Steroid nasal sprays

8th February, 2022 • 10 min read

What are steroid nasal sprays?

Steroid nasal sprays, also called corticosteroid nasal sprays, are

steroid medicines
that you spray into your nose.

There are a few different types of steroid medication, such as inhalers, tablets, creams and injections. Nasal sprays help you target congestion and stuffiness from allergies such as hay fever (known as allergic rhinitis) or other inflammation from, say, a cold (this general inflammation is called

rhinitis
).

Natural steroids are hormones found in your body. The steroids you’re given by a doctor are man-made versions of these hormones.

Read on to discover which conditions steroid nasal sprays treat, how long they work for and their possible side effects.

Natural steroids are hormones found in your body. The steroids you’re given by a doctor are man-made versions of these hormones.

Read on to discover which conditions steroid nasal sprays treat, how long they work for and their possible side effects.

Which conditions do steroid nasal sprays treat?

Steroids
are anti-inflammatory medicines. Steroid nasal sprays can help treat a range of conditions, including:

Which conditions do steroid nasal sprays not treat?

Steroid nasal sprays are known as

topical steroids
, as are
steroid creams
. They’re absorbed into the area where they’re applied. This means they can only reduce inflammation and swelling in that problem spot, such as in the nose or on the skin. They can’t treat any inflammation in other areas of the body – for example:

For these conditions, you would be prescribed

steroid injections
or
steroid tablets
– they’re known as ‘systemic’ steroids, and they can be used to treat inflammation throughout the body.

What are the different types of steroid nasal sprays?

Some steroid nasal sprays can be bought from a pharmacy without a prescription, while others need to be prescribed by your doctor.

The most common types of steroid nasal sprays include:

  • beclometasone
  • budesonide
  • fluticasone
  • mometasone

Whether you need a prescription from your doctor can depend both on the type of spray and the condition you need treatment for.

How to get the best results from your steroid nasal spray

If you buy a steroid nasal spray without a prescription, discuss its use with a pharmacist. If you’ve been using it for more than 1 month and your symptoms haven’t improved, then speak to a doctor.

If you've been given a prescription spray, use it exactly as your doctor has advised. Don’t stop using it without speaking with your doctor – some steroids need to be gradually reduced in dose, if you’ve been taking them for a longer period of time. This can help prevent side effects.

How do you use a steroid nasal spray?

You should always read the instructions on the packaging before using your steroid nasal spray. But following these steps may help you get better results as the spray won’t drip down the back of your throat and get wasted:

  1. Remove the cap and gently shake the bottle.
  2. Blow your nose gently, then close 1 nostril with your finger.
  3. Bend your head forward slightly, then carefully put the nozzle into your other nostril.
  4. Slowly breathe in through your nose and press down with your fingers on the widest part of the nozzle to squirt the spray once into your nostril.
  5. Breathe out through your mouth.
  6. If prescribed or needed, follow steps 3 and 4 again to squirt a second spray into the same nostril.
  7. Repeat the process with the other nostril, if needed.

After use, wipe the nozzle and replace the cap.

How long do steroid nasal sprays take to work and how long do they last?

  • Steroid nasal sprays work differently depending on your condition. You might be advised to use a spray at times when you need it to reduce symptoms, or you may need to use it as a long-term treatment. For example, if you have allergic rhinitis, you may need to use a steroid nasal spray only during the summer months. But if you have non-allergic rhinitis or polyps you might need to use them for more than a few weeks. Even after your symptoms have cleared, taking it regularly may stop them coming back
  • Your dose might change over time. At first, your doctor or pharmacist might recommend the best dose to help control your symptoms. Once your symptoms improve, you may be advised to reduce your dose gradually until you end up on the lowest possible dose
  • Steroid nasal sprays take a few days to start working. You might need to use them for a week or two to notice their full benefit. For hay fever, it may mean you benefit from using a spray for 1 to 2 weeks before the hay fever season begins. That means you might use the spray for a few months in all
  • How often you use your steroid nasal spray depends on the type of steroid. For fluticasone, for example, the dose is usually 1 or 2 sprays in each nostril, twice a day (morning and evening), but your doctor may suggest a different dose. Other forms of steroid nasal spray should only be taken once a day. Check the recommended dose with your doctor if you aren’t sure

What are the common side effects of steroid nasal sprays?

Steroid nasal sprays are proven to be safe and effective if you use them as your doctor or pharmacist advises.

Like all medications, steroid nasal sprays can cause side effects, though they are usually mild and go away after a few days. This is because they’re applied directly to the nose, so very little medicine is absorbed into your body.

The most common side effects affect around 1 in 10 people and include:

  • dryness in your nose or throat
  • an unpleasant taste in your mouth
  • a stinging or burning feeling in your nose
  • itching, redness or swelling in your nose
  • crusting and bleeding in your nose, including nosebleeds

Remember most people – up to 9 out of 10 – won’t get any of these side effects.

How to reduce the chance of steroid nasal spray side effects

There are also some things you can do to reduce the chances of side effects.

  • To prevent nosebleeds, make sure you angle the inhaler nozzle away from the middle of your nose
  • If you’re experiencing nose irritation, talk to your doctor about changing to another spray or to a different brand in case are intolerant to one of the ingredients

Rare side effects from long-term use of steroid nasal sprays

If you use a nasal spray for a long time at a high dose, it’s possible to get other side effects, including mood changes and problems with your sleep. In children, there have been a few rare reports of growth problems, as well as behaviour changes like hyperactivity and anxiety. However, many people, including children, do need to take steroid nasal sprays long term, even for years, to help treat conditions like chronic rhinitis. Most people use nasal sprays in this way without any problems. In fact, these rare side effects affect less than 1 in 1000 people.

If you're prescribed a nasal spray for more than a few months, then speak to your doctor about any possible side effects. They'll be able to discuss any concerns you may have. It's also important to keep reviewing your medication to ensure it's always to most appropriate treatment for you and your symptoms.

Before you use steroid nasal sprays, speak to a doctor or a pharmacist if:

  • you have ever had an allergic reaction to steroids
  • you have recently had surgery on your nose
  • you have
    tuberculosis (TB)
    or an infection in your nose
  • you’re having, or have recently had, treatment with steroid tablets or steroid injections into your blood
  • you’re looking for a nasal spray for your child (some nasal sprays aren’t suitable for children)
  • you’re pregnant, breastfeeding or trying for a baby

When to see a doctor if you’ve used steroid nasal sprays

Serious side effects are rare. They’re more likely if you’re using a strong steroid nasal spray, or if you’ve been using it for a long time.

However, you should call an ambulance or go to an emergency department if you have serious side effects, or notice any signs of

anaphylaxis
, a serious allergic reaction.

You should see a doctor as soon as possible if:

  • your symptoms don’t get better, get worse or come back after treatment
  • you get symptoms you didn’t expect, you feel generally unwell or you’re worried about your symptoms
  • you have problems with your breathing
  • you notice damage to your nose or sores inside your nose
  • you notice changes in your eyesight, such as blurred vision or a cloudy lens in the eye – these may be signs of
    glaucoma
    or a
    cataract

In rare cases, high doses of nasal steroids can also cause side effects similar to those of oral steroids. You should see a doctor if you think you have any of

these side effects
.

Your health questions answered

What’s the best steroid nasal spray?

Answered by:

Healthily's medical team

“This depends on your symptoms and condition. A doctor or a pharmacist can help you find the right steroid nasal spray and dose for you. The different types available vary a bit in how they’re used, but there’s very little difference in their effectiveness. They include beclomethasone, flunisolide, budesonide, fluticasone propionate, mometasone furoate, fluticasone furoate, and ciclesonide.”

How do you use a steroid nasal spray?

Answered by:

Healthily's medical team

“You should always read the instructions on the packaging before using your steroid nasal spray. But following the steps may help:

  1. Remove the cap and gently shake the bottle.
  2. Blow your nose gently, then close 1 nostril with your finger.
  3. Bend your head forward slightly, then carefully put the nozzle into your other nostril.
  4. Slowly breathe in through your nose and press down with your fingers on the widest part of the nozzle to squirt the spray once into your nostril.
  5. Breathe out through your mouth.
  6. If prescribed or needed, follow steps 3 and 4 again to squirt a second spray into the same nostril.
  7. Repeat the process with the other nostril, if needed.

After use, wipe the nozzle and replace the cap.”

Key takeaways

  • steroid nasal sprays are used in the nose and can reduce inflammation, congestion and swelling, and are often used to treat hay fever (allergic rhinitis) and other types of rhinitis
  • there are a few different types of steroid nasal sprays, including beclometasone, budesonide, fluticasone and mometasone
  • most people don’t get any side effects from steroid nasal sprays, but any side effects are usually mild and go away after a few days
  • you can use some steroid nasal sprays as and when you need them, while others may be needed over longer periods
  • you can buy some steroid nasal sprays without a prescription from the pharmacy, but others will need to be prescribed by your doctor

Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.