Steroid Nasal Sprays: The Effective Allergy Treatment You Might Not Be Using
Don’t fear the spray: It may be the best way to fight your seasonal allergies.

Given the option, many people might choose an oral pill over other forms of medications, like shots and sprays. It’s no surprise that many people with seasonal allergies choose oral antihistamines to minimize allergic reactions: Oral meds are mess-free and easily portable—and admittedly the least intimidating.
That said, you may be missing out if you’re choosing oral antihistamines and skipping the steroid nasal spray. “Nasal steroid sprays are probably the most effective treatment we have for seasonal allergies,” says Clifford Bassett, MD, allergist at NYU Langone Health. “They’re effective because they work on the nose symptoms: sneezing, runny nose, itchiness, as well as congestion and stuffiness.”
Oral meds for seasonal allergies work great at reducing itchiness and sneezing, but they’re not as effective at reducing congestion, according to a 2016 study in Advances in Dermatology and Allergology. If your nose starts to feel like a faucet as soon as spring hits, you already understand that congestion is arguably the most frustrating seasonal allergy symptom.
Nasal steroid sprays work so well because they “suppress allergic inflammation in your nose,” says Dr. Bassett. Less inflammation leads to less congestion, and less congestion can improve your overall quality of life. For example, severe nasal congestion can affect your quantity and quality of sleep, which may lead to that foggy feeling you have at work all spring long.
You can find a variety of OTC steroid nasal sprays for seasonal allergies at your drugstore, no prescription needed. “They’re quite safe,” says Dr. Bassett, “and studies and guidelines indicate they’re first-line treatment for people with bothersome seasonal allergies.”
But don’t just grab any nasal spray from the drugstore aisle: Decongestant sprays can help your runny nose, but they are not recommended for long-term use to treat seasonal allergies. Using a decongestant for too long can cause the nose to be chronically congested and reliant on the medication. “Decongestant nasal sprays can be used for a period of three to five days,” says Dr. Bassett. “After that, they create a condition called rebound congestion, or rhinitis medicamentosa.” Stick to nasal steroid sprays, which are approved for long-term use.
Medication is one way to treat seasonal allergies, but taking drugs work best in combination with certain lifestyle tweaks. Here are daily habits to reduce allergy symptoms.
Dr. Bassett is an allergist and clinical assistant professor of medicine at New York University School of Medicine and on the teaching faculty at Weill Cornell Medical College.
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Nasal steroid sprays are probably
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the most effective treatment we have for seasonal allergies.
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They're effective because they work on the nose symptoms,
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sneezing, runny nose, itchiness,
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as well as congestion and stuffiness,
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a very prominent and bothersome symptom.
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One thing antihistamines can't do,
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is they don't work on nasal congestion or stuffiness,
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and that's one of the most vexing and bothersome symptoms
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when you have allergies.
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In that we rely on other types of approaches,
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such as a nasal spray,
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called a nasal steroid spray,
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and they suppress allergic inflammation in your nose,
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and they're very helpful
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in reducing congestion, and stuffiness,
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one of the main symptoms we see.
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People have allergies and having bothersome symptoms.
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Nasal congestion also affects night-time sleeping,
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quality sleep and therefore
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people wake up during the season, they say they feel tired,
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they feel not alert, they're not learning,
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or perception is down,
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and that may be 'cause they're getting poor quality sleep
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from nasal obstruction.
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Nasal steroid sprays are largely available,
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and many of them over the counter.
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They're quite safe and studies and guidelines
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indicate they're first line treatment
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for people with bothersome seasonal allergies.
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Nasal corticosteroid sprays do not have a rebound effect
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like we see with over usage of nasal decongestant sprays.
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Decongestant nasal sprays can be used
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for a period of three to five days, after that
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they create a condition called, rebound congestion,
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or rhinitis medicamentosa which is the medical term.
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It causes a cascade of mucus and secretions
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like Niagara Falls taking over your nasal lining,
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and that can cause worse symptoms than the beginning.
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So you wanna avoid using nasal decongestant sprays
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more than three to five days continuously.
Kuna P, Jurkiewicz D, Czarnecka-Operacz MM, Pawliczak R, Woron J, Moniuszko M, Emeryk A. the role and choice criteria of antihistamines in allergy management--expert opinion. Postepy Dermatol Alergol. 2016 Dec;33(6):397-410.
Patient education: allergic rhinitis (seasonal allergies) (beyond the basics). UpToDate. (Accessed on January 20, 2021 at https://www.uptodate.com/contents/allergic-rhinitis-seasonal-allergies-beyond-the-basics#H15.)
Seasonal allergies. Arlington Heights, IL: American College of Allergy, Asthma, & Immunology. (Accessed on January 20, 2021 at https://acaai.org/allergies/seasonal-allergies.)