If your nose is congested or runny because of hay fever or allergy, an allergy nasal spray will often ease the problems. There are many different types of nasal sprays to choose from depending on what symptoms are bothering you the most, and on how your daily life is affected. Some nasal sprays are available over-the-counter in pharmacies. They will often help if the allergy problems are temporary and mild. If the symptoms are more severe, an over-the-counter spray may not be sufficient, and if that is the case you should contact your doctor in order to receive a more effective treatment. It is important that you tell your doctor how your symptoms are affecting you, what medicines you have tried and how well they worked, so that you can find another option. The target is for you to become completely free of symptoms, so that your allergy will not affect the quality of your life.
When you are allergic the immune system is overreacting, releasing histamine and other inflammatory substances, as you come into contact with, for example, pollen or pets. Antihistamines block the effect of the histamine, and inhibit the allergic reaction. Nasal spray with antihistamine works rapidly and is usually good for easing temporary and mild problems. It mainly affects symptoms such as sneezing, an itchy or runny nose. Its effect on nasal congestion is, however, poor. There are several nasal sprays with antihistamine available over-the-counter in pharmacies, but they can also be prescribed. Antihistamine treatment is also available as eye drops and tablets.
Not everyone is helped by over-the-counter histamine spray. In such cases nasal spray that combines antihistamine and corticosteroids may be an option. A combination spray does not just inhibit the histamine provoked allergic reaction, but also counteracts the actual inflammation in the nose. Nasal spray containing both antihistamine and corticosteroids has to be prescribed by a doctor and is effective in treating nasal congestion, runny nose, sneezing, itchy nose, as well as red, watery and itchy eyes.
Nasal spray with chromones is used to alleviate mild and temporary nose problems. It is not known exactly how the chromones work, but they are probably stopping some cells in the mucous membrane of the nose from releasing histamine and other inflammation provoking substances. In this way the reaction is suppressed. It takes several days for the chromones to reach full effect, so it is important to start the treatment as soon as possible. Chromones are also found as eye drops, and as a dry powder or liquid for asthma treatments.
Corticosteroid (nasal steroid)
Nasal spray with corticosteroids inhibits the swelling of the mucous membrane in the nose, which decreases nasal congestion. It also stops the inflammation of the nasal mucous membrane from spreading. It might take a few days, sometimes weeks, until full effect of the corticosteroids spray is reached. So if you have hay fever you should start the treatment a week or so before the trees start blooming, which may be difficult to remember sometimes. Corticosteroid spray is available over-the-counter in pharmacies, but also by prescription from a doctor.
If you are suffering from more severe symptoms, an over-the-counter nasal spray might not be sufficient. In that case you should talk to your doctor about trying out something more effective. There is, among other things, a prescribed nasal spray that contains both antihistamine and corticosteroid. A benefit of the combination nasal spray, apart from effective symptom treatment, is that it works within 15 minutes - that is significantly faster than nasal spray that contains only corticosteroid.
If you know that your runny or congested nose is caused by hay fever or an allergy, you should avoid using decongestant nasal sprays which only decrease nasal swelling by contracting blood vessels. Decongestant nasal sprays which only affect blood vessels do not have an effect on the allergic mechanism. If you use them for too long, your nose might even lose the ability to contract the blood vessels on its own, which will then result in the opposite effect. This can lead into a vicious circle that might make you "addicted" to nasal spray. If you have suffered from your symptoms for a long time and you are not sure of the cause, you should contact a doctor, for a full examination.
UK/GEN/15/0057e Date of preparation: December 2015
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