Nasal Spray Addiction and Rebound Congestion

What is rhinitis medicamentosa?
Rhinitis Medicamentosa is a condition of rebound congestion from long-standing use of topical nasal decongestants. This includes nasal sprays like Afrin® (oxymetalazine), Neo-synophrine® (phenylephrine), or Otrivine® (xylometazoline). If a patient uses these sprays for more than 2-3 days straight, they often experience worsening of congestion and postnasal drip each time it wears off. This makes the spray extremely addictive.

• Why do I get rebound congestion with Afrin®?

The mechanism of how Afrin® works is to decrease blood supply to your turbinates and nasal lining (the structures in your nose that swell in response to allergy). Once the spray is stopped, the turbinates and nasal lining respond by swelling even more. The patient then experiences even worse congestion than before use and is inclined to use the Afrin spray again.

• Can long-term use of Afrin® damage my nose?

It can cause damage to the nasal lining, resulting in infection and septal perforation, due to the lack of blood supply.

• How do I stop using Afrin® spray?

The best way is to quit “cold turkey” and throw away all the Afrin. The patient will then be directed to use specific medications to help with the rebound congestion. Often an oral steroid is used in conjunction with fluticasone (Flonase®), azelastine (Astelin®), and/or Ipratroprium bromide (Atrovent®) nasal sprays.

• Is there ever a reason to use Afrin®?

Afrin is useful during medical procedures and to stop a severe nose bleed.

• What do I do for my nasal congestion issues if I can’t use Afrin®?

  People get started on Afrin initially because they have structural issues in their nose and sinuses.  A comprehensive evaluation at our office can confirm this.  Contact us today at 512.601.0303 to schedule an appointment for a comprehensive evaluation.   We can help you get off Afrin and see if you have a structural issue.  We can do simple in-office procedures, such as a septoplasty, to correct the structural issues permanently, and also manage your allergies with allergy drops.