As an otolaryngologist, I am frequently asked if nasal steroid sprays, one of the most common treatments for chronic sinus and allergy problems, are dangerous to use over the long term. In general, the answer is no.
Let’s look at a few issues specifically...
The most common side effects from nasal steroids are local. Some patients have mild burning, dryness, or nose bleeds. These are reasons to change brands or stop the medication all together. A rare local complication includes septal perforation, or a hole in the septum that divides the nose in half. This is a complication that would typically happen after significant nose bleeds develop. So again, if nose bleeds are a problem, stop the medication and see your otolaryngologist.
Systemic side effects such as adrenal suppression, blunted growth, glaucoma, cataracts, osteoporosis, and diabetes have long been a worry since high dose oral steroids can have these complications. The good news is that over the years, nasal steroids have become much less “bioavailable” . The nasal sprays treat topically, but very little is actually absorbed into the bloodstream. More recent studies have failed to show any significant risk for any of these side effects with properly used nasal steroids.
If you suffer from chronic nasal/sinus problems and nasal steroid sprays help, feel confident that long term use is quite safe.
Zachary Wassmuth, MD
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