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How Does Saline Nasal Spray Work?

Common Nasal Spray Questions, Answered

Dr. Melody Hartzler Profile Photo

Written by Dr. Melody Hartzler on June 25, 2021

Whether it’s caused by a cold, allergies, or simply dry air, nasal congestion can stop you in your tracks and make your day miserable. There are many different over the counter treatment options that can help relieve symptoms of nasal congestion, but if you’re looking to minimize your use of medication, saline nasal spray is a good bet.

Saline nasal spray is an effective way to temporarily reduce nasal congestion, but how does saline nasal spray work?

What is saline nasal spray?

People hoping to find relief from nasal congestion can choose from three different types of nasal sprays: saline nasal spray, decongestant nasal spray, and steroid nasal spray.

Saline nasal sprays are made of a salt water solution and do not contain any medication. These nasal sprays can be purchased over the counter without a prescription and can also be made at home.

Saline nasal sprays work by moisturizing the nose, dissolving and loosening the mucus in the nasal passages, adding moisture to the nasal passages to prevent them from becoming more inflamed, and preventing the nasal passages from drying out.

Because saline nasal sprays consist of a natural solution that does not contain any medication, they can be used as often as needed. Saline nasal sprays are especially popular for use in children because they can help relieve congestion in children who are unable to blow their noses and clear mucus.

Decongestant nasal sprays are available over the counter and by prescription. Unlike saline nasal sprays, which do not contain any medication, decongestant nasal sprays work by narrowing the blood vessels that line the nose. As the blood vessels narrow, the swollen tissues around them become less inflamed, helping to reduce congestion.

Decongestant nasal sprays can cause a “rebound effect” when used for a period of three or more days, after which time your congestion might start to get worse. Decongestants are also commonly available in the form of a pill.

Additionally, most decongestant nasal sprays should not be used on toddlers, and for children aged 6 through 12, should be used with adult supervision and under the direction of their pediatrician.

Steroid nasal sprays are also available both over the counter and with a prescription. Although steroid nasal sprays are most commonly used to treat allergy symptoms, they can also be helpful in reducing congestion caused by a sinus infection or similar illness. Steroid nasal sprays work similarly to other steroid medications and reduce inflammation in the tissues, though it should be noted that steroid nasal sprays are used chronically, which is different from decongestants.

What is saline nasal spray used to treat?

Because saline nasal sprays are so gentle, they can be used to treat a variety of different conditions with low risk. It should be noted that while saline nasal sprays can help to reduce symptoms associated with congestion, they do not treat the root cause of the congestion.

  • Saline nasal sprays are commonly used to treat the following conditions:
  • Relief of general nasal congestion and dryness
  • Relief of symptoms caused by upper respiratory infections such as colds or sinusitis
  • Relief of symptoms caused by respiratory allergies
  • Prior to using an inhaler medication
  • When breathing cold or dry air that can dry out the nasal passages
  • Prior to using nasal steroid sprays
  • Relief of symptoms caused by hay fever
  • Prior to using medicated allergy nasal sprays
  • Following nasal surgery that leaves the nasal passages feeling dry or crusty

How does saline nasal spray work?

Saline nasal sprays work in several ways to improve symptoms associated with nasal congestion.

First, saline nasal sprays help to minimize your risk of getting sick by washing foreign invaders like viruses, irritants, and allergens out of your nasal passages before they have a chance to trigger an immune response.

Second, saline nasal sprays can help to improve the effectiveness of medicated nasal sprays when the saline spray is used first, as it improves the moisture content in the nasal passages, making them more receptive to medication.

Third, saline nasal sprays help to clean and hydrate the lining of the nasal passages, which is important in maintaining a strong nasal immune response.

Finally, and perhaps most importantly when you are feeling sick, saline nasal sprays thin and loosen excess mucus in the nose and sinuses, helping to reduce symptoms of nasal and sinus congestion and feelings of discomfort.

How do you use saline nasal spray?<

Using saline nasal spray is simple enough that anyone, including children, can do it.

  1. If possible, blow your nose first in order to remove as much congestion from your nasal passages as possible. If you are helping a child who cannot blow their nose, it’s ok to skip this step.
  2. Remove the cap from the bottle and follow any instructions on the label to get the spray ready for use.
  3. Close off one nostril by pressing your finger lightly against the side of the nostril. Place the spray bottle underneath your open nostril and place your thumb at the bottom of the spray bottle.
  4. Next, squeeze the spray bottle as you inhale to breathe the saline solution into your nostrils.
  5. Repeat if indicated on the directions, then switch sides.

After you have finished using the spray, try to avoid blowing your nose right away and avoid sneezing if possible. Give the saline solution time to work to loosen and thin mucus before blowing your nose to relieve congestion.

Are there any side effects associated with saline nasal spray?

Saline nasal sprays do not contain any medication, so most people will not experience side effects when using these sprays. However, some side effects may rarely occur. The vast majority of these side effects subside quickly.

Side effects associated with saline nasal spray include:

  • Sneezing
  • Eye irritation if the produce gets into the eye
  • Abnormal or salty taste in the mouth
  • Cough
  • Nose irritation

How much saline nasal spray should I use?

The amount of saline nasal spray that you should use depends on the condition being treated.

When saline nasal spray is used to relieve nasal congestion or dryness, it is recommended that patients use two sprays per nostril as needed. Because there is no medication in saline nasal spray, you don’t have to worry about using too much of this treatment.

If saline nasal spray is being used prior to administering nasal steroids, the recommended amount is one spray per nostril prior to using nasal steroid sprays, which are typically used two to six times per day.

What should I do if a saline nasal spray doesn’t relieve my congestion?

If you are experiencing nasal congestion and have been using saline nasal spray without any improvement for several days, you may benefit from using a different type of nasal spray.

Decongestant nasal spray and antihistamine nasal spray can both be effective at treating symptoms of nasal congestion depending on the cause of the congestion. Antihistamine nasal sprays are most helpful when used to treat drainage caused by a runny nose, postnasal drip, or itchy, watery eyes, while decongestant nasal sprays are most helpful for nasal or sinus congestion.

What are the differences between decongestants and antihistamines?

While decongestant nasal spray and antihistamine nasal spray both work to relieve congestion, there are some important differences between the two treatment options.

Decongestant nasal sprays work by reducing the swelling that occurs in the nasal passages. As a result, pressure in the nasal cavity reduces and airflow improves, allowing you to breathe more easily.

When used for more than three days, decongestants can cause congestion to get worse by producing a “rebound effect,” so talk to your doctor if the medication does not work within three days.

Decongestants are typically taken during the day because they can have a stimulant effect that keeps you awake, although decongestant nasal sprays are less likely to have this effect than decongestant pills. People with high blood pressure or heart disease may not be able to use decongestants safely, as these medications can cause blood pressure to increase.

Antihistamines work by blocking the action of a chemical produced by the body called histamine. Histamine is a substance produced by the immune system in response to the presence of allergens. People with allergies commonly experience symptoms like an itchy, runny nose or eyes and swelling of the nasal passages during an allergy attack.

Although histamines are not the cause of congestion in people with a runny nose caused by a cold, they can still be helpful in reducing symptoms of congestion.

The most common side effect caused by antihistamine nasal sprays is drowsiness, which means that it is generally best to use antihistamine nasal sprays at night. Other common side effects associated with antihistamines include dry mouth, headache, and dizziness.


Saline nasal sprays work by thinning and loosening thick mucus inside the nasal passages to help reduce congestion. Although saline nasal sprays contain no medication, they are effective at providing temporary moisture to the nasal passages, which can help reduce symptoms of congestion.

Saline nasal sprays have very few, if any, side effects for most people and can be used as many times per day as needed because they do not contain medication.