Struggling with a blocked-up nose or stuffy feeling in the head?
It’s that time of year, but while the temptation is to keep blowing your nose, it probably won’t help.
A blocked nose from a common cold is caused not by mucus, but by swelling and inflammation of the blood vessels in the nasal airways, triggered by the infection, explains Dr Ayham Al-Ayoubi, an Ear, Nose and Throat (ENT) surgeon at Chase Farm Hospital, London.
Not only will blowing not work, studies show that forceful nose blowing can propel some infection-laden mucus into the sinuses, where secondary bacterial infections may take hold.
So if you must blow your nose, it’s best to blow gently, one nostril at a time.
And don’t bother inhaling the steam from a bowl of recently boiled water because that won’t help unblock your nose either.
But what about an over-the-counter remedy?
Decongestants — in the form of tablets or medicated nasal sprays — contain different chemicals that work as vaso-constrictors.
These narrow the small blood vessels in the nose, so reducing blood flow, which brings down the swelling and helps to open up the nasal airway so you can breathe more easily.
However, such decongestants should be avoided by people with heart disease, high blood pressure, glaucoma or diabetes.
That’s because the vaso-constricting drugs also work as stimulants, raising the heart rate and blood pressure.
These problems are more common with oral tablets which provide a higher dose to the bloodstream than sprays because, if used properly, sprays should be limited to the vessels in your nose.
Yet despite this, sprays are actually four to five times more effective than tablets as they are applied right at the source of the congestion, says Professor Ron Eccles, director of the common cold centre at Cardiff University.
A spray is also unlikely to cause side-effects since the amount of medicine absorbed into the bloodstream from the nose is fairly limited.
Sometimes a spray can cause more sneezing and a dry mouth or throat; tablets can cause raised heart rate and dizziness in some people.
Because of their stimulant effect, these products may well disturb your sleep, says Nicholas Eynon-Lewis, a consultant ENT surgeon at the London Nose Clinic.
So if you do take an oral decongestant, it is better to do so during the day. This is not such a concern with the sprays.
Don’t use decongestants for more than a week, or you could end up with more severe congestion — rhinitis medicamentosa.
Normally, the spray shrinks the tissue. But overuse of the drug causes the tissue to swell rather than shrink, making a blocked nose even worse.
And as the tissue swells, the medication stops working.
Dr Ayham Al-Ayoubi adds that you should also limit use of sprays to no more than three times a day.
Any kind of spray will only be effective if used properly, says Henry Sharpe, a consultant ENT surgeon at East Kent Hospital.
‘They need to go into the nose, rather than ending up down your throat, if you want them to work.
'To do this, kneel on the floor with your head on the ground or lean over the edge of a table or chair so that your head is forward. Don’t use them sitting up.’
‘Once the drops are in your nose, stay in this position for a minute or two to let the drops work their way up to the top of the nose between the eyes.’
We asked Dr Ayham Al-Ayoubi to give a verdict on the most useful over-the-counter remedies...
Otrivine Adult Nasal Decongestant Spray
An effective nasal decongestant, the active ingredient is xylometazoline, which reduces nasal congestion quickly by narrowing the small blood vessels in the nose (vaso-constriction).
This, in turn, reduces blood flow, which brings down the swelling and helps to open up the nasal airway so you can breathe more easily.
The main disadvantage is that there is the risk of rebound congestion if you use a spray like this for more than ten days.
To view Dr Ayoubi in the media click here.