Afrin, the good, the bad and the ugly!

If you suffer from a really stuffy nose, use of over the counter nasal decongestant nose sprays (like Afrin, Vicks, Sinex etc.) can feel like a miracle. However, you have probably seen the warnings on the label stating not to use these sprays for more than 3 or 4 days. The relief is usually transient and often the congestion returns worse than before. In short, these sprays are useful at the beginning of a cold or sinus infection but are not meant for long term relief and management of chronic underlying problems that result in nasal obstruction.

What is Afrin?

Afrin is a brand of a nasal decongestant that contains the drug oxymetazoline. Other brands may also contain this medication or phenylephrine. These drugs work by causing vasoconstriction of the mucous membrane inside the nose. This results in reduced blood flow to nasal tissues including the nasal turbinates (structures inside the nose that humidify, filter and direct airflow). The reduced blood flow results in shrinkage of the turbinates which results in improved nasal breathing.

Can Afrin be addictive?

While Afrin may be useful for short term relief, prolonged use results in increased inflammation of the nasal lining which causes even more congestion. At this point increased amounts of nasal spray are required to produce decongestion. This is said to be a localized chemical dependency called rhinitis medicamentosa. Use of Afrin may be difficult to discontinue at this point because of severe congestion. Prolonged use may also cause damage to the mucous membrane resulting in bleeding, scabbing and perforation of the nasal septum.

How to treat Afrin dependency

At Nevada Sinus Relief, we recommend discontinuing all nasal decongestant sprays. Often, this requires replacing the Afrin (or equivalent spray) with a course of oral steroids, nasal steroids, saline rinse and other medications for a short period of time in order to treat rebound stuffy nose. It is also important to identify the underlying causes of nasal congestion such as a deviated nasal septum, enlarged turbinates, allergies and chronic sinusitis. These conditions may also require specific treatment in order to prevent relapse and restore the nose to good health.