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Steroid nasal sprays are powerful anti-inflammatory medications used to treat the symptoms of allergies such as allergic rhinitis. They help relieve sneezing, nasal congestion, runny nose and other symptoms by decreasing inflammation and mucus production in the nose and sinuses. Steroid nasal sprays are also used to treat sinusitis, an inflammation of the mucous membranes lining the sinuses. Sinusitis can be caused by infection, allergies or irritants. In some cases, steroid nasal sprays may also be effective in treating nasal polyps.

Steroid nasal medications are not the same as anabolic steroids, the dangerous substances used by athletes to increase muscle. Rather, steroid drugs are synthetic substances modeled upon natural steroids (cortisone and hydrocortisone) produced by the adrenal glands. These glands are located on top of the kidneys, and by the ovaries in women and testes in men. Naturally produced steroids control many reactions and functions of the body, including:

• Stress of illness and injury
• Development of sexual characteristics
• Immune function
• Inflammation
• Metabolism
• Salt and water balance

Corticosteroids help control inflammation, although it is not known precisely how. Some theories suggest that they may deactivate a protein associated with inflammation, or they may alter the function of cell membranes.

Steroid nasal sprays are a controller medication, meaning they work to prevent symptoms of an allergic reaction before they start. Daily use of this medication should begin one to two weeks before the start of seasonal allergy symptoms. Patients with perennial allergies should use the medication daily throughout the year, even when symptoms have improved.

The frequency with which steroid nasal sprays are used also varies among those with sinusitis. Individuals with chronic sinusitis may require daily use of the spray, while those with occasional sinusitis may only need the drug from time-to-time.

While the effects of these medications can be apparent within several hours of first using the spray, it can be up to three weeks before their full effect is apparent.

A patient who has near-total obstruction of the nasal passages may need to take more powerful oral corticosteroids for a short time until congestion clears enough to allow a nasal spray to be effective.

Steroid nasal sprays have an excellent safety record when used correctly. Patients must closely adhere to a physician’s directions for using steroid sprays. Using more of the drug, or using the drug more often than recommended, greatly increases the risks of side effects. For this reason, steroid nasal sprays are only available by prescription.

It is also important for patients to continue use of the drug for the duration prescribed, regardless of whether symptoms are present. Discontinuing the drug prematurely can cause symptoms to return.