Anyone who has ever played in rough surf at the shore can tell you there’s nothing quite so bracing as having cold seawater forced through your nasal passages. While initially unpleasant, this forced irrigation sometimes results in unexpected, but not unwelcome, relief from clogged sinuses. Perhaps it was just such an experience that inspired someone in India, long, long ago, to try voluntary nasal irrigation to relieve the annoying symptoms of allergies.

Among the worst symptoms of nasal allergies, also called allergic rhinitis, are excess mucus production, stuffy nose, runny nose, and irritated nasal passages and sinuses. Some people with allergies develop a condition called chronic rhinosinusitis, a continually inflamed condition characterized by irritated or even infected sinus cavities.

Centuries ago, practitioners of Ayurveda, the traditional Indian medicine system, pioneered the use of warm saltwater to flush nasal cavities and remove excess mucus, pollen, and other debris.

Also known as “nasal douche” or “nasal lavage,” nasal irrigation uses two simple ingredients: salt water and a specially designed vessel, called a neti pot, which delivers a stream of salt water into your nasal cavities through one nostril and out the other. Practitioners usually do this one to four times per day, with no dip in the sea required.

Supporters of the technique claim it offers significant relief from nasal congestion and irritation. They also claim it can reduce headaches associated with sinus congestion and allows people to reduce their reliance on antibiotics to combat sinus infections. It can decrease the use of nasal corticosteroid sprays for the control of allergy-related nasal inflammation. Users report feeling “empowered” to take control of their allergies and claim that it delivers significant improvements in their quality of life.

Numerous clinical trials have been conducted, and most agree that nasal irrigation is safe and well tolerated. At worst, they note that the procedure can be cumbersome, requiring more effort than other options, such as taking medications.

At best, nasal irrigation provides significant improvements in a wide range of allergy symptoms. Researchers at the University of California, San Diego, studied more than 200 patients who used the procedure. Subjects experienced “statistically significant improvements” in 23 of 30 symptoms, plus improvements in subjective quality-of-life ratings.

There are a few caveats, however.

Don’t Use on Infants

Irrigation shouldn’t be used on infants.

Don’t Use Regularly

Regular use of nasal irrigation may actually increase the risk of sinus infection. Occasional use hasn’t been linked to this risk, but routine use should be discouraged. Routine use may remove some protective elements of the mucus membranes lining the nasal passages and sinuses.

Only Use Sterile Water

One final warning: It’s crucial to use sterile water to prepare the irrigation solution. Boiling before use should be sufficient. A parasitic amoeba, Naegleria fowleri, has been linked to several deaths among neti pot users who failed to use sterile water. Once introduced into the sinuses, the parasite makes its way to the brain, causing an infection that is fatal.

A neti pot is a simple device that looks like a small teapot. Warm, sterile water is mixed with pure salt in the pot. While tilting your head slightly to one side, place the spout in your nostril on top and let the saline solution drain through your bottom nostril.

As noted above, it’s crucial to use sterile water. Create a saline solution by adding the correct amount of pure, non-iodized sodium chloride to the water, to create one of two solutions:

  • isotonic, which is 0.9% salt and 9 g sodium chloride dissolved in one liter of water
  • hypertonic, which is a 0.7% to 0.3% salt solution

Kosher salt is a suitable source of pure sodium chloride with no added minerals. Nasal irrigation should not be attempted with tap water or distilled water. Sterility is essential for safety, and salt prevents the uncomfortable burning sensation associated with the use of non-isotonic solutions.

Isotonic solutions contain enough dissolved solids to match the concentration of solutes dissolved in the blood. Not surprisingly, seawater is essentially an isotonic solution of salt and water. However, seawater should never be used deliberately, due to risk of introducing unwanted contaminants.

Neti pots are a great, natural way to relieve nasal congestion and allergies, as long as you use sterile water and don’t use it too frequently. They have been a part of Ayurvedic medicine for hundreds of years. Be sure to ask your doctor if you have any concerns about using one.