Is it okay to use nasal spray daily?
I have terrible seasonal allergies, so I use a nasal spray to treat them daily. Recently, though, a friend got a brain infection, and his doctor told him the nasal spray may have been a factor. The doctor told him people shouldn’t use it that often. Is daily nasal spray dangerous? — Kashmir, New York
As allergy season gets worse and goes on for longer, more and more people are looking for ways to cope. Over-the-counter medicated nasal sprays are a great and generally safe option, so long as you follow the dosing guidelines, says Donald Dvorin, an allergist in New Jersey.
“After 35 years of practice, I have never come across any patient with meningitis or other brain disease that can be attributed to nasal steroids or antihistamines,” he says. The most common complications from use of nasal sprays, he says, are localized irritation or bleeding.
John Accarino, an allergist at Massachusetts General Hospital, agrees that frequent, long-term nasal spray use is “generally safe.”
“Patients with perennial allergies such as dust mites, animal dander or molds frequently benefit from regular use,” he says.
There are, though, he says, some rare exceptions to the rule.
“For infections that reach the brain such as meningitis, an organism needs to gain access to the brain tissue or spinal cord. The nasal mucosa itself acts as a barrier,” he says. “Very rarely sinus infections can lead to infectious invasion of the brain or spinal cord called meningitis.”
If a person is immunocompromised or has had a head injury that’s impaired that barrier, they are more at risk of pathogens getting past the sinuses in general.
Additionally, nasal sprays, in rare cases, can be contaminated with bacteria and other microorganisms. In some cases, products have been recalled by the Food and Drug Administration after microorganisms were found in them.
Nasal irrigation tools, like neti pots, Accarino notes, are a different beast, because they are flushing fluid deep throughout the sinuses. It’s important to used sterilized water for these treatments to reduce the chance of infection.
When adhering to the warnings, using nose-clearing products can hopefully provide some safe relief during allergy season.
“While nasal sprays carry a theoretical risk of increased infection, they are routinely prescribed for regular use. There are not even case reports published in the literature of clear causation of nasal sprays leading to meningitis,” Accarino says. “While the risk of infection related to nasal sprays is not zero, it is exceedingly low.” — Kristen V. Brown
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