Nasal Spray for Allergies: Types, Side Effects, and More - Healthline

Allergies can present in many different ways. But for many people, a sneezy, sniffly, and runny nose can be one of the most bothersome symptoms. One way to tackle nasal allergies is with special sprays that target nasal allergies directly.

If your allergy symptoms mainly affect your nose, a nasal spray might be right for you.

Read on to learn more about the different types of nasal sprays, their side effects, and other treatments for nasal allergies.

While all nasal sprays may be the same in terms of use, the medications contained within each type can have different purposes. Choosing the ones that target your specific symptoms can help you find relief.

Some examples of the most common types of nasal sprays include:

Steroid sprays

How they work: Nasal steroid sprays work by reducing inflammation. This can relieve allergy symptoms such as nasal congestion, runny nose, sneezing, and watery eyes.

Some examples: Nasal steroids are often a first-line treatment for allergies. Examples like triamcinolone acetonide (Nasacort) and fluticasone propionate (Flonase) are available over the counter. Doctors can also prescribe nasal sprays like beclomethasone (Beconase), ciclesonide (Zetonna), and mometasone (Nasonex).

Key tips for use: To reap their benefits, nasal steroid sprays should be used consistently, usually at least once or twice a day over the course of several weeks. Occasionally, people will develop a bloody nose from using these sprays.

Antihistamine sprays

How they work: Antihistamines block the effects of histamine, a substance that causes allergy symptoms like sneezing, itching, and runny nose.

Some examples: Doctors can prescribe antihistamine sprays, which include azelastine (Astelin, Astepro) or olopatadine (Patanase).

Key tips for use: Some people find antihistamine nasal sprays can cause drowsiness. If you commonly experience drowsiness upon using these sprays, you may want to take them later in the evening.

Decongestant sprays

How they work: Decongestant sprays work by shrinking swollen, irritated blood vessels that line the nose. The irritation from these can cause congestion, itching, and sneezing.

Some examples: You can purchase most nasal decongestant sprays over the counter. Examples include oxymetazoline hydrochloride (Afrin, Sinex) and phenylephrine hydrochloride (Neo-Synephrine).

Key tips for use: These are a short-term solution to your nasal allergy symptoms. You shouldn't use them for more than 3 days because they'll start working less effectively and likely make the situation worse. They're also not a good fit for people who have glaucoma or high blood pressure, as they can worsen these conditions.

Anticholinergic sprays

How they work: These medications work on special receptors in the nose to help dry up extra mucus. They treat runny nose that's related to seasonal allergies or other conditions.

Some examples: Currently, the only anticholinergic nasal spray is ipratropium bromide (Atrovent). It's available only by prescription.

Key tips for use: These medications aren't intended for long-term use. You can usually use them for about 3 weeks when your nasal allergy symptoms are at their peak.

Mast cell inhibitor sprays

How they work: Cromolyn sodium sprays, a type of mast cell inhibitor sprays, stabilize mast cells. These cells release histamine, the substance that mediates allergy symptoms.

Some examples: You can purchase cromolyn sodium nasal sprays, such as NasalCrom, over the counter.

Key tips for use: You'll use most cromolyn sodium sprays about once or twice daily. Because they block histamine release, you'll do best by starting to use them about 1 or 2 weeks before allergy season in your area starts.

As a general rule, nasal steroid sprays are the most effective in treating nasal allergy symptoms, according to the American Academy of Otolaryngic Allergy.

This is because they treat most major symptoms of nasal allergies, such as inflammation, congestion, runny nose, or sneezing.

Research from 2016 compared the nasal steroid mometasone furoate with other available steroids on the market. The researchers found mometasone furoate showed better symptom control compared with other steroid nasal spray types.

Examples of comparisons included beclometasone, budesonide, triamcinolone acetonide, and fluticasone propionate.

Versus oral allergy medications

You can use nasal sprays in combination with oral allergy medications to treat your allergies or just use nasal sprays as your sole treatment.

Though, some research supports the use of nasal sprays over oral medications for treating nasal allergies.

One study compared a fluticasone furoate nasal steroid spray with taking a combination of the oral antihistamine (cetirizine) and antileukotriene (montelukast). The researchers found that nasal sprays were more effective in treating nasal symptoms than taking oral medications.

Yes, there are steroid and antihistamine sprays available in a combination product. However, this combo is currently available only with a doctor's prescription. An example is the medication Dymista (azelastine and fluticasone).

Ideally, you'll be able to use a steroid nasal spray alone to treat your nasal allergy symptoms. But if the steroid alone isn't as effective as it could be, you may wish to try a combination product.

Side effects occur with almost any medication. It's important to review the potential effects and talk to your doctor before you start using a nasal spray for allergies. This can help ensure that the sprays won't interfere with medications you're already taking.

Examples of some side effects of each nasal spray type include:

• Steroids: nosebleeds and nasal perforations (a rare complication)
• Antihistamines: drowsiness, dizziness, nosebleeds, and dry mouth
• Decongestants: burning, stinging, dryness, fast heartbeat, increased blood pressure, and rebound nasal congestion if used longer than a few days
• Anticholinergic: dry nose, nosebleeds, irritation, and headaches
• Mast cell: worsening congestion, sneezing, itching, nosebleeds, and burning sensations

The best treatments for allergies depend on your symptoms. If you commonly experience nasal symptoms, nasal sprays can directly address these symptoms.

However, if you have a lot of other symptoms, there are other allergy treatments. These include:

• Antihistamines: can help address eye itching and sneezing
• Decongestants: can help reduce mucus in the nose and airways
• Leukotriene receptor antagonists: can block chemicals called leukotrienes to reduce allergy symptoms overall

If oral medications or nasal sprays don't help treat your allergies, you may wish to talk to a doctor about immunotherapy. This involves either shots or drops to expose you to small amounts of allergens.

By doing this, your body becomes less sensitive to allergy triggers.

Allergies aren't usually a cause for concern, but they can be bothersome and interfere with your daily activities and comfort. See a doctor if you experience the following symptoms and can't manage them with medications:

• constant postnasal drip
• itching eyes, nose, or face
• sneezing
• stuffy or runny nose

You may need doctor-prescribed treatments if these symptoms start interfering with your daily life.

Nasal sprays can be effective in treating nasal allergy symptoms that may affect you seasonally. Nasal steroids are the most researched in terms of effectiveness, but there are other treatment options for short-term relief.

If over-the-counter treatments aren't effective for your nasal allergies, see a doctor to find out about prescription treatments.