August 16, 2022

Nasal Sprays Work Best When You Use Them Correctly — Here’s How

Correct positioning is one of the keys to getting the best results

Person holding nasal spray.

Another sneeze, another sniffle. You can’t wait to get ahold of a nasal spray so you can find relief for your stuffy nose ASAP.

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“While nasal congestion can be treated with an over-the-counter nasal spray, using the spray isn’t always as simple as seems,” says allergist Mark Aronica, MD. “Correct positioning and technique are the keys to getting the best results.”

What are nasal sprays used for?

The simple explanation of nasal sprays is that they target inflammation in your nasal passages, which reduces swelling and helps clear up stuffiness.

Some nasal sprays (steroid nasal sprays and antihistamine sprays) are specifically designed to treat allergy symptoms and can be used for the long term.

A third type, called decongestant nasal sprays, should only be used for a few days at a time, so they’re best for treating congestion caused by a cold or the flu.

How to use nasal sprays

Nasal sprays are medication — and like any medication, if you take them wrong, you won’t get their full benefits. With nasal sprays, it all comes down to proper usage.

“Technique is very important with nose sprays,” Dr. Aronica says. “Sometimes, patients tell me their spray isn’t working, but when we improve their technique, it really helps.”

Step-by-step instructions

Here’s the right way to use your nasal spray:

  1. Before applying, gently blow your nose. This will clear your nasal passages and clear the way for the medicine.
  2. Read the product directions. If it directs you to do so, be sure to shake the bottle or squirt out a small amount, which is called “priming” a nasal inhaler.
  3. Position the bottle opening under one nostril. To use your nasal spray properly, it’s important to make sure to point the spray toward the back of your nose so the medicine makes it into your sinuses. “Steer away from the midline of your nasal cavity when you squirt it in,” Dr. Aronica says.
  4. Gently squeeze or pump the bottle and, with your mouth closed, inhale slightly and gently to ensure that the product remains inside of your nose. “Usually, the pump action on the spray is enough to drive the spray into the nose and sinus,” Dr. Aronica says. “You can take a gentle sniff, but you don’t want to taste it in the back of your throat.”

Safety tips for using nasal sprays

Dr. Aronica also weighs in on a few common usage errors — things you shouldn’t do when you’re using a nasal spray.

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Don’t aim toward your septum

“You never want to direct the spray at the nasal septum, which is the middle portion of your nose,” he says. When you push a spray directly onto your septum, the force can damage the tissue, and you can end up with irritation or a bloody nose.

Don’t tilt your head back

Most products can be applied while you’re in an upright position, so you don’t have to tilt your head back. “You don’t want it dripping down the back of your throat,” Dr. Aronica notes.

Don’t take a big sniff

If you suck the medicine to the back of your throat and swallow it, it doesn’t have the opportunity to do what you need it to do — get into your sinus cavity. A gentle sniff should do the trick.

Don’t blow your nose

It’s tempting to grab a tissue after you’ve used a nasal spray, but try to avoid it. “You want as much of the medicine to stay in the nose and sinus as possible,” Dr. Aronica advises.

Don’t share your nasal spray

To avoid spreading bacteria, keep your spray to yourself. You don’t want anyone else sticking something up their nose that’s just been in yours!

“Keep the bottle clean and only allow one person to use it,” he says. “Remember to wipe down the nasal spray bottle and put the cap back on after each use.”

Should you worry about the rebound effect?

Have you ever heard that if you use a nasal spray too much, you’ll stop feeling relief from them? This is called the rebound effect, but it’s only possible with one type of nasal spray — and it’s one you shouldn’t be using for more than a few days in a row, anyway.

Because there are a few different kinds of nasal sprays, it’s important to know exactly what you’re using, how often to use it and whether it’s habit-forming. Only decongestant nasal sprays can result in the rebound effort. Here’s what to know about each type:

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  • Nasal steroid sprays: These once-a-day sprays are available over the counter and work best when you start using them a few weeks before allergy season starts. “They’re not habit-forming and should be used regularly for best effect,” Dr. Aronica says. They include fluticasone (Flonase®) and betamethasone (Nasacort®).
  • Antihistamine sprays: Like nasal steroid sprays, these sprays aren’t habit-forming and should be used once a day for the best results in treating your allergies. The main difference is that they’re only available with a prescription. They include azelastine (Astepro® and Astelin®) and olopatadine (Patanase®).
  • Decongestant nasal sprays: These sprays, which are good for people who have congestion from a cold or the flu, shouldn’t be used more than three or four days in a row. “Using them longer invites building up a tolerance to the medicines,” Dr. Aronica states. They include oxymetazoline hydrochloride (Afrin®, Dristan® and Sinex) and phenylephrine hydrochloride (Neo-Synephrine®).

If you experience the rebound effect from using a decongestant nasal spray, it may be accompanied by minor side effects like a bitter smell or taste, sneezing, runny nose and nasal irritation, including burning and stinging. If you experience major side effects like a change in heart rate, tremors, unusual sweating or persistent nosebleeds, consult a doctor.

When you shouldn’t use a nasal spray

While most people can safely use nasal sprays, your doctor or pharmacist may have other recommendations if you have diabetes, high blood pressure or hyperthyroidism, or if you’re taking other medications.

You also shouldn’t use a nasal spray if your nasal passages are damaged. This condition, known as rhinitis medicamentosa, happens when you use a decongestant nasal spray for longer than a few days. “When this happens, you might need more medicine to control your congestion, or your congestion might worsen if you stop using the spray,” Dr. Aronica cautions.

As always, the best thing to do is to consult your doctor to make sure that nasal spray is safe for you. With their help, you’ll be well on your way to safely getting your allergies under control.

To learn more about allergies from Dr. Aronica, listen to the Health Essentials Podcast episode, “Dealing with Spring and Summer Allergies.” New episodes of the Health Essentials Podcast publish every Wednesday.

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