contact your doctor.

Tips for Using a Nasal Spray

1. Gently blow your nose to clear your nostrils.

TIP— Try using one spray of over-the-counter nasal saline in each nostril prior to blowing your nose, then use the corticosteroid. You can use additional doses of nasal saline or vaseline throughout the day for nasal dryness.

2. Open the container and shake the bottle thoroughly. Grasp the container between your thumb and fingers. Press straight down to deliver a spray. When using the inhaler for the first time, spray into the air several times to “prime” the unit.

3. Hold the nasal steroid nozzle directly up to your nose and pointed straight back towards the outside, towards the right ear for the right nostril, towards the left ear for the left nostril. This aims the nasal steroid away from the nasal septum thereby decreasing nasal irritation.

4. Press down on the container once or twice as instructed by your physician. Breathe gently after spraying. Do not inhale deeply. Repeat in the other nostril.

5. Wipe the nasal applicator with a clean tissue and close the unit.

TIP—To ensure that you have medication remaining, keep track of the number of sprays used, or the number of days used. Try to refill a week before you need it. Most containers last for 4–6 weeks.