Stuffy Nose? These Medicines Might Help

You wake up and try to take a deep breath, and you can’t. Not to worry, you’re not underwater, you just have a stuffy nose. It’s not dangerous, but it sure is unpleasant.

A stuffy nose is not a diagnosis—it’s a symptom that could be caused by a number of conditions, but it’s one that can make you particularly miserable. “A stuffy nose is the most bothersome symptom that leads people to visit a doctor for allergies,” says Nora Odisho, D.O., an allergy and immunology expert at Banner Health in Tucson, AZ. “It is more bothersome than a runny nose, sneezing, or eye symptoms.”

What’s going on in your nose when it’s stuffed up? What medical conditions can cause one? And most importantly, how can you get relief? We’ve got answers.

Most of the time (with the exception of nasal polyps; see below), a stuffy nose is caused by inflammation, which in turn is caused by your immune system fighting off what it perceives to be “invaders.”

Those invaders could be something that should be harmless like pollen or pet dander (hello, allergies), or something more dangerous like bacteria or viruses that make you sick. In the case of nasal polyps, your nose is physically blocked by a growth.

Regardless of the cause, you need to get those nasal passages clear, and the first step in doing so is figuring out what’s causing the stuffy nose in the first place. Here are some of the likely suspects.

Allergic and Non-Allergic Rhinitis

A stuffy nose is often present in allergic rhinitis, which can be triggered by pollen as well as indoor allergens like pet dander and mold. If you have rhinitis, your immune system pounces on foreign particles like pollen and pet dander and releases inflammatory chemicals that irritate your eyes, make you sneeze, or give you a stuffy nose.

At least one in three people with the symptoms of rhinitis do not have allergies, according to the American Academy of Allergy, Asthma, and Immunology (AAAAI), yet they have the symptoms of allergies (like a stuffy nose.) This is called non-allergic rhinitis. “Tobacco, air pollution, perfume, dust, or car exhaust fumes can all be irritating to your nose,” says Jehan Riar, M.D., a primary care physician at Mercy Medical Center in Baltimore, MD.

Cold and Flu

A viral infection like the common cold and the flu will trigger your immune system in similar (but different) ways to allergens. Unlike an allergic reaction, which is more like a damaging overreaction to something innocuous, the inflammation that results from your immune system fighting a viral infection will eventually kill the virus and make you safe. In the meantime, however, you’ll have to deal with the symptoms.

The common cold (How common? More than a billion each year in the U.S.) is the name for upper respiratory infections caused by any of more than 200 viruses. Along with sneezing, coughing, and runny eyes, a stuffy nose is one of the main symptoms of colds.

The flu is similar to a cold but it’s caused by a specific group of viruses—influenza viruses. An influenza infection is typically more severe than a cold, and stuffy noses aren’t quite so common with the flu as they are with a cold.

Nasal Polyps

A stuffy nose can be a symptom of nasal polyps, which are benign growths in the nasal cavities. These tissue overgrowths block your nasal passages, leading to a stuffed-up feeling. The symptoms of nasal polyps include a stuffy nose, nasal drainage, facial pressure or pain, and a decrease in your sense of smell that can last for more than 12 weeks, according to the AAAAI.

Sinus Infections

Also called sinusitis, sinus infections are infections of the sinuses, air-filled cavities around the nose. These infections cause inflammation to the tissues in the sinus and nasal cavities which can lead to difficulty breathing out of your nose. Infections can be from bacterial or viral causes; if your doctor suspects that it is bacterial, you may be prescribed an antibiotic.

When you have a stuffed up nose, you’re probably less concerned with how you got it than how to relieve it. Various home remedies can help.

Top tip: To relieve a stuffy nose, you want to keep the mucus in your nasal cavities thin so it will drain from your nose and sinuses and relieve the congestion, per Cleveland Clinic and others. To help accomplish this:

• Drink plenty of clear fluids.

• Inhale steam several times a day by sitting in the bathroom with the shower running.

• Keep your head elevated when you are resting or sleeping.

• Use a humidifier.

In addition, avoid common irritants like smoke and strong perfumes, advises Dr. Riar.

You also can use a nasal saline spray or a neti pot, says Heather Viola, D.O., a primary care physician at Mount Sinai Doctors-Ansonia in New York City. Neti pots use a saltwater solution to help congested sinuses and they can moisten nasal passages that are exposed to dry indoor air.

Make sure to start with distilled (sterile) or boiled and cooled water as a base to guard against infectious organisms like bacteria and amoebas that could be found in tap water, and mix in the salt packet that comes with the neti pot. Plain water can irritate your nose, but the saline solution you mix can pass through nasal membranes, according to the U.S. Food and Drug Administration.

Neti pots, along with other nasal irrigation devices like bulb syringes and squeeze bottles, are usually safe and effective when they are used and cleaned properly, according to the U.S. Food & Drug Administration.

If neti pots and natural remedies don’t do the trick, head to your local pharmacy for some OTC medicines. Your options include decongestants, antihistamines, and corticosteroid prays. Let’s look at how each of these works.

Decongestants

Decongestants are a type of vasoconstrictor: they work by narrowing the blood vessels in your nose, thereby shrinking the swollen tissue and allowing you to breathe deeper. Decongestants come in liquids, tablets, and nasal sprays. Example include:

• Afrin (oxymetazolone)

• Sudafed (pseudoephedrine)

• Sudafed PE (phenylephrine)

Keep in mind that although products containing pseudoephedrine can be available without a prescription, you’ll have to ask the clerk or pharmacist to get it for you, and you’ll have to show ID. That’s because pseudoephedrine can be used to make illegal methamphetamine, so federal law requires more regulation for those products.

Antihistamines

Antihistamines are medicines that treat allergy symptoms, one of which is a stuffy nose. Histamines are inflammatory chemicals that your immune system releases during an allergic reaction. Antihistamines work by preventing the effects of histamine. Like decongestants, these are available in liquids, tablets, and nasal sprays. The first generation, sedating antihistamines may cause drowsiness while the second generation, low-sedating or non-sedating antihistamines are less likely to make you drowsy, according to the American Academy of Family Physicians.

Per Farheen Mirza, M.D., an expert in allergy and immunology at Northwestern Medicine Central DuPage Hospital in Winfield, IL, long-acting antihistamines that are available over the counter include:

• Allegra (fexofenadine)

• Claritin (loratadine)

• Zyrtec (cetirizine)

Corticosteroids Sprays

Corticosteroid nasal sprays are inhaled anti-inflammatories that can un-stuff your nose. Unlike decongestants or antihistamines, corticosteroid nasal sprays don’t work right away; they may need one to three weeks of regular use for you to see a reduction in symptoms.

Because they reduce symptoms and are safe in the short-term, nasal corticosteroid sprays are mainstays of treating rhinitis—allergic and non-allergic—and nasal polyps. “Most commonly we recommend nasal sprays such as intranasal corticosteroid sprays,” says Dr. Odisho. Options include:

• Flonase (fluticasone)

• Nasacort (triamcinolone)

• Nasonex (mometasone)

Medications such as decongestants and antihistamines that help a stuffy nose are largely available over the counter, says Dr. Odisho. If you need a higher dosage, your doctor may suggest prescription-strength medicine.

If your stuffy nose is caused by a bacterial sinus infection, your doctor may prescribe antibiotics, says Dr. Viola. Prescription oral steroids or steroid rinses may be prescribed if you have nasal polyps, very inflamed nasal passages, or sinuses that are keeping mucous from draining out, Dr. Viola says.

Leukotriene Modifiers

Your doctor may prescribe leukotriene modifiers to help with allergic rhinitis if antihistamines aren’t doing the trick. Leukotriene modifiers either neutralize or prevent the production of inflammatory chemicals called leukotrienes that can cause a stuffy nose. Some brands you might be prescribed include:

• Accolate (zafirlukast)

• Singulair (montelukast)

• Zyflo (zileuton)

One meta-analysis in PLoS ONE suggests that leukotriene modifiers are particularly useful overnight—if your stuffy nose is keeping you up at night, waking you up in the middle of the night, or if it’s particularly bad in the morning, leukotriene modifiers might be right for you.

If you experience any of the following, call your doctor, Dr. Viola says. These symptoms indicate an infection that won’t go away on its own, she says:

• Congestion accompanied by a high fever lasting more than three days

• Congestion lasting longer than two weeks

• Green nasal discharge along with sinus pain and fever

“You should also contact your doctor if symptoms are not improving with over-the-counter medications,” Dr. Viola says. If your congestion goes hand in hand with a loss of your sense of smell or taste for more than six weeks, see a doctor, Dr. Odisho recommends.