Over-the-counter Medicines for Nasal Symptoms

Dr. John Overholt • December 16, 2016

What to Buy for Allergic Rhinitis Relief


Let's talk for a bit about common allergy medications. In the interest of time, I’ll focus on medicines used to treat nasal symptoms, what doctors call rhinitis.



The most common medications used for rhinitis are antihistamines. Antihistamines work, as their name suggests, by blocking the effects of the chemical histamine. They are particularly good for controlling symptoms of nasal itching, sneezing, runny nose, and itchy eyes. They are not very good at controlling nasal congestion and drainage. Older antihistamines like diphenhydramine (benadryl), chlorpheniramine (chlor-trimeton) , and hydroxyzine (atarax, vistaril) are very potent, but they are also very sedating. Newer antihistamines such as cetirizine (zyrtec), fexofenadine (allegra), and loratidine (claritin) are classified as low- or non-sedating and still have adequate potency. I generally recommend one of the newer medications. Cetirizine and loratidine are available over-the-counter and as store brands.



Decongestants also do what their name suggests: help control nasal congestion. Some people find they help with symptoms of pressure and pain as well. They work by constricting the blood vessels in the nose which, in turn, shrinks the lining of the nasal passage. Since they are oral medications, they will also constrict the blood vessels in the rest of the body, which can worsen blood pressure, In guys, they can also worsen prostate problems. They cause insomnia in a number of people as well. Because of all these side effects, I avoid decongestants as much as possible and limit their use to short periods of time.

Plain table salt is fine and could never make the nose a dirtier place than it already is.

Over-the-counter nasal sprays are a double-edged sword. They are sold under a variety of names, but most contain the drug oxymetazoline. They will open your nose like nothing else, but if used improperly can lead to dependence so be very careful with them and always follow the instructions. Never use them for more than 3 days in a row or more than twice a day. If you do, when you try to stop, your nose will be worse than when it started- a phenomenon called rebound. I see patients every week who have become dependent on these medications to breathe through their nose. Don’t become one of them.

Finally, I’ll talk about saline rinse. This is a great treatment for most nasal symptoms, including drainage. It’s essentially free and devoid of side effects. I’m not referring to “ocean spray” that simply moistens the nose, but rather forcing a large volume of saline through the nose. This can be done with gravity (a neti pot) or with force (a plastic squeeze bottle). Either way, make sure you don’t use plain tap water- it’s too dilute and will irritate the lining of the nose. A simple mix involves using a teaspoon of salt in 8 ounces of water. Some companies try to sell you their mix, claiming that they have “pharmaceutical grade NaCl”. This is ridiculous. Plain table salt is fine and could never make the nose a dirtier place than it already is.

Hope this is helpful.

You might also like

Gel Nails and Allergic Contact Dermatitis

By Dr. Nicholas Cline • July 10, 2026
Allergic Contact Dermatitis from Gel Nail Polish (HEMA / Methacrylates) What is happening? The itching, swelling around the cuticles, small blisters, and peeling skin are signs of allergic contact dermatitis — an allergic reaction caused by chemicals in gel nail polish called (meth)acrylates. The most common culprit is a chemical called HEMA (2-hydroxyethyl methacrylate). Why did this happen after months of use? This type of allergy is a delayed immune reaction. The body needs repeated exposures — often over many months — before the immune system becomes sensitized. This is why the product may have seemed perfectly fine at first. Why are home kits riskier? Gel nail polish must be fully "cured" (hardened) under a UV or LED lamp. When the polish is fully cured, the chemicals become locked into a solid polymer and are no longer irritating. The problem occurs when the polish is not fully cured — leftover uncured chemical monomers sit on the skin and trigger the allergic reaction. Home kits are riskier because: The lamp may be underpowered or mismatched to the polish formula Layers may be applied too thickly for the lamp to cure completely Curing times may be too short Technique without professional training increases skin contact If you're having an allergic reaction to at-home gel nail kits, discontinue use and review your products and technique to ensure quality ingredients, sufficient curing times, and properly powered lamps.

Celebrate Summer Safely With Asthma

By Dr. Phil Jones • July 4, 2026
Summer is in full swing! Learn why some seasonal activities can cause flare-ups and how you can protect your lungs while still enjoying the festivities.
Mailbox

Mail-in Allergy Testing

By Dr. Nicholas Cline • May 27, 2026
If you spend any time browsing the internet or social media, you’ve likely seen advertisements for mail-in allergy kits. They promise to test for hundreds of food intolerances and environmental sensitivities using just a few strands of your hair or a quick saliva swab. It sounds incredibly convenient, painless, and comprehensive. But if it sounds like a gimmick, it probably is. While these mail-in tests are heavily marketed, they often lack scientific backing and can leave patients feeling more confused than comforted. The Science of Allergy Testing. What Are We Looking For? To understand why hair and saliva tests don't work, we have to look at how the immune system reacts to allergens. When you have a true allergy, your body produces a very specific type of antibody called IgE (Immunoglobulin E) . These antibodies bind to mast cells (allergy cells), which are on high alert to protect you from perceived invaders like pollen, dust mites, or specific food proteins. The fundamental flaw with mail-in hair and saliva kits comes down to basic biology: Wrong Locations: Mast cells and IgE antibodies are not traditionally found in your hair follicles or saliva. Unreliable Results: Because these testing methods are looking in the wrong place, they are highly unstandardized and unvalidated. You are highly likely to get a flood of false positives or false negatives that are impossible to interpret accurately. What the Experts Say: Major medical organizations strongly advise against these methods. The National Institute of Allergy and Infectious Diseases (NIAID) explicitly recommends against using hair analysis for food allergy evaluations due to a lack of diagnostic value. Furthermore, the American Academy of Allergy, Asthma & Immunology (AAAAI) and the American College of Allergy, Asthma & Immunology (ACAAI) have issued strong practice guidelines stating that hair analysis should not be used to evaluate food allergies. The Big Misconception: IgE vs. IgG Many mail-in companies charge anywhere from $150 to upwards of $600 for "sensitivity" panels. When patients produce these multi-page reports, the testing is almost always checking for IgG (Immunoglobulin G) antibodies, not IgE. There is a massive difference between the two: