Can nasal irrigation help with winter colds and congestion?

As winter settles in, so does the cold season, with the sniffling and annoying congestion that comes with having a cold. To help keep your nasal passages clear and symptoms at bay, try daily nasal rinses, also known as nasal irrigation.

Nasal irrigation uses saline (salt water) to rinse the nasal passages. "Studies have shown that nasal rinses can reduce both symptom severity and the duration of a cold," says Dr. Alan D. Workman, a sinus specialist at Harvard-affiliated Massachusetts Eye and Ear.

Whether nasal rinses can prevent you from getting a cold is less certain. "There is some evidence that it can reduce the number of colds you get, but the data are from lower-quality studies," says Dr. Workman. However, he notes that irrigation is a low-risk and inexpensive way to ease nasal congestion and possibly prevent infections.

How saline rinses relieve congestion

Nasal rinses can help reduce congestion from sinusitis. Sinusitis is the medical term for inflammation of the sinus tissue, which might be caused by sinus infections (viral, bacterial, or fungal) or environmental exposures (such as smoke and air pollution). The most common cause of sinusitis is a viral infection such as the common cold. Nasal rinses may also relieve the symptoms of allergies triggered by pollen, dust mites, or animal dander.

In all these cases, congestion occurs when the nasal tissues become inflamed, which can cause nasal obstruction and a sensation of fullness. "The rinse helps wash away mucus and some chemicals that trigger inflammation, helping to reduce the swelling," says Dr. Workman. "For allergies, nasal rinses can help with symptoms, but they are most effective when used along with allergy medications," he says.

Doctors are also beginning to use saline rinses as a delivery method for medications in people with severe chronic sinusitis, especially those who have previously had sinus surgery. With severe chronic sinusitis, symptoms persist continuously for 12 weeks or longer and can be difficult to treat. "We can mix topical steroids or antibiotics into the rinse to treat persistent inflammation or infections," says Dr. Workman.

How to perform nasal irrigation

There are three main irrigation systems. They all enable the saline to enter one nostril and pour out of the other. "The method you use is less important than choosing one that works well for you," says Dr. Workman.

• Squeeze bottles or bulbs use gentle pressure to push saline into the nostril.
• Neti pots, which resemble small teapots, use gravity.
• Battery-powered nasal lavage systems use battery power to deliver and suction out the saline solution.

The technique is the same for all of them: Bend your head forward at a 45° angle and tilt it to one side. Introduce the solution into the upper nostril and let it flow out of the lower one. Repeat on the other side.

Once a day is often enough, and the time of day doesn't matter. "I tell people to do it at whatever time fits best in their daily schedule," says Dr. Workman.

How to get the saline right

Saline solution can be made at home, but it's safer and simpler to buy packets made for nasal irrigation. "That way you don't risk making a solution that's too salty or not salty enough," says Dr. Workman. Without salt, or even with too little salt, the nasal rinse can be irritating. Squeeze bottles generally come with premixed salt packets.

Follow the product instructions carefully when preparing the saline and use lukewarm sterile water, meaning distilled or cooled boiled water. To make cooled boiled water, boil tap water for three to five minutes. Let it cool until it is lukewarm. Don't use sterile water without salt. Never use plain tap water, which can be unsafe.

When to avoid nasal irrigation

Sometimes, you should avoid nasal rinses. "If you don't have access to sterile water, such as when traveling abroad, it's not worth the risk," says Dr. Workman.

You may find that rinsing causes discomfort or even some bleeding, particularly if you're using blood thinners or if you're prone to nosebleeds. "If this happens, I tell people to take a break," says Dr. Workman. "Nasal rinsing is not dangerous, but if it's irritating, it's best to back off for a short time," says Dr. Workman.

People with severe cases of an ear condition called eustachian tube dysfunction, which causes the ears to feel clogged all the time, may find that rinses make their ears feel even more blocked. They can still improve with rinses, but it's important to use correct technique.

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