My nose usually stuffed only on one side, when a side clears up, the other side becomes stuffed. Any suggestions?

Question

My nose has always been stuffy. I have had this condition since I was a small child needed braces because I needed to breathe through my mouth. I have tried using a Netipot, which helped for 5 minutes, then one side got stuffy again. I had a cold recently and used Zicam Extreme Congestion Relief spray, which completely cured my stuffy nose. Although I hated using it because I lost my sense of smell and taste for 12 hours, it was the first time (that I could remember) where I was able to actually breathe wholly through my nose.

Robert S. Schmidt, MD · Answer

It sounds like your septum is not the issue. Instead, you probably have inflammation of the turbinates. Turbinates are like radiators for the nose. They sit along the side walls of the nose and humidify and filter out the air before it goes to your lungs. Prescription nasal medications sprays are the first line treatment for this. Frequently patients with your problem also have narrowing of the sinus passages which may need to be addressed to get full relief. The nose spray you tried certainly works well, but if you use it on an ongoing basis, your nose will become dependent on it. I would visit with a local ear, nose, and throat doctor to get a proper evaluation.

William Portuese, MD · Answer

There are many reasons  patients have difficulty breathing out of their nose which include allergies, turbinate hypertrophy, deviated septum, chronic sinusitis and valve collapse. Each one of these is treated differently with either medications or surgery. An internal examination of your nose by an ENT/ facial plastic surgeon is in order to  figure out the cause of the obstruction.

Sachin S. Pawar, MD · Answer

Based on your description of your stuffy nose symptoms, it sounds like you may have underlying inflammation or swelling of the nasal mucosa, which is the tissue that lines the inside of the nose and sinuses. The Zicam spray that you used contains oxymetazoline, a potent decongestant which is also the same active ingredient in Afrin. Your response to the spray suggests that you have swelling of your nasal mucosa which is obstructing your breathing and giving you a stuffy nose. Unfortunately, use of this spray for more than 3 days consecutively can lead to significant rebound congestion, and therefore cannot be used for prolonged periods of time.One of the most common reasons for swelling of the nasal mucosa is allergic rhinitis. The mainstay of treatment for this condition are intranasal steroid sprays such as fluticasone (Flonase) or mometasone (Nasonex). Nasal steroid sprays act at the cellular level to decrease inflammation and swelling in the sinonasal mucosa and are very well tolerated and safe to use on a long term basis, unlike sprays containing oxymetazoline. There are also other non-allergic causes for rhinitis as well.Another contributing factor may be what is known as the "nasal cycle". This is a normal physiologic process where one side of the nose, particularly the nasal turbinates, will swell and shrink, the the process alternating sides over roughly a 4 hour period.I would recommend seeking out evaluation with a local ear, nose, and throat specialist (otolaryngologist) who can evaluate you and make treatment recommendations. Good luck!

Michael Elam, MD (retired) · Answer

Dear dvit123, There are multiple possible causes for a patient to have difficulty breathing and an examination would be needed to begin this process. Difficulty breathing may be caused due to deviated septum, hypertrophy of the nasal turbinates, allergies, sinusitis, etc.. An in person direct examination will begin to determine the problem and then after diagnosis a plan can be made to help you on the road to better breathing. Best regards, Michael V. Elam, M.D.

My nose usually stuffed only on one side, when a side clears up, the other side becomes stuffed. Any suggestions?

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