Allergies Nose & Eye Allergies Nasal Steroid Sprays for Allergies By Daniel More, MD Daniel More, MD, is a board-certified allergist and clinical immunologist with a background in internal medicine. Learn about our editorial process Daniel More, MD Medically reviewed by a board-certified physician on October 03, 2020 Print Professional societies, like the American Academy of Allergy, Asthma and Immunology (AAAAI) and the American College of Allergy, Asthma, and Immunology (ACAAI), recommend nasal steroid sprays as the single best therapy for people with persistent or moderate-to-severe symptoms of allergic rhinitis (also known as hay fever), including seasonal allergies. ballyscanlon Collection / Digital Vision / Getty Images How Nasal Steroids Work Nasal steroids work by decreasing the allergic inflammation within your nasal passages, treating symptoms such as sneezing, itchy nose, runny nose, congestion, and post-nasal drip. Since steroids generally take many hours before they begin to work, nasal steroids do not work well on an as-needed basis and need to be used routinely for best results. In addition, nasal steroid sprays can take a few days up to a week to obtain relief—so remain patient if this is the first time you are trying one out for allergies. Side Effects The good news is that nasal steroid sprays are generally well-tolerated, although some are associated with a mild, unpleasant odor or taste. That said, nasal steroids can dry out the lining of the nose in some people and even cause some crusting or bleeding, especially during cold, winter months. Switching to a non-alcohol based spray, and/or applying a moisturizing nasal gel (for example, petroleum jelly or a saline nose spray) before using the steroid spray can be helpful. Nasal Steroid Options There are a number of nasal steroids available.There are some subtleties between the nasal steroids that may result in a doctor recommending one over another or a patient having a particular preference; it is certainly possible for someone to find that one nasal spray works better for them or causes fewer side effects than another. Here is a closer look at some of the pros and cons of popular nasal steroid sprays, and why switching to a different one is a reasonable next step if you are not getting adequate relief with the spray you're currently using. Comparison of Brand Name Nasal Steroids Brand Advantages Disadvantages Flonase Allergy Relief (fluticasone propionate) Available in generic form (lower cost) and over the counter (OTC); approved by the Food and Drug Administration (FDA) to treat non-allergic rhinitis and for use in children as young as 2 years of age Its flowery smell bothers some people; contains an alcohol preservative that may cause irritation in some people Nasarel (flunisolide) Available in generic form Needs to be used two to three times a day for best results; only available by prescription Nasonex (mometasone) Available in generic form; generally the lowest cost brand name nasal steroid; FDA approved for the treatment of nasal polyps and for children as young as 2 years of age Only available by prescription Flonase Sensimist fluticasone furoate) Available OTC; FDA approved for children as young as 2 years of age; multiple studies show consistent benefit for the treatment of eye allergies (although not currently FDA approved for this reason) High cost Nasacort AQ (triamcinolone) Available in generic form and OTC; FDA approved for children as young as 2 years of age High cost; generally poor medical insurance coverage Omnaris (ciclesonide) Fewer steroid side effects (as it is a pro-drug); less nasal irritation given the lack of benzalkonium chloride as a preservative (present in all other nasal steroids) High cost; generally poor medical insurance coverage; only available by prescription Rhinocort Allergy(budesonide) Available in generic form and OTC; preferred nasal steroid during pregnancy (pregnancy category 'B' risk) High cost; generally poor medical insurance coverage Proper Use It's important to know that the efficacy of steroid nasal sprays depends, in large part, to how they are used. Be sure to read and follow the instructions provided with your medication. Among the universal tips for using a nasal spray properly: Shake the bottle well before dispensing the medication.Point the tip to the back/outer side of your nose upon insertion.Do your best to avoid blowing your nose or sneezing immediately after use. A Word From Verywell If you are looking for a nasal steroid, work with your medical provider to determine which medication is best for you. While nasal steroid sprays are generally considered safe to use for many years, it's important to follow up with your doctor as advised for periodic nasal exams—this way your doctor can check for any nasal irritation, infection, or rare side effects. Lastly, if your child is using a nasal steroid spray, be sure to talk to his pediatrician. There is a small worry that nasal steroids may slightly slow the growth rate in children, so limiting their use to no more than two months a year is often advised. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Academy of Allergy, Asthma and Immunology. Allergy & Asthma Medication Guide. National Health Service. Steroid Nasal Sprays. deShazo RD,KemoSF. (2017). Patient education: Allergic rhinitis (seasonal allergies) (Beyond the Basics). In Corren J (Ed.),UpToDate. Kariyawasam HH, Scadding G.Seasonal allergic rhinitis: fluticasone propionate and fluticasone furoate therapy evaluated. J Asthma Allergy. 2010;3:19-28. Additional Reading deShazo RD, Kemp SF. (2018). Pharmacotherapy of allergic rhinitis. In Corren J, (Ed.), UpToDate. Dykewicz MS et al.Treatment of seasonal allergic rhinitis: An evidence-based focused 2017 guideline update. Ann Allergy Asthma Immunol. 2017 Dec;119(6):489-511.e41. doi:10.1016/j.anai.2017.08.012. Wallace DV, Dykewicz MS, Oppenheimer J, Portnoy JM, Lang DM.Pharmacologic Treatment of Seasonal Allergic Rhinitis: Synopsis of Guidance From the 2017 Joint Task Force on Practice Parameter. Ann Intern Med. 2017;167(12):876. Epub 2017 Nov 28. doi:10.7326/M17-2203