Winter brings many reasons to reach for a nasal spray, from seasonal viruses and allergies to dry nasal passages. However, health professionals are urging people not to overuse them, as they can cause unwanted side effects.
We explain how long you should use nasal sprays for, the potential downsides of overuse, and why it’s important to take care while using them.
What causes nasal congestion?
Nasal congestion occurs when your nasal passages become blocked or ‘bunged up’ due to swollen blood vessels and inflamed tissues inside your nose. It’s often accompanied by excess mucus during a cold or flu.
Triggers include viral infections, environmental dryness, structural obstructions – for example, nasal polyps – and allergic reactions such as hay fever or allergic rhinitis.
There are various over-the-counter treatments available to help manage nasal congestion, depending on the underlying cause. If your condition does not require treatment from a health professional, it will usually clear up on its own. In these cases, treatment focuses on managing your symptoms until the condition passes.
One of the most widely used options for relieving nasal congestion is decongestant drops and sprays.
In the UK, pharmacy-bought nasal decongestants include xylometazoline, oxymetazoline, and ephedrine. These treatments work by narrowing swollen blood vessels in your nasal passages, helping to quickly reduce congestion and make it easier to breathe.
MHRA introduces a five-day limit for some nasal sprays
Previously, it was recommended that these nasal decongestants be taken for no more than seven days. However, the Medicines and Healthcare products Regulatory Agency (MHRA) has since issued updated safety advice regarding their use.
The MHRA now advises that nasal sprays and drops containing xylometazoline or oxymetazoline should not be used for more than five consecutive days. This is because prolonged use can lead to rebound congestion and cause symptoms to worsen.
What happens if you overuse nasal decongestant sprays?
We are now entering the first cold and flu season under the new MHRA guidelines, so it’s important to be mindful of how often you use these medicines.
Mr Samit Unadkat, a London-based ENT surgeon, warns that overusing nasal sprays can leave you feeling more congested rather than less. In rare cases, prolonged overuse can also cause lasting damage to the lining of your nose.
He explains that because these sprays are so effective and fast-acting, often providing relief within minutes, it is easy to become reliant on them. However, with repeated use, your nasal tissues can become less responsive to the treatment.
As the effects of each dose wear off, the lining of your nose can swell even more than before, creating a vicious cycle of increasing congestion, more frequent spray use, and, ultimately, even more blockage.
“This is called rhinitis medicamentosa – commonly known as rebound congestion,” says Unadkat. “It is not an addiction in the same way as nicotine or opioids, but people can develop a powerful physical and psychological reliance on the bottle.”
The potential side effects of overusing nasal sprays
When used sensibly and only for a few days, decongestant sprays are generally safe and effective. However, Unadkat warns that using them well beyond the recommended five-day limit can increase your chance of side effects and complications.
A more detailed list of these can include:
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Rebound congestion– your nose becomes more blocked as each dose wears off, encouraging repeated use and creating a self-reinforcing cycle.
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Reliance on the spray– some people may find themselves keeping a bottle by the bed, in the car, or in every coat pocket so it is always within reach.
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A dry, raw, and fragile nasal lining– this can cause burning, crusting, and recurrent nosebleeds.
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A reduced or temporarily lost sense of smell– prolonged use can affect your ability to smell normally.
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Septal perforation in rare cases– prolonged misuse can potentially cause a permanent hole in your septum, the wall that separates the two sides of your nose.
Unadkat concludes that most cases settle once you stop using the spray. At this point, the underlying cause of the congestion – such as an allergy, lingering infection, or structural issue such as a de
He adds that saline rinses and, where appropriate, a steroid nasal spray may be a better long-term option than repeatedly reaching for a decongestant.
“Used correctly, decongestants are safe and effective,” he says. “The rule is simple – five days, then stop. If your nose is still blocked, the spray may no longer be treating the issue. It may have become part of it.”
Article history
The information on this page is peer reviewed by qualified clinicians.
Article also available inEnglish,German,Spanish,French,Italian,Portuguese,Hindi,Hebrew,Arabic, andSwedish.
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Next review due: 12 Oct 2029
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12 Oct 2026 | Originally published
Victoria Raw
Dr Colin Tidy, MRCGP
Disclaimer: The views expressed in the community do not represent medical advice. For any health concerns, consult your GP or healthcare provider.
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