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What is Rebound Congestion?

By Nicole Long
Updated Jan 26, 2024
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Someone that uses decongestant sprays in excess may experience rebound congestion. The condition is characterized by a persistent nasal congestion even in the absence of other typical cold or allergy symptoms. Rebound congestion can develop quickly or over time.

People turn to nasal decongestant sprays to relieve nasal congestion related to colds and allergies. Nasal congestion can often cause pain and discomfort in the nasal passages. Decongestants work to alleviate the pressure caused by nasal congestion.

When someone uses a nasal decongestant too often, it may result in rebound congestion. This is evidenced by a stuffy nose and nasal pressure without any other cold or allergy symptoms. Other symptoms that would be present if nasal congestion was related to a cold or allergy could be fever, headache, itchy eyes, or sore throat.

Short-term development of rebound congestion typically occurs when a nasal decongestant spray is used for more than three days. The spray initially may help by alleviating pressure and reducing the swelling in the sinus membranes. When the sinus membranes begin to swell again, a person may increase the frequency or dose of the preferred nasal spray decongestant to help alleviate the feeling of congestion. This creates an ineffective and repetitive cycle of trying to treat nasal congestion.

This condition can become a serious and persistent problem. Tolerance levels increase with repeated use, making a once effective treatment ineffective. Users of nasal decongestant sprays need to use higher doses on a more frequent basis. Long-term use can create a scenario where congestion is present on a routine or permanent basis. This type of congestion can crop up as soon as the use of nasal spray decongestant is stopped, fueling the cycle of use.

Some debate exists about whether rebound congestion should be considered an addiction. Studies have shown that over-the-counter decongestants do not contain addictive properties. Addiction is typically related with a psychological or chemical dependency or need, and nasal spray decongestants don’t contribute to that type of behavior.

Rebound congestion can be prevented. Following the directions on the label and using the spray as recommended for a maximum of three days can prevent rebound congestion. Instead of using over-the-counter spray, prescription nasal spray can be prescribed that will not result in rebound congestion. This is due to the steroid properties of prescription nasal spray decongestants. Prescription sprays can be used on a regular basis without the threat of this condition.

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