Rhinitis Medicamentosa – Rebound Nasal Congestion from Decongestant Nasal Spray Overuse

Rhinitis medicamentosa (also known as rebound or chemical rhinitis) is a non-allergic form of rhinitis characterised by nasal congestion in the absence of sneezing and runny nose. Rhinitis medicamentosa is typically caused by the overuse of decongestant nasal sprays (Graf, 2005).

Decongestant nasal sprays are medications used to ease nasal congestion. They reduce swelling in the nose and open the nasal passages, by narrowing and reducing blood flow to the small blood vessels in the lining of the nose. Decongestant nasal sprays are not recommended for long term use and should not be used for more than 3-5 days in succession. They are not appropriate for individuals with chronic nasal symptoms.

When decongestant nasal sprays are overused they can have a rebound effect and cause the nasal mucosa to become inflamed, swollen and congested. As a consequence individuals continue to experience nasal congestion, even after the original cause of nasal symptoms has passed (Davis, 2013; Graf, 2005). So begins a vicious cycle of decongestant overuse and dependence, which untreated, can go on for months or even years. Unmanaged, rhinitis medicamentosa can be very damaging to the nasal mucosa.

The management of rhinitis medicamentosa fundamentally entails the complete withdrawal from decongestant nasal spray use, to allow the damaged nasal mucosa to recover. Appropriate treatment of the underlying nasal condition is also necessary. The regular administration of a corticosteroid spray may be prescribed to help alleviate rebound swelling within the nose while individuals are weaned from the decongestant nasal spray (Graf, 2005).

It is important to note that not all nasal sprays used for the management of nasal symptoms and allergic rhinitis (hayfever) are the same. Choosing the appropriate nasal spray, and using it correctly, is very important to ensure the optimal management of nasal symptoms.

At the Australian Allergy Centre, our doctors specialise in the diagnosis and management of allergic rhinitis and rhinitis medicamentosa. Affiliate Ear Nose and Throat specialists are also on site to discuss complicated cases. All consultations are bulk-billed, and no referral is necessary. For more information visit our website www.australianallergycentre.com.au or call us today on 1300 MY ALLERGY.

Note: This information is not intended nor recommended as a substitute for medical advice, diagnosis or treatment. Individuals should always seek the advice of a qualified health care professional with any questions regarding their health or a medical condition.

References:

Davis, S. 2013. Nasal Sprays. SA Pharamacist’s Assistant 13, 3, 14-16. Accessed August 19, 2015, http://reference.sabinet.co.za/sa_epublication_article/mp_sapa_v13_n3_a4

Graf, P. 2005. Rhinitis medicamentosa. Treatments in Respiratory Medicine 4, 1, 21-29

Picture courtesy of http://www.emed.com.au/nasal-decongestant-sprays-quick-fix-or-health-risk/