When you're suffering from a nasty cold or seasonal allergies, all you want is relief—and fast. For some, using a decongestant nasal spray may clear stuffy nasal passages so they can finally breathe. While nasal decongestants are safe when used as directed, they can also cause rebound congestion.
Rebound congestion occurs when a nasal decongestant is used more than three days in a row. While you may find relief at first, the congestion can slowly creep back, causing you to rely on the spray more.
Some medical professionals suggest quitting cold turkey when rebound congestion occurs. Others advise tapering slowly since stopping abruptly can aggravate symptoms.
What Happens When You Overuse Decongestants?
Also known as rhinitis medicamentosa, rebound congestion is a side effect of overusing nasal decongestant sprays.
Normally, nasal congestion results from a cold, allergies, or sinus infections. When these conditions cause nasal membranes to become inflamed and swollen, they block airways, preventing air from flowing freely. This inflammation leads to the familiar symptoms of a stuffy nose, difficulty breathing, and even snoring.
Congestion associated with this rebound condition occurs when the nasal passages become too dependent on the decongestant and require greater doses to achieve relief, a phenomenon known as tachyphylaxis.
Other researchers believe nasal decongestant sprays may damage the blood supply to the nose by narrowing blood vessels too much, worsening swelling in the turbinates and nasal passage. Rebound congestion can also cause rebound rhinorrhea, or runny nose.
To ensure you don’t develop rebound congestion, follow the directions. The correct dosage for a nasal decongestant is once every 12 hours for a maximum of three days. Some rebound sufferers use these sprays multiple times a day and for prolonged periods of weeks or months. One study found that half of those with rebound congestion used decongestant sprays longer than recommended.
What Are Nasal Decongestants?
There are four main types of nasal sprays used to treat symptoms associated with the common cold, flu, and seasonal allergies. These include nasal decongestants, antihistamines, saline nasal sprays, and steroids.
How Do Decongestant Nasal Sprays Help?
Nasal decongestants constrict blood vessels in the nasal passages, which reduces swelling and inflammation. This reaction allows you to breathe more easily; however, it is not a long-term fix. Nasal decongestants only provide short-term relief and don't address the underlying condition.
What Are the Symptoms?
The most common symptom of rebound congestion is stuffiness that gradually worsens over time. However, it's not always easy to distinguish symptoms.
Nasal congestion that does not include a runny nose or sneezing is typically the only sign—and it might last as long as you keep using nasal decongestants. While you may be tempted to increase the use of nasal spray, that only exacerbates the congestion.
How Can I Prevent Rebound Congestion?
The best way to prevent rebound congestion is to use nasal decongestants as directed. No more than once every 12 hours for a maximum of three days. You may also want to try saline nasal sprays, which are safe for daily use and can keep the nose moist while reducing inflammation.
If symptoms persist, talk to your doctor or allergist about other options.
Is There a Treatment That Can Stop Congestion and Reduce Allergies?
Yes! Sublingual immunotherapy exposes you to small amounts of the allergens that cause your nasal congestion and allergy symptoms. Over time, your body gets used to the allergens and eventually stops reacting to allergens in your environment.
If you're struggling with rebound congestion or seasonal allergies and looking for long-term relief, take our quick assessment to see if sublingual immunotherapy is right for you!