A nasal rinse is a common practice to clear nasal passages, especially during cold, flu, and allergy seasons. It helps remove mucus, debris, and allergens that build in the nose.
“A saltwater rinse is basically brushing your teeth for your nose,” explains Kristine Smith, MD, assistant professor of Otolaryngology – Head and Neck Surgery at University of Utah Health. “It’s flushing out all the junk that we breathe in during the day.”
As we breathe, debris collects on the lining of the nose and on mucus, which can cause irritation or inflammation. This can make nasal and sinus symptoms worse.
Can anyone do a nasal rinse?
Nasal rinsing is recommended for nearly everyone but can be most beneficial for people with nasal or sinus inflammation, such as:
- Allergic rhinitis: Allergies caused by inflammation in the nose.
- Non-allergic rhinitis: Inflammation in the nose caused by particulate matter or other irritants in the air.
- Chronic rhinosinusitis: Also known as “asthma in the nose,” sinuses in the nose become inflamed and swollen for at least 12 weeks.
- Acute inflammation and infections: Sinus or viral respiratory tract infection causes head congestion, stuffiness, and drainage.
“In patients who are having a longstanding problem, like allergic rhinitis or asthma in the nose, we usually want to check in about six to eight weeks to see if they’re starting to have improvement,” Smith says. “It usually takes these patients a lot longer to get better.”
Is nasal rinsing safe?
Nasal rinsing is safe when you follow the recommended instructions. This means using distilled water (purchased at the store) or sterile water (boiled and cooled tap water) and adding premixed nasal rinse salt packets. A 0.1 micrometer water filter can also be safely used.
Using water straight from the tap can cause potential issues down the road. Tap water is not very clean; it contains various minerals and particulates that our noses don’t like.
“In Utah, some of our tap water has increased counts of bacteria that are fine for the stomach but not great for the nose,” Smith says. “It could potentially increase the risk of a sinus infection.”
Additionally, tap water can be contaminated by free-living amoeba, which can be acquired in the nostrils. A rare but serious infection called Acanthamoeba has been linked to 10 people who used tap water for nasal rinsing between 1994-2022. According to the Centers for Disease Control and Infection (CDC), all patients were immunocompromised.
“Using tap water for nasal rinses is more risky because it provides a direct pathway for the Acanthamoeba to enter your system,” explains Shreya Sreekantaswamy, MD, a dermatology resident at University of Utah Health. “While your stomach is built to handle these bugs when you drink tap water, your nose isn’t.
Infection with Acanthamoeba can present in different ways, including affecting the eye (keratitis), the brain, or causing bumps or ulcers on the skin.
TIP: If you feel irritation or a burning sensation while performing a nasal rinse, your nose might be too dry or raw. Smith advises her patients to take a break to let the nose heal.
When should you not nasal rinse?
While most people can benefit from a nasal rinse, it won’t work if you have severe inflammation in your nose blocking the nasal passages. Smith suggests using a decongestant spray for no more than three days in a row to help shrink the swelling down, to open the nasal passages and make it easier to perform a nasal rinse.
Additionally, talk to your doctor if you:
- Recently had surgery involving your nose
- Experienced recent trauma that impacted the nose
- Notice fluid in your ears while doing nasal rinses
If you do not have access to clean water, nasal rinsing is not recommended.
Nearly 12% people in the U.S. are affected by sinus or nasal inflammation. If you’re looking for relief, talk to your doctor about nasal rinsing and other available treatments.
“Saltwater rinses are very safe and effective,” Smith says. “They’re absolutely a cornerstone of my practice to get people feeling better.”
