By Professor Amira Guirguis, RPS Chief Scientist

For many people, nasal spray decongestants offer fast and effective relief from congestion caused by cold or sinus infections; when used correctly, they are safe and reliable medicines. However, they’re only designed for short-term use. Using them for longer than 7 days in a row can make your congestion worse.

How do they work?

Typically, they contain one of two decongestants, oxymetazoline or xylometazoline. These medicines work by shrinking swollen blood vessels inside the nasal passages, quickly opening the airway and making it easier to breathe. They are highly effective, but only when used as directed. Incorrect or prolonged use can lead to the opposite effect, causing ongoing congestion rather than relief.

The hidden risk: rebound congestion

Many people start using nasal decongestant sprays because of a cold or sinus infection but aren’t aware they shouldn’t use them for longer than 7 days in a row. Because the relief is quick, it’s easy to end up relying on them for longer than intended. This can lead to a condition called “rebound congestion” where nasal passages become persistently blocked due to overuse of the sprays. The congestion feels worse when the spray wears off, creating a cycle that can be difficult to break. It’s a preventable issue, but many people are unaware of the risks.

Signs you might be overusing nasal sprays include:

• Needing to use the spray more often
• Your congestion feels worse when you stop
• Buying multiple bottles or exceeding the recommended dose.

The 7-day rule

Nasal decongestant sprays are designed for short-term relief only and should not be used for longer than seven days in a row. Prolonged use can cause persistent congestion and discomfort, and in rare cases, may lead to more serious nasal issues.

In our survey of over 300 community pharmacists nearly 60% said they believe people aren’t aware of the risk of rebound congestion. That insight, drawn directly from frontline healthcare professionals, shows that there is a clear need for greater awareness and support for safe self-care.

Your pharmacist can help

If you’re still congested after 7 days, or you’ve been using sprays for a long time, don’t panic - and don’t keep spraying. Help is available and dependency is preventable. Talk to your pharmacist for confidential, non-judgemental advice. They will:

• Help you stop safely if you’ve been using sprays for too long
• Help you manage your symptoms
• Suggest alternatives like saline sprays, nasal strips, steam inhalation, or menthol products
• Advise you on other medicines and recommend suitable options
• Tell you when to see your GP

Top tips

Here’s our top three tips on nasal decongestant sprays:

• Always follow the instructions on the packaging and read the patient information leaflet
• Don't use them for longer than seven days in a row
• Talk to your pharmacist if your symptoms persist, they can suggest alternatives to ease your congestion

Read what the RPS is calling for to help people use nasal sprays safely.