Introduction
Nasal sprays are commercially available in different versions and with different ingredients and active ingredients. The classic decongestant nasal sprays used for colds lead to a constriction of the vessels in the nose due to their special active ingredients and thus reduce the blood flow in the nasal mucosa. This swelling subsides and the nose becomes free again in the case of a cold.
Effect of the nasal spray
However, prolonged use of decongestant nasal sprays can lead to the side effect of rhinitis medicamentosa (inflammation of the nose caused by medication). This is caused by the sympathomimetics contained in the decongestant nasal sprays. At first, the swelling of the nasal mucosa declines as intended, but after the end of the period of action there is a severe swelling: the nose is blocked and the mucosa is severely reddened.
A vicious circle is created when the nasal spray is applied again against the blockage, although it is the cause of the blockage. In addition, the nasal spray must be used more and more often. Further symptoms are snoring or sleep disturbances, as well as permanent breathing through the mouth.
In addition, there are changes in the nasal mucous membrane. Due to the ever more frequent use of the nasal spray, the supplying vessels become more and more constricted. The nasal mucous membrane is less well supplied with blood and tissue shrinkage (atrophy) and drying of the mucous membrane occurs.
In the course of the disease, tears in the mucous membrane occur, resulting in nosebleeds from nasal sprays. After how many days rhinitis medicamentosa occurs is not exactly clear. However, a decongestant nasal spray should not be used for longer than 1 week.
If rhinitis is already present, the remedy of choice is to omit the nasal spray. The swelling of the nasal mucosa will then subside. At the beginning, however, the swelling can be very disturbing.
A glucocorticoid nasal spray can then be used as a substitute for the decongestant nasal spray, which also has a decongestant effect but does not lead to rhinitis medicamentosa. Alternatively, one nostril can be weaned from the nasal spray first, while nasal spray is still used in the other to reduce swelling. After weaning one nostril, the other one follows.
This form of nasal spray contains the glucocorticoid cortisone as the active ingredient. There are also nasal sprays with other forms of glucocorticoid on the market. They are mainly used for allergies (hay fever, allergic rhinitis).
They work well against a stuffy nose, but also against other symptoms such as burning, redness or tears in the eyes. If used frequently, however, the preservative contained in the product often irritates and dries out the nasal mucous membrane. However, tissue shrinkage (atrophy) cannot be observed with cortisone nasal sprays.
However, cracks and nosebleeds may occur as a result of the dry mucosa. They usually contain common salt (sodium chloride) or sea salt. They are mainly used to moisturize the nose, but also care for it at the same time.
In addition, seawater nasal sprays have a decongestant effect and promote the healing of wounds in the nose and the regeneration of the nasal mucous membrane. The advantage of seawater nasal sprays is that they have no constricting effect on the blood vessels and can therefore be used without hesitation. It is also possible to use them over a longer period of time, as they do not cause any major side effects.
They are therefore suitable for incrustations or dry noses, but they can also provide relief for colds. Furthermore, seawater nasal spray can be used for nosebleeds caused by other forms of nasal spray to moisten the nasal mucous membrane and protect it from tearing. In order to stop an acute, severe nosebleed, it is advisable to compress the nostrils briefly by applying light pressure from outside (for this purpose, gently squeeze the nostrils with thumb and index finger).
The bleeding should then stop within about 10 minutes. In addition, a cold washcloth or an ice pack in the neck can help to stop the nosebleed. The head should be bent forward slightly to allow the blood to drain through the nose or mouth.
Under no circumstances should the head be placed in the neck and the blood swallowed, as in the worst case it could enter the respiratory tract. If the bleeding cannot be stopped by any of these measures or if new nose bleedings occur again and again, it is important to consult a doctor.Furthermore, the cause of the nosebleed should be treated: If the nosebleed is caused by an existing rhinitis medicamentosa with excessive use of decongestant nasal sprays, the therapy of choice is to discontinue the decongestant nasal spray. It may be possible to switch to a glucocorticoid nasal spray to counteract severe swelling of the nose. However, glucocorticoid nasal sprays can also dry out the mucous membrane and lead to nosebleeds through cracks. In this case, a nourishing ointment or seawater nasal spray should be used additionally to keep the nasal mucous membrane moist and to care for it.
