Your nose gets clogged when blood vessels in the nasal lining swell from a cold, allergies, sinus infection, or dry air.
Why
Congestion happens when blood vessels in the nasal lining swell and produce mucus. It is not blocked by mucus alone.
Causes
- Colds and flu.
- Allergies.
- Sinus infection.
- Deviated septum.
- Nasal polyps.
- Dry air.
- Overuse of decongestant sprays (rebound congestion).
Relief
Saline rinses, humidifier, steam and decongestants.
See a doctor
If it lasts more than 10 days or comes with fever.
Inflamed tissue
A stuffy nose is usually caused by swollen blood vessels and tissue lining the nasal passages, not just mucus. Inflammation narrows the airway, and mucus adds to it.
Common causes
- Viral infections like the common cold and flu.
- Allergies (hay fever), triggered by pollen, dust mites, mold and pet dander.
- Sinus infections (sinusitis).
- Nasal polyps.
- Deviated septum.
- Irritants like smoke and strong smells.
- Dry air.
- Hormonal changes in pregnancy.
- Overuse of decongestant nasal sprays, which causes rebound congestion (rhinitis medicamentosa) after more than 3 days.
Nasal cycle
Normally, the nose congests on one side and opens on the other, alternating every 2 to 4 hours. Most people do not notice this.
Relief
- Saline rinse with distilled or boiled and cooled water, to avoid the rare but serious amoeba infection from tap water.
- Humidifier or steamy shower.
- Staying hydrated.
- Elevating the head while sleeping.
- Antihistamines for allergies and nasal steroid sprays for ongoing swelling.
- Short term oral decongestants, unless you have high blood pressure.
Children
Use saline drops and a bulb syringe for infants. Do not give over the counter cold medicines to children under 4.
See a doctor if
Congestion lasts more than 10 days, comes with high fever, severe facial pain, vision changes, thick green discharge for several days, or happens only on one side. Ongoing blockage could be polyps or a structural issue.
The role of swollen tissue
Congestion is usually caused by inflamed, swollen blood vessels in the nasal lining, not just mucus. The nasal passages naturally alternate in size, a pattern called the nasal cycle, where one side becomes more open than the other every 2 to 6 hours, which is normal. Colds, allergies, sinus infections, dry air, irritants, a deviated septum, nasal polyps and pregnancy can all cause stuffiness. Adults average two to three colds a year, and allergic rhinitis affects about 25 million US adults.
Relief and when to get help
Saline sprays or rinses with distilled or boiled and cooled water, steam, a humidifier and elevating the head help. Decongestant nasal sprays such as oxymetazoline should be used for no more than three days, because longer use can cause rebound congestion called rhinitis medicamentosa. Antihistamines help allergic causes. Children under 4 should not take over the counter cold medicines, per FDA advice. See a doctor if congestion lasts more than 10 days, comes with high fever, facial pain, thick green discharge for days or bloody discharge, or if one nostril is always blocked.
Based on data from the American Academy of Otolaryngology and the FDA
