Nasal polyps are common, benign (noncancerous) growths that typically develop when people are in their 30s or 40s.
These growths are often linked to inflammation in the nose lining, a condition known as chronic rhinosinusitis. When they occur together, the condition is known as chronic rhinosinusitis with nasal polyps (CRwNP).
You may have small polyps without even realizing it until they grow larger and cause symptoms like:
- loss of smell
- other sinus-related symptoms
Nasal polyps can even eventually block the inside of your nasal cavity, and symptoms may worsen as polyps grow.
In some cases, surgery is the best course of treatment to remove nasal polyps. However, growths can come back even after they’re removed.
Whether you’ve already had surgery or not, your doctor can recommend medications that can help shrink these growths while improving your symptoms.
About 80 percent of people find that polyps shrink and symptoms subside with prescription steroid sprays or oral medications. Other options may include medications that are usually prescribed for asthma and nasal allergies.
Medications likely won’t get rid of nasal polyps completely. The only way to totally remove nasal polyps is with surgery. Surgery is typically used as a last resort when other treatments don’t alleviate your symptoms — and even with it, polyps may return.
Depending on the size and location of your nasal polyps as well as your symptoms, your doctor may recommend one or more of the following options:
Nasal steroid sprays are the most common medications for nasal polyps. These work by reducing inflammation and polyp size to alleviate symptoms.
Unlike oral steroids, newer sprays aren’t absorbed by your body and are safe to take for many years.
Your doctor may also recommend a nonprescription saline spray or rinse. This may be used multiple times a day to help clear nasal passageways.
For larger nasal polyps, your doctor may prescribe a course of short-term oral steroids. These may help shrink polyps and improve more severe symptoms, such as loss of smell.
Due to the risk of side effects, oral steroids are intended for temporary use only.
Oral antibiotic medications are sometimes prescribed alongside steroids if you experience infections with nasal polyps.
These don’t shrink nasal polyps, however, and using them too frequently increases the risk of developing antibiotic resistance.
Asthma and allergy medications
People with adult-onset asthma are more likely to have nasal polyps. And environmental allergies may often come alongside them.
Medications used to treat asthma and allergies may help treat nasal polyps in some people.
Fluticasone (Flonase) spray is an over-the-counter corticosteroid nasal spray that’s typically used to treat allergies. It may also help treat nasal polyps by reducing inflammation.
Nasal fluticasone is also offered in a version called Xhance that’s specifically designed to reach higher in the nasal cavity.
The leukotriene antagonist montelukast (Singulair) is an oral medication prescribed for allergies and asthma. It has been found to help with nasal polyp symptoms in some people.
Dupilumab (Dupixient) is a biologic medication first used to treat eczema and moderate to severe asthma. It’s now approved by the Food and Drug Administration (FDA) to treat CRwNP.
A biweekly injection may:
- decrease polyp size
- improve symptoms
- decrease the need for nasal polyp surgery in people who don’t respond well to steroids
Omalizumab (Xolair) is another biologic medication previously used for allergic asthma that has also been recently approved by the FDA for the treatment of CRwNP that doesn’t get better after treatment with steroid nasal sprays.
Steroids have the strongest track record for shrinking polyp size. They alleviate symptoms for 80 percent of people who take them. Due to the long-term risks of oral steroids, steroid nasal sprays or biologics are preferred.
For people with CRwNP that doesn’t respond to steroids, allergy and asthma medications may be an option.
One 2020 review of studies concluded that people with CRwNP who took dupilumab for 24 weeks found that their polyps significantly shrunk and their quality of life improved compared with people taking a placebo (sugar pill).
Another 2020 study of two random controlled trials in people with severe CRwNP who didn’t respond to corticosteroid sprays found that omalizumab significantly improved quality of life and symptoms versus placebo.
Nasal polyps can come back even when you’ve taken medications. There’s also a high chance that nasal polyps will come back after surgery.
The success rates of nasal polyp treatment without surgery depends on:
- the size of these growths
- their location
- whether you respond to standard medications
If you’re struggling with ongoing congestion, post-nasal drip, or loss of smell from nasal polyps, call your doctor to discuss your treatment plan.
They may make modifications based on:
- an exam of your nasal passageways
- imaging tests
- your symptoms
Nasal steroid sprays are usually effective at shrinking polyps and reducing symptoms.
If they don’t help, your doctor may recommend other medications.
The only way to completely remove large nasal polyps is with surgery, although polyps may return even after they’ve been removed.