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Steroid Spray Side effects for Sinusitis

Updated: Apr 16

Steroidal nasal sprays, also known as intranasal corticosteroids, are commonly prescribed medications for the treatment of Sinusitis and other nasal conditions. While touted as generally  ‘safe and effective’ when used as directed, they do carry concerning side-effects and warnings. 

Steroid Spray Side Effects
Nose Anatomy

Here's what you need to know:

Side Effects of Steroidal Nasal Sprays:

  • Nasal Irritation: Some individuals may experience mild irritation or discomfort in the nasal passages, including stinging or burning sensations.

  • Nosebleeds: Steroidal nasal sprays can sometimes cause nasal dryness or irritation, leading to occasional nosebleeds. If nosebleeds occur frequently or are severe, consult with a healthcare professional.

  • Throat Irritation: Some individuals may experience irritation or soreness in the throat after using a steroidal nasal spray. Gargling with water after each use can help alleviate this symptom.

  • Headache: Headaches are a possible side effect of steroidal nasal sprays, although they are relatively uncommon. If headaches persist or worsen, consult with a healthcare professional.

  • Alterations in Taste or Smell: In rare cases, steroidal nasal sprays may cause temporary changes in taste or smell perception. These changes are usually mild and resolve once treatment is discontinued.

  • Nasal Septum Perforation: Prolonged or excessive use of steroidal nasal sprays may increase the risk of nasal septum perforation, a rare but serious complication characterized by a hole in the nasal septum.

  • Allergic Reactions: Although rare, some individuals may experience allergic reactions to the ingredients in steroidal nasal sprays. Symptoms of an allergic reaction may include itching, swelling, rash, or difficulty breathing. Seek immediate medical attention if you experience any signs of an allergic reaction.

Warnings and Precautions:

  • Abrupt Discontinuation Avoid to prevent worsening of condition: Do not abruptly stop using the steroidal nasal spray without consulting with a healthcare professional, as this can lead to a rebound effect, causing worsening of symptoms.

  • Worsening Signs of Infection: Steroidal nasal sprays can suppress the immune system in the nasal passages, increasing the risk of nasal or sinus infections. Monitor for signs of infection, such as fever, facial pain, or discolored nasal discharge, and consult with a healthcare professional if symptoms occur.

Nasal steroid sprays should be used as a temporary measure - as they may cause body-wide side effects, including

  • Eye conditions (Cataracts)

  • Irregular menstrual cycles

  • Hormonal disruption (HPA)

These are stated by the product manufacturers as side effect warnings from prolonged use - however it indicates that these products are significantly toxic for the body from the beginning of use, to eventually accumulate and cause such significantly harmful side effects.

Growth and Behavior in Children

There are concerns now arising regarding their prolonged use and potential effects on growth and behavior.

  • Growth: Nasal steroid spray usage may affect a child's vertical growth, particularly with prolonged use. Some studies suggest a slowdown in growth, but long-term effects remain unclear.

  • Behavior: There are concerns about hyperactivity, irritability, or behavioral issues in children using nasal steroid sprays regularly, though research results vary.

Parents and healthcare providers should remain vigilant for any changes in a child's growth or behavior while using nasal steroid sprays.

Recap: Prolonged use of steroid nasal sprays may influence a child's growth and behavior, emphasizing the importance of monitoring by parents and healthcare providers.

Although steroidal nasal sprays are not addictive in the same way that some other medications, such as opioids or benzodiazepines, can be there are certain considerations regarding their use that may warrant caution and open discussion:

  • Tolerance: With prolonged use of steroidal nasal sprays, some individuals may develop a tolerance to the medication. This means that over time, the effectiveness of the spray in reducing symptoms of sinusitis or nasal congestion may likely decrease. In such cases, a healthcare professional may recommend alternative treatments or adjustments to the dosage.

  • Rebound Effect: Abrupt discontinuation of steroidal nasal sprays can lead to a rebound effect, where nasal congestion and other symptoms worsen temporarily after stopping the medication. This is not addiction in the traditional sense, but rather a physiological response to the sudden removal of the medication.  To avoid this, it's important to follow the tapering instructions provided by a healthcare professional when discontinuing the nasal spray.

  • Dependency: While steroidal nasal sprays are not addictive in the same way as drugs that cause physical dependence, some individuals may come to rely on them for symptom relief. This can occur if the individual experiences significant improvement in symptoms while using the spray and feels reluctant to stop using it, even when other treatment options may be available.

  • Psychological Dependence: In some cases, individuals may develop a psychological dependence on steroidal nasal sprays, feeling anxious or uncomfortable when not using the medication even if their symptoms are well-controlled through other means. This can lead to overuse of the nasal spray, which may exacerbate side effects or tolerance issues.

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