Allergies Common Treatments Side Effects Caused by Nasal Steroid Sprays By Daniel More, MD 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 Medically reviewed by Jurairat J. Molina, MD Medically reviewed by Jurairat J. Molina, MD on February 13, 2021 Facebook Jurairat J. Molina, MD, MBA is a board-certified allergist who has been practicing in field of allergy and clinical immunology for the past two decades. Learn about our Medical Review Board on February 13, 2021 Print Short-term and long-term use of nasal steroid sprays is generally considered safe for children and adults, but you may experience some side effects if you use them. Side effects may only affect the superficial mucosa of the nasal passages or involve the sinuses, or they may be systemic, causing symptoms and complications that affect other areas of the body. Nasal steroid sprays are often used for treating respiratory allergies or chronic sinusitis, and they differ from steroid irrigation and steroid injections. dragana991 / Getty Images If you have just started using nasal steroids for allergies, it may be difficult to know whether some of your symptoms are side effects of the spray or if they are related to your allergies. Topical side effects are generally the most obvious and the most easily confused with allergies, while the systemic side effects are not as easily recognizable. Localized Side Effects The topical side effects of nasal steroids generally occur near the opening of the nasal passage, where you insert the nasal applicator, and rarely higher in your nostrils. They can occur right after you use the nasal spray or days afterward. Topical side effects commonly include: Irritation Itching Dryness Redness Nosebleeds Crusting Burning Infection Improper technique can increase your risk of having side effects. If you are starting to use nasal steroids, it helps to become familiar with the appropriate way to administer a nasal spray. While your technique is important, it is possible to experience these side effects even when you use steroid nasal sprays as directed. The side effects can decrease as your body adjusts to the steroid spray, but sometimes the side effects persist or worsen. If you experience these symptoms, talk to your healthcare provider. Your practitioner might advise you to stop taking your nasal steroids for a few days or to adjust your dose or administration technique. This is especially important if you have bleeding and irritation of your nasal passages, which can increase your risk of more serious complications such as ulceration or septal perforation. Though not as common as the above, side effects can affect your eyes and sinuses. These may occur immediately after or days after use. Such side effects include: SneezingWatery eyesA runny nose or stuffinessHeadachesAftertasteA cough Systemic Side Effects Steroid nasal sprays can induce systemic side effects. These effects occur as the result of the steroid's effect on the body, but they are not common. For example, the drug can suppress your immune system, alter your hormone levels, or increase pressure in your eyes. Systemic complications from nasal steroids are very rare—they generally require months or years of use if they do appear. Systemic side effects include: Nausea or vomiting Upper respiratory tract infections Abnormal menstrual cycles Cataracts Glaucoma Systemic infection Growth and Behavior in Children There have been concerns about the prolonged use of nasal steroid sprays in children, specifically with regard to growth and behavior. So far, research suggests that nasal steroids are safe for children, but there is a chance of some side effects. Growth: Nasal steroids may have a small impact on a child’s vertical growth, particularly when used consistently and for a long period of time. It does not appear that the child's final height is affected, though—most of the growth slowing occurs during the first year of use, with final height remaining intact.Behavior: There has been some concern about hyperactivity, irritability, or behavioral problems in children who regularly use nasal steroid sprays. The studies show mixed results, so it is best to be aware of the potential problem and to observe your child closely for behavioral changes if they are using a nasal steroid spray. Contraindications If you have cataracts or glaucoma or a family history of these diseases, using nasal steroids can increase the risk of exacerbation. If you will use nasal steroids, it is recommended that you have routine annual eye exams by an optometrist or ophthalmologist. If you have an adrenal disease, it is possible that using nasal steroids could exacerbate your disease, particularly if you use them frequently and for a long period of time. 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 4 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. Chang GH, Wang WH. Intranasal fungal (Alternaria) infection related to nasal steroid spray. Am J Otolaryngol. 2013;34(6):743-5. doi:10.1016/j.amjoto.2013.07.016 Sastre J, Mosges R. Local and systemic safety of intranasal corticosteroids. J Investig Allergol Clin Immunol. 2012;22(1):1-12. Bridgeman MB. Overcoming barriers to intranasal corticosteroid use in patients with uncontrolled allergic rhinitis. Integr Pharm Res Pract. 2017;6:109–119. doi:10.2147/IPRP.S129544 Lee LA, Sterling R, Máspero J, Clements D, Ellsworth A, Pedersen S. Growth velocity reduced with once-daily fluticasone furoate nasal spray in prepubescent children with perennial allergic rhinitis. J Allergy Clin Immunol Pract. 2014;2(4):421-7. doi:10.1016/j.jaip.2014.04.008.