Side Effects Caused by Nasal Steroid Sprays

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.

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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:

  • Sneezing
  • Watery eyes
  • A runny nose or stuffiness
  • Headaches
  • Aftertaste
  • A 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.


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.

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4 Sources
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