Many of us are familiar with these white plastic tubes as its commonly seen and at one point of time, probably tried it. People claim that they “can’t breathe” or “nose is blocked” are reasons to use nasal inhalers.

Many more people are seen to be sniffing little tubes, and noticeably more than usual during the “circuit breaker” period.

The reason could be allergic rhinitis, which can cause more nasal obstruction that could be triggered by dust if you haven’t been cleaning your flat often which is where you are in nearly all the time during this circuit breaker.

Dr Lim Keng Hua, an ENT (ear, nose, throat) specialist at Mount Elizabeth Medical Centre’s Ear Nose Throat, Head & Neck Surgery clinic, said “Allergic rhinitis can cause sinus and nasal congestion, and pain.”.

“At night, the nasal congestion affects sleep, causes snoring and sometimes, sleep apnoea.”

According to Dr Leslie Koh, a consultant with Changi General Hospital’s Otorhinolaryngology department, other allergies and a sensitive nose can also make you suffer from nasal congestion.

How do these little inhalers work?

For those of you who aren’t aware, nasal inhalers contain camphor, menthol and/or eucalyptus oils to give out the cool, minty vapours, according to Dr Lim.

Even though breathing feels easier when using a nasal inhaler, as it feels like there’s an increased sense of airflow through the nose due to the oils, there is no solid evidence to substantiate this claim.

“On the contrary, the administration of menthol via nasal inhaler has been shown to cause nasal congestion,” said Dr Lim, who also explained that the congested sensation“might be due to an irritant action”.

Furthermore, Dr Koh cautioned the constant usage of nasal inhalers because “excessive amounts of menthol can cause vertigo, dizziness, agitation, abnormal eye movements, unsteady gait, hallucinations, lethargy, and even coma,”.

Camphor should not be taken for granted, even though it is classified as natural. “Excessive amounts of camphor can cause irritation in the mouth and throat, nausea, vomiting and abdominal pain. Agitation and seizures have also been described as a sign of menthol and camphor poisoning,” he said.

Nasal inhalers may also contain powerful decongestants such as ephedrine, oxymetazoline, or pseudoephedrine aside from some plant-based oils, said Dr Lim. However, the problem is that these decongestants have consequences.

“They are very effective in relieving nasal congestion but their prolonged use can damage the nasal tissue, resulting in a rebound phenomenon, that is, the nose becomes even more congested,” said Dr Lim.

“Other side effects include an increase in runny nose, fast heartbeat, headache, dizziness, lightheadedness, nervousness and trouble sleeping.”

Dr Koh advises to limit the usage of a nasal inhaler to not more than thrice a day and not to use it for a stretch of one to two weeks to be on the safe side.

“If you need them daily for more than a week, you should consult your doctor and treat the underlying cause of nasal congestion,” said Dr Lim.

Addiction

According to Dr Koh, there aren’t addictive ingredients in the OTC (over-the-counter) nasal inhalers sold in Singapore.

Dr Koh says“However, overusing the product may develop into a habit, especially if the patient feels that he derives some physical benefit from it.”

Could nasal inhalers cause severe problems?  Well, according to Dr Lim “Some develop rhinitis medicamentosa, a medical condition whereby the mucosa lining of the nose is damaged, replaced by fibrotic tissue that is no longer contractile”.

“As such, the nose is mostly blocked, and is only relieved momentarily with nasal decongestants. Some have worsened signs such as a runny nose, crusting and a foul smell.”

Dr Lim highlighted a case of one patient continuously using the nasal inhaler for duration of five years. She developed pregnancy rhinitis so she began to use nasal inhaler to relieve the severe nasal congestion.

“It was almost like helping someone quit an addiction. You need to ‘cold turkey’ them,” he said. “It took two months to wean her off the effect of nasal decongestants and treat her without surgery.”

Aside from using nasal inhales, there are other solutions to unblock a congested nose. If it is chronic congestion, do consult a doctor for possible causes.

Dr Koh went on to say “Patients with allergies may require intranasal steroids, which could help significantly with the nasal congestion.”

“In the worst case scenario, some patients may actually have tumours of the nasal cavity and sinuses. Hence, a consultation with a doctor would be helpful,”

OCT sprays containing oxymetazoline, nasal inhalers, oral decongestant medications and antihistamines all provide relief for nasal congestion. But these are all readily available general options of treatment. Do make an effort to consult a doctor on your specific needs, instead of guessing or using the trial and error method to decide which one will work best for you.

By Aaron
28th May 18:55

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