How Nasal Polyps Are Treated

Nasal polyps are soft, swollen, abnormal, sac-like growths that line the inside of a person's nose or sinuses. Treatment may include medications to shrink them or manage symptoms like nasal congestion and sinus pressure. If this doesn't help, surgery to remove them may be recommended.

This article discusses the different types of treatments for nasal polyps, including prescriptions, over-the-counter therapies, surgery, and home remedies.

Prescriptions

Most of the medications used to treat nasal polyps require a prescription. The goal is to shrink the polyps and reduce swelling and nasal congestion. These treatments include the following.

Nasal Steroid Sprays and Drops

Your healthcare provider may prescribe a nasal steroid spray to help reduce the size of nasal polyps. The prescription nasal spray Nasonex (mometasone) aims to shrink polyps and help clear blocked nasal passages and runny nose.

In 2017, the FDA also approved Xhance (fluticasone propionate) for treatment of nasal polyps. Xhance is a spray that enters the nasal passages via an oral mechanism. However, symptoms return if the spray is stopped.

Corticosteroid Pills or Liquid

If your nasal polyps don't respond to inhaled steroid medications, your healthcare provider may prescribe steroid medicines that you can take by mouth.

Oral corticosteroids like prednisone and dexamethasone may also shrink polyps and/or reduce swelling and nasal congestion for a few months.

Oral corticosteroids have a number of potential side effects, including dizziness, headache, muscle weakness, nausea, and vomiting, among others.

Antibiotics

Antibiotics may be prescribed if your healthcare provider suspects you have an infection related to the nasal polyps.

The medications Augmentin (amoxicillin/clavulanate), Zithromax (azithromycin), Levaquin (levofloxacin), Bactrim, or Septra (trimethoprim-sulfamethoxazole), and Amoxil (amoxicillin) can be used to treat a sinus infection caused by bacteria.

However, they can't treat polyps or sinus infections caused by a virus. Also, there is not much scientific evidence that they are effective for treating nasal polyps.

Biologic Medication

Dupixent (dupilumab) has been shown to decrease polyp size, reducing the need for surgery and oral steroids.

Given by injection, dupilumab is a monoclonal antibody, a laboratory-made molecule that enhances the immune system. It was initially approved for the treatment of dermatitis and asthma. It can also target inflammation that may cause polyps.

Talk to your healthcare provider about the potential side effects of Dupixent, which can include oral herpes and a number of eye-related issues.

Oral Antileukotriene Medications

Oral antileukotriene medications, like Singulair (montelukast), have also been found to reduce the size of nasal polyps.

These medications have been found to especially be beneficial for those with a chronic condition called aspirin exacerbated respiratory disease (AERD). AERD can involve nasal polyps and an allergic reaction to aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs).

Those taking phenobarbital or rifampin should talk to their healthcare provider before starting Singulair, as interactions may occur.

Over-the-Counter (OTC) Therapies

Your healthcare provider may also recommend over-the-counter (OTC) therapies. OTC medicines can help you deal with nasal congestion from polyps, reduce inflammation, and manage your allergies.

While OTC treatments may help to manage symptoms, they may not be as effective as prescriptions in decreasing the size of your polyps. Check with your healthcare provider if you feel like OTC treatments aren't working.

Examples of OTC treatments include:

• Antihistamines like Zyrtec (cetirizine), Claritin (loratadine), Allegra (fexofenadine)
• Topical nasal steroid sprays, like Flonase (fluticasone propionate) and Nasacort (mometasone furoate)

Surgeries

In situations where medications aren't doing much to alleviate your symptoms related to nasal polyps, your healthcare provider may recommend surgery.

Most often, endoscopic sinus surgery is performed. Much like the endoscope used to diagnose nasal polyps, the surgeon will use a thin, flexible tube with a light and instruments at the other end.

The tube is inserted into the nasal passages. Then the surgeon uses instruments to remove the polyp, which is preventing the flow of sinus and nasal fluids from properly draining.

This is typically an outpatient procedure. Also, there is no guarantee that the nasal polyps won't regrow.

Home Remedies and Lifestyle

Home remedies and lifestyle changes will not directly treat nasal polyps. However, they can help prevent them by managing some of the underlying conditions that can cause polyps, like chronic sinusitis and allergies.

These remedies can also help improve mucus flow and relieve nasal symptoms that occur with nasal polyps.

Some examples include:

• Taking your allergy and asthma medications as directed
• Avoiding places with large amounts of airborne allergens or irritants that lead to inflammation of your nose and sinus cavities (i.e., a dusty attic, a field of grass, etc)
• Washing your hands regularly to prevent bacteria and viruses from entering the nasal passageways
• Using a humidifier in your home and/or inhaling steam over a pot of hot water when the inside of the nose feels especially dry
• Using a saline nasal rinse or spray to remove allergens or other irritants by rinsing out your nasal passages

Summary

If you have nasal polyps, your healthcare provider may recommend trying medications first. They may prescribe a nasal steroid spray, corticosteroid pill, antibiotic, or oral antileukotriene medication. They may also suggest an over-the-counter treatment to help manage symptoms.

If these treatments don't work, your healthcare provider may recommend outpatient surgery to remove the nasal polyps.

A Word From Verywell

While there are ways to help treat the symptoms related to nasal polyps, there isn't a way that will remove them once and for all. Medications can make living with nasal polyps more bearable—in some cases, even shrinking them a bit. The only way to remove them is through surgery. But even that isn't a guarantee that they won't return.

The key is to pay attention to your ability to breathe through your nose, whether or not you've had surgery to treat nasal polyps. If something doesn't feel right, or you're having trouble breathing through your nose, contact your healthcare provider. They can help you find out whether your symptoms are caused by nasal polyps.