A stuffy nose is caused by swollen blood vessels and inflamed tissue in the nasal passages from a cold, allergies, or sinus infection.
Causes
Congestion happens when blood vessels in the nasal lining swell and mucus builds up.
- Colds and flu.
- Allergies.
- Sinus infection.
- Deviated septum or nasal polyps.
- Dry air, irritants and smoke.
- Pregnancy and medication overuse (rebound congestion from nasal spray).
Relief
- Saline spray or rinses with distilled water.
- Humidifier.
- Warm showers.
- Decongestants for short use only (no more than 3 days for sprays).
- Elevate your head at night.
See a doctor if
Symptoms last more than 10 days, with fever, or severe facial pain.
Why your nose feels blocked
A stuffed nose is usually not caused by mucus alone. The main reason is swollen blood vessels in the lining of the nose, which narrow the airway. Inflammation from infection or allergy makes these vessels dilate and leak fluid. The result is congestion even when little mucus is present.
Common causes
- Viral colds, which last 7 to 10 days.
- Allergic rhinitis from pollen, dust mites, mold or pets, affecting 25% or more of US adults according to the CDC.
- Sinusitis, when congestion lasts more than 10 days or comes with facial pain and thick discolored mucus.
- Deviated septum, nasal polyps and enlarged adenoids.
- Rebound congestion from overusing decongestant sprays for more than 3 days.
- Pregnancy and hormonal changes.
- Dry air, smoke and irritants.
Relief that works
- Saline sprays or rinses with distilled or boiled water, which thin mucus and wash out allergens.
- A humidifier set to 30% to 50% humidity.
- Warm showers and steam.
- Decongestant pills such as pseudoephedrine, for a few days, with caution if you have high blood pressure.
- Nasal steroid sprays, such as fluticasone, which work best for allergies and need several days of daily use.
- Antihistamines for allergy symptoms.
About decongestant sprays
Sprays such as oxymetazoline give fast relief but should not be used more than three days in a row. Longer use can cause rebound congestion, where the nose gets worse once the spray wears off.
For babies
Babies breathe mostly through their noses. Use saline drops and a bulb syringe or nasal aspirator. Do not give over the counter cold medicines to children under 4 years old, since the FDA warns of serious side effects.
Neti pots and safety
Use only distilled, sterile or previously boiled and cooled water in a neti pot. Tap water can contain amoebas that cause a rare, often fatal brain infection.
See a doctor if
Congestion lasts more than 10 days, comes with fever over 101.3 F, severe facial pain, one-sided blockage that does not improve, bloody discharge, or if a child has symptoms that last.
Anatomy and timing of congestion
Nasal congestion is swelling of the blood vessels and tissue lining the nose, and not just mucus. The nasal passages swell and shrink in a cycle every few hours called the nasal cycle, which is normal. A cold usually causes congestion for 7 to 10 days. Allergic congestion lasts as long as the exposure. Nasal sprays containing oxymetazoline should not be used longer than 3 days, because longer use can cause rebound congestion called rhinitis medicamentosa. Saline sprays, steam and head elevation at night are safe options.
Based on data from the American Academy of Otolaryngology and the Mayo Clinic
