Millions rely on over-the-counter nasal decongestant sprays for rapid relief from congestion caused by colds, allergies, and sinus issues, but medical experts are warning that prolonged use can lead to a worsening of symptoms. The Spanish Society of Otorhinolaryngology and Head and Neck Surgery (SEORL-CCC) is now raising awareness about “medicamentous rhinitis,” a condition stemming from overuse that creates a cycle of dependence and can even cause damage to nasal tissues. This caution comes as rates of upper respiratory infections remain elevated nationwide following the winter season.
Prolonged use of over-the-counter nasal decongestant sprays – beyond seven days – can backfire, leading to chronic nasal congestion, medical experts warn. This is a common issue, particularly during cold and allergy seasons, as many people rely on these sprays for quick relief.
The Spanish Society of Otorhinolaryngology and Head and Neck Surgery (SEORL-CCC) is raising awareness about this potential problem, noting that nasal sprays have become a go-to solution for congestion, especially during winter months when colds are prevalent and in the spring when allergies flare up.
These topical nasal decongestants contain vasoconstrictor drugs that work by reducing blood flow to the nasal passages, providing rapid relief from blockage. However, the SEORL-CCC cautions that extended use can disrupt the natural function of the nasal lining.
The Risks of Long-Term Use
Using nasal sprays for approximately more than seven days can trigger a condition called medicamentous rhinitis. This is characterized by a “rebound effect,” where congestion worsens once the medication wears off, and “drug tolerance,” meaning increasingly higher doses are needed to achieve the same level of relief. These factors can lead to a worsening of symptoms and dependence on the medication.
Otolaryngologists explain that both of these phenomena contribute to a progressive worsening of the condition and an addiction to the medication, hallmarks of medicamentous rhinitis. This condition is frequently seen in patients who self-treat without medical guidance.
Beyond the risk of dependence, nasal sprays can also cause adverse effects such as rapid heartbeat, elevated blood pressure, and direct damage to nasal tissues due to reduced blood supply, including perforation of the nasal septum. While these serious complications are rare with appropriate use, they can become severe with uncontrolled, long-term use.
It’s important to understand that nasal congestion doesn’t always mean a lack of space for airflow. In many cases, inflammation is the primary cause of congestion, without significantly affecting nasal permeability. Therefore, treating the underlying inflammation may be more effective than relying on vasoconstrictor sprays.
Understanding the Causes of Congestion
The SEORL-CCC emphasizes that nasal congestion can stem from various underlying issues, such as allergic rhinitis, sinusitis, enlarged nasal turbinates, or a deviated nasal septum. The findings highlight the importance of accurate diagnosis for effective treatment.
In these situations, the indiscriminate use of decongestants is ineffective in the long run, can delay a correct diagnosis, and postpone the initiation of specific treatment. This is in addition to the risk of developing medicamentous rhinitis, which can be difficult to treat.
Responsible Use and When to Seek Help
The society stresses the need for public education regarding the responsible use of nasal vasoconstrictor sprays and encourages individuals to consult a doctor when congestion persists or recurs frequently. Proper diagnosis and treatment are crucial for maintaining long-term nasal health.
The SEORL-CCC emphasizes that being able to breathe easily is “an essential element of quality of life,” and prevention involves avoiding prolonged self-medication and seeking professional medical attention for persistent symptoms.
“Persistent nasal congestion should not be normalized. When a patient needs a spray continuously to breathe, it is very likely that there is an underlying cause that should be evaluated,” says Serafín Sánchez, president of the SEORL-CCC.
Early diagnosis, the society notes, not only improves clinical outcomes but also prevents the chronification of nasal pathologies and the unnecessary use of treatments that may be harmful in the long term.
