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11 Reasons You Have a Stuffy Nose–and What to Do About It

To get rid of a stuffy nose, find the cause

Stuffy nose? It could be a cold, but it could also be the flu, a sinus infection, allergies, pregnancy, your body wash, and about a dozen other things. That’s what makes a congested nose one of the most common complaints doctors see.

But if you have nasal congestion that’s making it hard to breathe, something is probably wrong. “Your nose isn’t there to just look good,” says Melinda Thacker, MD, a rhinologist in private practice in Worcester, Massachusetts. “It has functions. It should smell, and it should breathe.”

Your nose gets stuffed up when blood vessels in the tissues lining your nose become inflamed. But there are loads of reasons for that inflammation. So to get rid of your stuffy nose, look for a specific cause. Chances are there’s a simple way to unstuff it.

Allergies

Some 50 million people in the U.S. suffer from allergies, including to pollen, pets, dust, mold, and grass. In addition to sneezing and itchy, watery eyes, the classic symptom of allergies is a stopped-up nose. How to get rid of a blocked nose? The simplest strategy is avoidance. If you know you have an allergy, stay away from your triggers or protect yourself by wearing a mask and taking showers after being outdoors, especially on dry, windy days.

Over-the-counter antihistamines, which work by blocking an immune system chemical called histamine that’s involved in allergic reactions, can help unstuff your nose. So can nasal rinses to wash away allergens. Make sure you use purified, distilled, or boiled water, or consider picking up an OTC saline spray or wash.

If nothing clears your stuffed-up, allergic nose, consider allergy shots. “It comes as close [as we have] to a cure for allergies,” says Christopher Chang, MD, an ear, nose, and throat (ENT) specialist in Warrenton, Virginia.

Colds and flu

A dramatically stuffed nose is a hallmark symptom of both colds and the flu, which are caused by viruses. There’s no cure for either and they usually go away on their own. However, if you don’t take care, you could get a secondary infection from bacteria that grow in your “stagnant mucus,” says Lisa Liberatore, MD, an ENT specialist at Lenox Hill Hospital in New York City, which could be even more serious.

An array of over-the-counter cold and flu medicines containing decongestants (which shrink the inflamed blood vessels blocking your nose) and/or antihistamines can help clear congestion. Nasal rinses can help wash viruses and bacteria away.

But other self-care is also key. “I emphasize the importance of hydration, staying away from alcohol, and getting plenty of sleep because lack of sleep [hampers] the immune system,” says Dr. Liberatore. “If there’s any time you want to prioritize sleep, it would be when you’re sick.”

Acute sinusitis

Your sinuses are the cavities in your skull that help drain mucus out of your system. If the sinuses become infected or inflamed, you could end up with congestion and a blocked nose.

Bacteria, viruses, and allergens can cause sinusitis. The condition can be acute, meaning it lasts only a few days to a couple of weeks, or chronic, when it lingers for 12 weeks or more.

If your sinus infection is from bacteria, antibiotics may help, but the best thing you can do for sinusitis caused by a virus is control the symptoms. Stay away from antihistamines, which dry things out, says Dr. Liberatore, in favor of OTC decongestants, which help drain the sinuses instead. Decongestants can raise blood pressure though, so if you have hypertension, talk to your doctor before taking them. Nasal sprays containing steroids may also help.

Once the congestion and stuffy nose of acute sinusitis have eased, flush away the mucus with a saline rinse, says Dr. Liberatore.

Chronic sinusitis

When inflamed or infected sinuses don’t get better, you might have chronic sinusitis. “All cavities have drainage pathways, and when they become obstructed, there’s usually a vicious cycle,” explains Dr. Thacker. “Mucus gets trapped in the lining, the lining gets more inflamed, and the symptoms persist. You end up with pressure in your face and a stuffy nose.”

If decongestants, nasal sprays, and self-care routines like rinsing don’t help, you may need to see a specialist who can recommend other medications or may even suggest surgery. Traditional sinus surgery involves taking out some bone and tissue to open up the passages to make more room for mucus to drain.

Sinusplasty is another option. The doctor inserts a balloon into the sinuses, inflates it to stretch the area, then removes it. Or, you might benefit from a stent-like device, which keeps the drainage holes in the sinuses open and releases medicine to help prevent the opening from scarring over, says Dr. Thacker.

Deviated septum

Sometimes a stuffy nose is caused not by outside invaders but by internal structural problems. The most common is a deviated septum. That’s when the cartilage-and-bone divider between the nostrils warps out of shape, usually because of an injury such as a broken nose. One sign of a deviated septum is only being able to breathe out of one side of your nose. “If [the septum] is bent over to one side, it’s only going to cause problems on that one side,” explains Dr. Chang.

Treatment depends on how badly your breathing is affected. If you can still breathe fairly easily, allergy medications to open up the breathing passages might help, but many people need surgery to widen the passages permanently. Procedures to repair a deviated septum are usually quick (30 to 90 minutes), effective, and relatively painless, says Dr. Thacker.

Pregnancy

Certain things you expect with pregnancy: a protruding belly, morning sickness, swollen feet. A stuffy nose when you’re expecting may take you by surprise. It’s called rhinitis of pregnancy and is due to more blood flowing into the soft tissue of the nose, says Dr. Liberatore. Some women escape the problem, but if you do develop a blocked nose, it can last the entire nine months.

The condition isn’t life-threatening, but treating it with medicines can be risky. Instead, most women have to rely on saline rinses. “It may seem low-tech, but it actually really does help move any stagnant mucus out of your nose,” says Dr. Liberatore. That will help prevent a secondary bacterial infection and can relieve the pressure you might be feeling.

If you have a deviated septum, talk to your doctor about correcting it before getting pregnant, as surgery isn’t an option once you’re expecting, she says.

Enlarged adenoids

Enlarged adenoids are a common cause of a stuffy nose during childhood. The adenoids are folds of tissue at the back of the throat, which, in a child under 5, help stave off infections. After age 5, the adenoids shrink and aren’t as involved in fighting off bugs. Sometimes, though, infections cause swelling in the adenoids. This can leave your child with not just a congested nose but blocked ears and chapped lips from breathing through his or her mouth.

Nasal spray or antibiotics may make the symptoms manageable until the adenoids shrink on their own. Some children will have to have them removed though, especially if they have trouble sleeping.

Nasal polyps

Nasal polyps are little bits of tissue that grow in your nose. Ongoing irritation to your nose from chronic sinusitis or allergies can cause inflammation, which then causes the lining of the nose to blister. Polyps usually don’t hurt or bleed, but if they become big enough, they can block the sinuses and nasal passages, giving you a stuffy nose. They can also impair your sense of smell and taste. If you have cystic fibrosis or asthma, you may be more susceptible to developing nasal polyps.

For about 10% to 20% of people with these growths, oral or nasal steroids are enough to shrink the polyps and prevent them from coming back, says Dr. Chang. Everyone else is a candidate for surgery–but even that may not be enough. “Once you get them, they tend to come back,” he says. Some people may need more than one surgery; others may need to stay on medication for years. If nasal polyps do return, you’ll need to be diligent about preventing the triggers of the polyps, like infections, he says.

Narrow nasal passages

Some people happen to be born with narrow nasal passages. If you’re one of them, you may also suffer from a perpetually stuffed nose. This can be caused by overly large turbinates, which are tiny humidifiers in the nose that make sure air you inhale is moist when it hits your lungs.

If you have narrow nasal passages, you might find breathing to be difficult just some of the time. “If [people with narrow nasal passages] breathe slowly through their nose then they’re just fine,” says Dr. Chang. “But if they try to breathe quickly, the airway collapses, and they end up having to mouth breathe.” Surgery to reduce the size of the turbinates may be necessary, although some allergy meds and steroid sprays may also help.

Chemical irritants

Certain compounds might irritate your nose and lead to congestion. Fragrances are a common culprit, especially in body or hair products that you put on or near your face. Not only can fragrances stuff up your nose, they can also cut off your sense of smell, which can in turn stuff up your nose even more. “You’re using more [product] because you’re not appreciating the smell, then all those chemicals are irritating the nasal cavities,” explains Dr. Liberatore.

If you think products could be contributing to your stuffy nose, look for fragrance-free options, including shampoos, soaps, detergents, and fabric softeners.

Stress

Stress and other strong emotions can cause changes in hormone levels that make the blood vessels in the nose get bigger, constricting your nose and making it harder to breathe. This is called vasomotor rhinitis or nonallergic rhinopathy and is similar to what happens to some pregnant women who get stuffed up. The best course of action is to identify the source of your stress and either eliminate it or find a healthy way to deal with it, like playing with your dog, getting some exercise, or taking a few minutes to meditate.

Other things that irritate the nose can also cause nonallergic rhinopathy, like dry air, air pollution, and spicy foods. Talk to your doctor about finding your trigger and the best course of treatment.

When to call your doctor about a stuffy nose

Treatments for a stuffy nose run the gamut, and most doctors start with the least invasive option before working their way up to more extensive measures. “I usually recommend to a patient with nasal stuffiness to start with a daily regimen of extra-salty (hypertonic) nasal saline rinse followed by two sprays in each nostril of a nasal steroid like Flonase, Nasonex, or Rhinocort,” says Dr. Thacker. You can also try over-the-counter antihistamines and keep that routine going for about four weeks. “If nasal congestion persists despite all of this, the patient should be seen by a doctor,” she says.

See a doctor sooner if your stuffy nose comes with thick, discolored mucus, an overall feeling of being unwell, fever, dental pain, or severe headache.

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