Nasal Congestion: Its Symptoms, Its Causes, and How to Treat It (2024)

Nasal congestion treatments include drinking liquids, clearing out the nasal passages, and, when needed, using over-the-counter or prescription medication.

These remedies will ease symptoms but may not cure the underlying cause of congestion, which occurs when the blood vessels inside the sinuses are inflamed, causing the tissue lining inside of the nose to swell.

Treating Nasal Congestion

Often, nasal congestion will clear up on its own. At-home remedies can help you manage symptoms until the issue underlying issue is resolved. However, you may need OTC or prescription medication to help permanently cure what's causing your congestion.

At-home self-care can consist of the following:

• Drinking fluids to stay hydrated
• Applying a warm compress to the face several times a day
• Inhaling steam from a shower that is not too hot several times a day
• Using a vaporizer or humidifier
• Staying elevated instead of lying down

Over-the-counter medications for allergies and non-allergic congestion may include:

• Saline nasal rinses
• Nasal decongestant spray (do not use for more than three days)
• Decongestants that reduce swelling in the nose and dry up nasal passages
• Antihistamines that calm your immune system's response to allergens

Causes of Nasal Congestion

Nasal congestion consists of a stuffy feeling in your nose. This can be caused by a variety of factors including the following:

• The common cold and flu: The common cold and flu are caused by viruses that spread via air droplets from people's noses and mouths as they sneeze or cough. These viruses can irritate the nasal passages and cause inflammation leading to nasal congestion.
• Sinus infection: A sinus infection is caused by fluid buildup in the sinuses, which are air pockets in the face. The fluid can become a breeding ground for viruses and bacteria, which can also irritate the nose.
  
• Allergies: When allergens (substances that cause allergic reactions) enter the nasal passages, inflammation results.
• Nasal polyps: Nasal polyps are usually noncancerous growths caused by inflammation in the nasal passages.
• Pregnancy: About 65% of pregnant people experience nasal congestion at some point during their pregnancy. This is partly because pregnancy increases fluid in the body and causes swelling.
• Environmental irritants: Indoor and outdoor pollutants irritate nasal mucosa, which results in an allergy-like response that includes congestion.

Medications That Cause Nasal Congestion

While people assume that most cases of stuffiness are related to viruses, allergies, or other illnesses, nasal congestion may also be a side effect of certain types of medication.

The following medications can cause nasal congestion:

• High blood pressure medications: Research has found that people may have nasal congestion because of high blood pressure medication and might not be aware of it. Nasal steroids or surgery could help.
• Erectile dysfunction (ED) medications like Viagra (sildenafil)
• Antianxiety drugs like Xanax (alprazolam)
• Antipsychotic drugs like chlorpromazine
• Tricyclic antidepressants like Cymbalta (duloxetine)
• Nasal decongestant spray: If nasal congestion doesn't improve after three days of using a nasal decongestant spray, there is a chance of "rebound congestion" because of a return of swelling in the nose once medication wears off.
• Aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs (NSAIDs): Up to 25% of people with asthma can develop Aspirin-exacerbated respiratory disease (AERD) in which they are sensitive to medications like Advil or Motrin (ibuprofen). Taking these results in an overproduction of disease-fighting chemicals that cause inflammation.
  

Understanding Phenylephrine and Pseudoephedrine

If you are looking for a decongestant to ease congestion, you will likely come across medications with one of these two common active ingredients: phenylephrine or pseudoephedrine. In recent years, both have faced some scrutiny and regulation, though, from the FDA.

Phenylephrine has been determined to be ineffective in oral medication. It is now only available in OTC nasal sprays.

Pseudoephedrine has been considered one of the most effective nasal decongestants. It is available in OTC and prescription oral medication. However, because pseudoephedrine is often misused to manufacture methamphetamines, there are restrictions on the sale of medications that contain this ingredient. Specific regulations vary by state, but in general, you must present photo identification to purchase it, and there are limits to how much you can buy in a 30-day period.

Complications Associated With Nasal Congestion

If left untreated, chronic nasal congestion (nasal congestion that lasts longer than two or three weeks) could be a sign of a more serious conditions like:

• Nasal polyps: These are usually noncancerous growths in the nasal lining that could make it difficult to breathe.
  
• Nonallergic rhinopathy (vasomotor rhinitis): Nonallergic rhinopathy occurs when a trigger that is not an allergy or an infection causes symptoms like stuffy nose, drainage, and sneezing. Triggers for nonallergic rhinopathy can include dry air, pollution, intense emotions, alcohol, medications, and strong odors.
• Bacterial infection
  
• Inherited disorders

Summary

Nasal congestion occurs when tissue lining the nose swells because of inflamed blood vessels. Symptoms of nasal congestion include runny nose, itchy nose, sneezing, and loss of smell. The common cold, flu, and sinus infection are the most likely causes of nasal congestion. It's easily treated at home or with OTC medication.