How to clear up congestion
It may sound simple, but first try clearing out your nose as much as possible by gently blowing into a tissue, said Dr. Raj Sindwani, an otolaryngologist at the Cleveland Clinic. You can use an over-the-counter saline nasal spray to help irrigate your nasal passages two or three times a day, Dr. Dykewicz said. It’s also important to stay hydrated, as fluids can help thin the mucus in your nose, allowing it to drain more easily. A steamy shower can help open up your nasal passages, too, Dr. Hochman said.
Certain over-the-counter medications may help combat congestion, although many come with caveats, Dr. Dykewicz said.
If allergies are the root cause of your congestion, your doctor may recommend an oral antihistamine such as cetirizine (Zyrtec) or fexofenadine (Allegra) for mild symptoms. Most antihistamines are safe to take in the long term, Dr. Hochman said, but if you’re going to use them for more than a week or two, you should consult a doctor.
For more severe symptoms, medicated nasal sprays may help, but some are safer for long-term use than others, Dr. Dykewicz added. Steroid nasal sprays that contain active ingredients like fluticasone (Flonase), triamcinolone (Nasacort) or budesonide are safe to use for as long as you need them, Dr. Sindwani said. “No problem, you can use those ad infinitum,” he said.
But nasal sprays that contain decongestants like oxymetazoline (Afrin) or phenylephrine (Neo-Synephrine) should be used for no longer than three to five days, or you risk what doctors call “rebound congestion,” Dr. Dykewicz said. These medications cause your blood vessels to constrict, opening up your nose for a brief period of relief — but then, if used repeatedly, the mucosal surfaces in your nose could swell, Dr. Hochman said, and some people end up feeling worse than before. There is some risk that, after long-term use of these nasal sprays, swelling could become persistent and require additional treatment such as with steroids, Dr. Dykewicz said.
“The nose gets stuffier and stuffier,” Dr. Dykewicz said. “People become de facto addicted to it.”
If chronic congestion is interfering with your daily life, Dr. Hochman said, you should seek care from an ear, nose and throat doctor who can investigate whether your nose has a structural issue or whether you have something like a chronic sinus infection.
“Everyone has a different threshold above which they can’t take it anymore,” she said.
