RHINITIS MEDICAMENTOSA
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Brett Scotch, D.O., F.A.O.C.O. Board Certified Otolaryngologist, CAQ in Sleep Medicine About the author: Dr. Scotch is Board Certified in Otolaryngology, Head & Neck Surgery, and Facial Plastic Surgery. He is a Diplomate of the American Osteopathic Board of Otolaryngology – Head and Neck Surgery. He has a certificate of added qualification in Sleep Medicine. His research work has been nationally published and he has presented at major ENT and medical conventions throughout the country. |
Can too much of a good thing really be bad?
Generally medications are a good thing. They are developed to treat symptoms, infections and keep us healthy. However, can too much of a good thing really be bad? In the case of topical decongestants like nasal sprays the answer is yes.
Topical nasal decongestants like Oxymetazoline work by shrinking the vessels in your nose, decreasing inflammation and giving you immediate relief from a pestering congestion. But these decongestants were designed for short-term use only, no more than 5 days. Any use beyond 5 days may actually cause the effects of the nasal spray to be reversed. Excessive use causes a rebound dilation of the vessels in the nose, which increases swelling and inflammation causing that annoying congestion to come right back. This creates a vicious cycle where patients will increase and prolong the use of their decongestant nasal sprays in hopes of getting that original relief back. This only worsens the condition, which in the medical community is called Rhinitis Medicamentosa or rebound rhinitis. In severe cases, heavy use of decongestant nasal sprays can even lead to permanent hypertrophy of the nasal tissues in the nose completely blocking nasal breathing.
The treatment involves stopping the habitual nasal decongestant, addition of nasal corticosteroid sprays; oral steroids if needed and saline irrigations will help reverse the swelling in your nose.
So if you are using a topical nasal decongestant (e.g. oxymetazoline) and this sounds like something you are experiencing, think twice before reaching for the bottle. That nasal congestion that is getting harder to clear could be the result of Rhinitis Medicamentosa and it may be time to see you doctor.
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