Risks and rewards of nasal rinses: What you need to know

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There’s nothing like taking a deep breath and feeling the air move easily through your nose and into your lungs. But when allergies and colds leave you congested, flushing out clogged nasal passages can help you breathe a little easier.

Nasal irrigation, also known as sinus rinsing, is the practice of moving a saline (saltwater) solution through your nasal passages to clear out mucus and flush out debris and allergens. Irrigation devices, such as neti pots, squeeze bottles and rubber nasal bulbs, push the water through one nostril and out the other.

If you’ve never done a nasal rinse before, the process may sound uncomfortable. But the benefits and relief are well worth it if you take steps to perform the rinse safely.

Here’s what you need to know:

How does nasal irrigation work?

Rinsing out your sinuses and nasal passages offers relief for symptoms of sinus infections, allergies, cold and flu. In one study, patients with chronic sinus issues performed a daily nasal rinse and saw an improvement in symptom severity of more than 60%.

As saline solution moves through your nasal passages, it:

  • Clears out light mucus
  • Moistens nasal passages exposed to dry indoor air
  • Removes allergens such as dust, pollen and other debris
  • Thins out stubborn, thick mucus so it can be expelled while blowing your nose or coughing

Performing a nasal rinse

To flush your nasal passages, you’ll need an irrigation device and saline solution — which you can purchase as part of a kit or make at home. Once you have the supplies, plan to perform the rinse over a sink and take these steps, outlined by the National Institutes of Health:

  1. Fill the device with saline solution.
  2. Keep your head over a sink or tub and tilt your head sideways to the left.
  3. Gently pour or squeeze the solution into your right nostril. The water will come out the left nostril.
  4. Repeat on the other side.
  5. Gently blow your nose to remove remaining water or mucus.

Side effects of sinus rinsing

When nasal rinses are done properly, the side effects, if any, are typically minor and temporary. The most common issues resulting from a nasal rinse are a burning or stinging sensation in the nose and mild irritation in the nasal passages.

To make your nasal rinse more comfortable, make sure to use a saline solution instead of plain water, which can aggravate the inside of your nose. Saline allows water to move through your delicate nasal membranes with little to no burning and irritation.

Saline solutions often come prepackaged with nasal irrigation devices or can be homemade. The American Academy of Allergy, Asthma & Immunology recommends the following saline sinus rinse recipe:

  1. Mix 3 teaspoons of iodide-free salt with 1 teaspoon of baking soda and store in a small airtight container.
  2. Add 1 teaspoon of the mixture to 8 ounces of lukewarm distilled or boiled water and perform a sinus rinse. (Use fewer dry ingredients to make a weaker solution if you experience burning or stinging.)

Safety tips for saline nasal washes

To avoid more serious issues associated with nasal irrigation, be sure to:

Use the right water

Never use tap water to rinse out your nasal passages — it isn’t filtered or treated and can contain bacteria. Tap water may be safe to swallow because your stomach acid kills any bacteria. But if you use tap water in a nasal rinse, the bacteria can continue to live. It can eventually cause infection and, in very rare cases, travel to the brain.

For a safe sinus rinse, use one of the following:

  • Boiled tap water, which is boiled for up to five minutes, cooled to room temperature and then used within 24 hours
  • Distilled or sterile water, which can be bought in stores
  • Filtered water that has passed through a filter meant to trap infectious organisms

Make sure the saline water solution is room temperature before rinsing with it. Using very hot water could scald or burn your nasal passages. If you’ve recently had surgery for chronic sinusitis, very cold water can increase the risk of developing bony growths in your nose.

Make sure the nasal irrigation device is clean

Plan to clean and air dry your neti pot or other irrigation devices after every use. Dirty or contaminated devices are a quick way to reintroduce bacteria into your nasal passages.

Follow the manufacturer’s instructions for the best cleaning method and remember to let the device dry completely. To avoid passing germs to others, do not share your irrigation device with anyone.

Only use nasal irrigation when you need it

Start by performing just one irrigation a day. If the rinse is helping, you can irrigate your nose up to three times a day. But nasal rinses should not be used as a preventive measure when you don’t have symptoms. It won’t prevent sinus issues and can cause infections to develop.

Your sinuses and nasal passages are lined with good mucus — it traps the irritants and germs that enter your nostrils and can kill some bacteria. Regular flushing can hinder those protective features and increase the risk of infection.

If you find yourself performing nasal irrigation all the time, reach out to your primary care physician about treatment for chronic sinus or allergy issues.