Nasal Steroid Sprays for Allergies: How They Work, Benefits, and Risks


Do steroids help with nasal congestion?

Yes, a nasal steroid can help reduce the nasal congestion associated with allergies. As an anti-inflammatory, they reduce swelling and help open the airways to make breathing easier. Nasal steroids are available as sprays, drops, or powders. They usually take a few days to start working.

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Steroid nasal sprays are a commonly-sought treatment for allergy symptoms like stuffy nose, nasal discomfort, and sinus congestion. But there's a lot more to the medication than what meets the eye. This article provides a comprehensive overview of nasal steroid sprays, from the science behind them to what you need to know before using them. 

What Are Nasal Steroids?

Nasal steroids are a type of medication that can be used to treat allergies and other inflammatory conditions in the nose. These medications reduce inflammation in the nasal passages, which can then help relieve symptoms such as congestion, runny nose, and sneezing.

Nasal steroids belong to a family of medications known as corticosteroids, or steroids for short. This class of drugs uses hormones to reduce inflammation and other symptoms that the body's immune system can create.

Nasal steroids come in several different forms, including nasal sprays, powders, and nasal liquids. The most commonly used form is a spray, which is generally used twice a day. Nasal sprays are applied directly to the nostrils and are generally well tolerated. Some intranasal corticosteroids may also be taken with irrigation.

What Are Nasal Steroids Used For?

Nasal steroid sprays can be used to treat many conditions that affect the nose, including hay fever, sinusitis, non-allergic rhinitis, and nasal polyps. All of these problems involve inflammation of the nasal passages, and steroids can help reduce this reaction to make managing symptoms easier.

Nasal steroid medicine is particularly helpful in reducing swelling. Spraying within the nose lessens the size of swollen tissues to relieve congestion. These medications also help slow the production of mucus, which can help improve symptoms like runny nose, post-nasal drip, and sinus pressure.

How Do Nasal Steroids Help Allergies?

When the immune system comes into contact with an allergen, like pollen or pet dander, it triggers inflammation in various areas of the body, including the nose. The nasal spray blocks the release of a chemical responsible for your symptoms during an allergic reaction.

Allergy-driven inflammation is attributable to a natural chemical called histamine, and this histamine is what causes the majority of allergy symptoms, including sneezing, runny nose, and congestion. Nasal steroid sprays work by blocking the release of histamine, curbing inflammation and therefore reducing symptoms.

But it's important to note that the effects of nasal steroid sprays don't always come immediately. Generally, you'll need to use the medicine consistently for at least a week before noticing any full symptom relief. This is because the steroids take time to build up in your system and start blocking the release of histamines.

Types of Nasal Steroids

Nasal steroids are a class of steroids in and of themselves, but under their umbrella, there are several different subtypes. This section will take a look at the most popular and explain how they work.

Beclomethasone (Qvar)

Beclomethasone, or Beclomethasone dipropionate, is a type of medication used to treat inflammation in the nose. It prevents cells from releasing substances that cause inflammation, like histamine and leukotrienes. It's typically used to relieve symptoms of hay fever, such as sneezing or a runny or stuffy nose. While effective, the spray is not well-suited for children, as it has been reported to affect growth. Beclomethasone can also cause insomnia when taken in high doses.

Budesonide (Pulmicort)

Budesonide, sometimes referred to as Tarpeyo and Pulmicort, manages the body's reaction to conditions such as Crohn's disease, asthma, COPD, hay fever, and allergies. It is commonly used to relieve symptoms like difficulty breathing, chest tightness, and coughing. This steroid medication can be administered orally but is usually taken in spray form for allergy relief. It is not recommended for those under six years old.

Fluticasone (Xhance)

Fluticasone is a prescription-only medication used in the treatment of asthma and hay fever. It works by decreasing the production of inflammatory chemicals in the body, which helps to reduce symptoms like sneezing, runny nose, and congestion. This medicine is great for powerful relief but has the potential to cause side effects when relied on long-term.

Triamcinolone (Kenalog)

Triamcinolone is a synthetic corticosteroid drug that is often prescribed to treat inflammatory skin conditions. But its effects are just as impactful for other areas of the body. When administered as a nasal spray, Triamcinolone can reduce inflammation in the nose and alleviate allergy symptoms.

Mometasone (Nasonex)

Mometasone is an anti-inflammatory, steroid-based nasal spray. It helps reduce the symptoms of hay fever and other allergies by blocking histamine and other substances in the body that can cause inflammation. The spray is also an effective treatment for nasal polyps, helping to reduce the size of polyps and relieve congestion. Mometasone is typically taken once daily but can be used more frequently if needed and recommended by your doctor.

Who Can Take Nasal Steroids?

Steroid nasal sprays can be taken by most adults and some types can be taken by children over the age of two. They are incredibly safe and available either over the counter or as a prescription. The main limitation to keep in mind is dosage - children are not recommended to take the same dosage as adults.

Who Can’t Take Nasal Steroids?

While most of the population can safely take steroid nasal sprays, there are a few other populations and demographics that should be cautious of them for certain reasons. These groups include pregnant women, people with high blood pressure, and people with diabetes.

Pregnant Women

Pregnant women should always check with their doctor before taking any medication, including a nasal steroid spray. While most are safe, The American Academy of Allergy, Immunology, and Asthma recommends avoiding triamcinolone and beclomethasone.

People with High Blood Pressure

Some steroid nasal sprays have effects on the body that can raise blood pressure. If you already suffer from high blood pressure or any other related condition, it's best to consult your doctor before taking nasal steroid spray.

People with Diabetes

Diabetes affects the body's ability to absorb and process insulin, hormones, and other nutrients. Taking steroids can make this problem worse and make it harder to control. Consult your doctor before taking nasal steroid sprays to see if they’re safe for you.

How to Take Nasal Steroid Spray

Nasal steroid spray should always be taken in line with the specific instructions provided on the bottle or label.

Generally, you will be advised to take them once per day in the morning or evening. It is important not to exceed the recommended dosage and to take the medication at a consistent time each day.

Before taking nasal spray, it is best to blow your nose to clear out any mucus. Then, follow these steps:

  1. Shake the bottle to ensure that it is well-mixed.
  2. Insert the nozzle of the spray bottle into one nostril.
  3. Point the nozzle towards the back and outer side of your nose and press down on the bottle to release a single spray.
  4. After the medication is released, inhale gently but deeply.
  5. Repeat steps 2-4 for the other nostril.
  6. Wipe off any excess medication from your face and nose with a tissue or cloth.
  7. Store the medication in a safe place, away from heat and light.

Can You Combine Nasal Steroids with Other Allergy Medications?

When it comes to managing your allergies and the resulting nasal congestion they cause, it's important to understand how different types of medications can work together. Nasal steroid sprays are usually safe in combination with other treatments, including antihistamines like Benadryl, Claritin, and Allegra.

But that's not to say that using two or more medications together is always a good idea—it's still important to listen to your doctor, who can make sure you're taking the right combination of medications for your specific condition. Some people may benefit from using nasal steroid sprays and antihistamines together, while others might only need one to get relief.

Side Effects and Risks

The symptom relief provided by steroid nasal sprays doesn't come without tradeoffs. This medication is known to cause a wide range of side effects, as well as present certain additional risks to people that take it. Take a look at the most common below.

  • Blurred Vision: Nasal steroid sprays can cause blurred vision, particularly if used at high doses or for a long period.
  • Itchiness: While it's formulated to prevent it, there are some cases in which nasal spray makes nose itchiness worse. This is usually mild and temporary but can be an extra annoyance.
  • Dry Nose and Mouth: This is one of the most common side effects of steroid nasal sprays. Using a saline solution or a saline nasal spray can help to reduce the issue.
  • Headache: Nasal steroid sprays can cause headaches in some people. If you experience this side effect, talk to your doctor about adjusting the dosage or switching medications.
  • Nosebleeds: These can occur with any type of nasal spray if the medication is used too often or if it's taken in higher doses.
  • Stinging or Burning Sensation: Nasal spray can cause a burning or stinging sensation when applied. This is usually mild and short-lived, but if it persists, you should contact your doctor.
  • Unpleasant Taste: Some people report an unpleasant taste in their mouth after using a nasal spray.

Nasal Steroid Alternatives

Steroid nasal sprays aren't the only option allergy sufferers have at their disposal when it comes to managing the symptoms of allergic rhinitis. Consider these long-term treatments for even more effective relief:

Allergy Shots

Allergy shots - also called subcutaneous immunotherapy - are a safe and effective way to treat allergic rhinitis. During treatment, small and incremental doses of allergens are injected into the skin to desensitize the body. This gradually reduces the individual's sensitivity to allergens and symptoms of allergic rhinitis. Allergy shots typically require consistent trips to the doctor's office, usually weekly for several months, and it can take up to five years for the full benefits to be felt.

Sublingual Immunotherapy

Sublingual immunotherapy is a newer approach to the same concept behind allergy shots. It, too, works by introducing small amounts of a given allergy to the immune system and increasing doses over time. The main difference is how this is done - through drops or tablets under the tongue as opposed to injection. Sublingual immunotherapy is just as effective as allergy shots but can be taken safely at home making it a popular alternative.

Take Our Allergy Assessment

Sublingual immunotherapy offers an easy and effective way to treat allergies without the use of nasal steroids. Wyndly's doctors will work with you to identify your allergy triggers and create a personalized treatment plan to get you long-term relief from your symptoms. Take our allergy assessment today to see if Wyndly is right for you.

Frequently Asked Questions

Any remaining questions about nasal steroids or allergies? Here are some common Q&As:

How Often Can You Take Nasal Steroids?

Depending on the specific medication, nasal steroids should be taken as directed by your doctor. Generally, these medications are used twice a day on an ongoing basis until symptoms subside. Recommended dosage quantity can change with age, weight, and severity of symptoms.

Can Children Take Nasal Steroids?

Yes, most nasal steroids can be used to treat allergies in children over the age of two. However, it's critical to follow your pediatrician's instructions and be mindful of any side effects. It's also important to distinguish the age difference, as children are usually given much smaller doses.

Can You Take Nasal Steroids During Pregnancy?

While many medications are safe, it's generally not recommended to use nasal steroids during pregnancy. There are additional risks to factor in, which for some women, may not be worth the benefit. Talk to your doctor if you have questions about taking nasal steroids while pregnant or breastfeeding.

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