Which is the best nasal spray?

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Which is the best nasal spray?

Healthylife Pharmacy24 May 2022|3 min read

Looking for the best nasal spray for your needs? Nasal sprays may help reduce nasal symptoms associated with allergies, nasal polyps and viral infections. Nasal sprays are commonly available with active ingredients under the categories of decongestant, antihistamine, steroids and saline. 

These can work to reduce symptoms of congestion, excess mucus production and sneezing, for example. Some nasal sprays have also been developed to work as preventatives of the common cold virus. 

Whether you’re looking for a nasal spray for a blocked nose or a hayfever nasal spray, we’ve got you covered.

Common culprits causing nasal symptoms

Allergic rhinitis

Allergic rhinitis is a common non-infectious form of rhinitis (nasal inflammation) due to an allergic response by the body to a perceived allergen. It results in nasal congestion, frequent sneezing, runny nose, post nasal drip, itchy eyes, ears, nose and throat; red, itchy or watery eyes, and headaches. The treatment prescribed is commonly medication for allergies and nasal sprays. These can address the allergic reaction and reduce the inflammatory response.

The common cold

The common cold virus causes symptoms of a runny nose, nasal congestion and frequent sneezing.

Nasal polyps

Nasal polyps are benign growths in the nasal passages. They are the result of inflammation from conditions such as allergic rhinitis, asthma or chronic sinusitis. Symptoms include nasal congestion or sensation of nose being blocked, runny nose and post-nasal drip. The best nasal sprays for sinusitis are often steroid nasal sprays which are often prescribed to reduce polyp size and symptoms

Different types of nasal sprays?

Antihistamines

Antihistamines block the action of histamine, which is released in response to allergens or an irritant. Symptoms include swelling and irritation in the nasal passages. Antihistamines can reduce mucous secretions, reduce sneezing, runny nose and itchy eyes.

What is histamine? 

Histamine is a compound found in the skin, intestinal mucosa, heart, lung, and nerve endings in the brain. It is involved in local immune responses, regulating physiological responses and acts as a neurotransmitter in the brain. In regard to allergens, histamine is released in response to a perceived allergen.  

It starts the process of removal of the allergen from the body – thus the symptoms of sneezing, runny nose, watery eyes and itchy skin. Common non-threats perceived as dangerous (allergens) by the body include pollen, animal dander and dust mites. Histamine is also found in foods, and for some people who are sensitive, eating too many foods containing histamine can result in gastrointestinal and other reactions.

Histamine intolerance. Symptoms of histamine intolerance include rhinorrhoea, rhinitis, nasal congestion, sneezing and dyspnoea, gastrointestinal symptoms and  other various symptoms. Unlike allergies, histamine intolerance is considered due to the intake of histamine and a deficiency of the enzyme diamine oxidase (DAO), in the intestines. DAO is involved in protecting the body against histamine, either from ingested food or generated by the intestinal microbiota. Diagnosing histamine intolerance is usually established after other possible causes have been ruled out. This includes allergic reactions/symptoms.

Steroids

Corticosteroids help reduce nasal swelling and are often suggested for chronic congestion related to allergies and irritants. Correct use of nasal sprays is needed to ensure adequate medication uptake.

Decongestant

Decongestants work by reducing swelling of blood vessels inside nasal passages and provide relief for nasal congestion. Decongestants are often suggested for use in short-term disorders such as colds and flu. They are only recommended for short-term use due to possible rebound effects.

What are rebound effects? Rebound effects or rebound congestion is inflammation of the nasal mucosa due to the overuse of topical nasal decongestants. Medically it is referred to as Rhinitis medicamentosa (RM) (drug-induced rhinitis). RM will often resolve on discontinuation of the topical decongestant.

Saline

The mucus layer covering nasal tissues needs to remain moist to enable it to trap and prevent inhaled viruses, bacteria and irritants from reaching the lungs. Airborne pathogens (viruses and bacteria) and irritants, such as dust and pollen, are removed through swallowing and destroyed by acid in the stomach. Saline can thin excess nasal mucus, flushing away inhaled airborne irritants, reducing pathogenic load and reducing congestion. Saline also helps keep nasal passages moist.

Saline nasal sprays are non-medicated - containing just saline (salt water). Some may contain preservatives which can be irritating on nasal passages. 

Preventative measures

Some nasal spray ingredients create a physical barrier capable of blocking virus uptake. These passive barriers are generated via semi-synthetic or natural gelling agents such as hydroxypropyl methylcellulose (HPMC) or carrageenan. 

Carragelose

Carragelose is a natural ingredient sourced from red seaweed. When applied to the nasal passages, carragelose forms a natural moisturising gel barrier that traps viruses causing the common cold, allowing the body's own defences to remove them from the body. Best used at the first sign of infection. Its moisturising ability helps keep the mucus membranes of the nasal passages moist for long-term benefits. 

Hydroxypropylmethylcellulose

Hydroxypropylmethylcellulose (pHPMC) is a powdered nasal spray that forms a protective gel against airborne allergens. It has been proven an effective barrier for people suffering from rhinitis, shown to reduce symptoms and works with medicated nasal sprays to enhance their effectiveness. It is also being studied as a possible viral preventative. 

Herbal and nutritional medicines

Oral intake of immune-supporting herbal and nutritional medicines may be used alongside nasal sprays for symptoms of allergies and upper respiratory infection. Suggestions include:

Natural antihistamines

  • Quercetin has antihistamine, anti-allergic and antioxidant properties. Quercetin reduces the release of histamine, down-regulating the immune response.
  • Vitamin C may help to reduce symptoms of the common cold and may have an antihistamine effect in high doses.
  • Chamomile (matricaria recutita) can be helpful for allergic disorders and inflammatory-mediated diseases. It offers potent anti-allergic activity by inhibiting histamine release from mast cells.
  • Albizia (Albizia lebbeck) inhibits histamine signalling, preventing allergic reactions.
  • Ginger (Zingiber officinale) can help in the prevention or alleviation of allergic rhinitis symptoms.
  • Turmeric offers anti-inflammatory, antiallergic and inhibitory effects on histamine release from mast cells.

Probiotic bacteria have been shown to both reduce symptoms of allergy and also reduce the allergic response.

  • Lactobacillus rhamnosus (particularly GG) - stabilise mast cells and reduce the sensitivity of allergy-associated receptors.
  • Bifidobacterium longum is a histamine degrading probiotic.
  • Bifidobacterium lactis – helps break down histamine and tyramine.
  • Lactobacillus plantarum – helps break down biogenic amines, including histamine and tyramine.

Related reads:

References

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