Using Nasal Steroid Sprays for Allergies

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.

To back this recommendation up, research shows that nasal steroids are better at treating allergy symptoms than oral antihistamines, nasal antihistamine sprays, and Singulair (montelukast). Nasal steroids are also particularly good at treating symptoms of eye allergies.

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, and studies comparing their benefits show no particular difference from one to another.

Despite this, 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.