7 Things You Might Not Know About Nasal Irrigation

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Ashley Festa on April 13, 2020
  • portrait-of-man-smiling-outside
    Rinsing your sinuses can be helpful, if it’s done properly.
    Nasal irrigation benefits are widely known—rinsing out the germs and gunk can help you breathe easier and offer allergy relief. When you take nasal rinse safety seriously, sinus cleansing is a harmless and simple process. But there are some things you might not know about nasal irrigation safety precautions. The better informed you are about this effective method of dealing with all sorts of sinus issues, the more beneficial the procedure will be for you
  • woman-using-neti-pot
    1. Nasal irrigation can lead to infection if done incorrectly.
    Sinus rinsing can be effective, as long as it is done safely. That means cleaning the device and any accessories thoroughly after every use. If you use a neti pot—one of the most common nasal irrigation devices—dry it completely or allow it to air dry after cleaning. And make sure you use distilled or previously boiled water to prevent germs from entering your nose. If you use the device frequently, be sure to replace it every few months.
  • Pot of boiling water on stove top
    2. The type of water you use matters.
    The water you flush through your sinuses must be free of germs, or it can make you sick. Be sure to use distilled water or water that has been boiled for at least three minutes (and then cooled). Untreated and unfiltered tap water can contain bacteria or other organisms—including the Naegleria fowleri, or brain-eating amoeba—that won’t hurt you if you swallow them because your stomach acid will kill them. But since there’s nothing to kill them in your sinuses, they can cause an infection. And while Naegleria fowleri infections are rare, most cases are fatal.
  • Asian elderly woman washes out the nose with saline
    3. Plain water doesn’t work the same as saline.
    Rather than using plain water, use a saline (saltwater) solution. Your sinus membranes are sensitive, and plain water can irritate your nasal passages. Saline in the right concentration actually reduces or even eliminates burning and irritation in your nose. A saline mixture usually comes with the nasal irrigation device. If you run out, you can buy it over the counter or make your own, but make sure you find a recipe from a reputable source.
  • high angle of baking soda and measuring spoon
    4. You can make your own saline solution.
    The American Academy of Allergy, Asthma and Immunology recommends a combination of salt, baking soda and distilled water. It’s important to use salt that contains no iodide, anti-caking agents or preservatives, such as pickling or canning salt. Mix together three teaspoons of salt and one teaspoon of baking soda. Store the mixture in a clean container. When you’re ready to use it, mix one teaspoon of the mixture into one cup of distilled water. Use less of the mixture if full strength burns your nose.
  • woman flushing her nose with saline
    5. If you’ve just had surgery, it’s important that the rinse is at room temperature.
    If your doctor has prescribed a medicated saline solution rinse after sinus surgery, it may need to be refrigerated. However, the liquid should be allowed to come to room temperature before you use it to avoid paranasal sinus exostoses (PSE), or bony growths in the sinuses. If you’re using nasal irrigation only to relieve allergy or cold symptoms, it may be more comfortable with room temperature water, but PSE is not a concern.
  • white nose wash spray bottle with hand isolated on white background
    6. There are many types of nasal irrigation devices.
    Perhaps the most well-known sinus and nasal cleaning device is the neti pot, which looks like a small teapot with a long spout. To use a neti pot, fill it with the saline solution and, while leaning over the sink, tilt your head and pour it into the top nostril. It will flow through the sinuses and out of your other nostril, loosening mucus and flushing out germs, pollen and other irritants. This method uses a lot of solution but low pressure (just gravity). Other devices, such as nasal spray, nasal drops or squeeze bottles, use varying degrees of pressure and solution, so you have many options to find the best method for you.
  • adult male patient describing his nasal problem to a physician
    7. Sinus rinses are safe, but short-term use is recommended.
    Nasal irrigation is good at reducing thick mucus, but sometimes it’s too good. Mucus helps prevent the lungs from inhaling viruses, so we need mucus to protect us against infections. In a study of patients who used nasal irrigation daily for a year and then stopped for a year, researchers found the patients had eight incidents of acute rhinosinusitis during the first year and only three incidents the following year. This may be because the patients washed away too much mucus, leaving the sinuses with little defense against germs. Rinse the sinuses for only 7 to 10 days for relief. If symptoms persist, you may need medication.
Nasal Irrigation: 7 Things You Might Not Know About Sinus Rinses
  1. Is Rinsing Your Sinuses With Neti Pots Safe? U.S. Food and Drug Administration. https://www.fda.gov/consumers/consumer-updates/rinsing-your-sinuses-neti-pots-safe
  2. Parasites — Naegleria fowleri — Primary Amebic Meningoencephalitis (PAM) — Amebic Encephalitis. Centers for Disease Control and Prevention. https://www.cdc.gov/parasites/naegleria/index.html
  3. Illness & Symptoms. Centers for Disease Control and Prevention. https://www.cdc.gov/parasites/naegleria/illness.html
  4. Saline Sinus Rinse Recipe. American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/saline-sinus-rinse-recipe
  5. Safe Neti Pot Use: 3 Tips. Cleveland Clinic. https://health.clevelandclinic.org/safe-neti-pot-use-3-tips/
  6. Haffey T, Woodard T, Sindwani R. Paranasal sinus exostoses: an unusual complication of topical drug delivery using cold nasal irrigations. Laryngoscope. 2012 Sep;122(9):1893-7. https://www.ncbi.nlm.nih.gov/pubmed/22753257
  7. Head K, Snidvongs K, Glew S, et al. Saline irrigation for allergic rhinitis. Cochrane Database Syst Rev. 2018 Jun; 2018;6(6):CD012597. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513421/
  8. Daily Nasal Saline Irrigation Not Recommended for Long-Term Use. Medscape. https://www.medscape.com/viewarticle/712146
  9. Piromchai P, Puvatanond C, Kirtsreesakul V, Chaiyasate S, Thanaviratananich S. Effectiveness of nasal irrigation devices: a Thai multicentre survey. PeerJ. 2019 May 27;7:e7000. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542345/
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Last Review Date: 2020 Mar 27
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