What Are the Risks of Sinus Rinses, and How Can You Avoid Them?

Sinus rinses can be done with a variety of nasal irrigation devices. Some come prefilled with sterile solution. Others require filling of sterile water or saline.

Nasal irrigation devices include:

• neti pots
• squeeze bottles
• bulb syringes
• battery-operated devices

Nasal irrigation devices work by flushing out the nasal cavity. Sterilized water (or saline solution) is poured into one nostril, where it flows through the nasal cavity, and out the other nostril. This removes mucus, dust, allergens, and bacteria. Sinus rinses also thin out thick mucus, making it easier to blow out or expectorate (cough up).

When done correctly, sinus rinsing is safe and effective for most people. However, side effects can sometimes occur.

Common side effects

The side effects from nasal rinsing are typically minor and temporary, resolving within a few hours to a day. They include:

• burning or stinging sensation in the nose
• slight nasal irritation

Some people may get a slight nosebleed when they use a neti pot or other nasal rinsing device. This is usually caused by overuse of the device, because this dries out the nasal passages.

Serious side effects

Serious side effects can occur when nasal rinsing is done too often or if unsafe water is used. Nasal rinsing can be done with water, that is:

• distilled
• sterile
• filtered
• boiled for 3 to 5 minutes, then cooled to room temperature

If you’re boiling water to sterilize it, make sure it’s sufficiently cooled before introducing it into your nostril. If the water is too hot, it can cause internal burning and blistering to occur.

Saline solution is also sterile and can be used for sinus rinsing as well.

You can reintroduce bacteria into your sinuses if you use a neti pot or bulb syringe that isn’t sufficiently cleaned between uses. Make sure to follow package directions for cleaning exactly. And to avoid passing germs to others, don’t share your nasal irrigation device with anyone else.

Nasal rinsing should only be done when you’re congested and have a stuffy nose. When you’re sick, your sinuses fill with thick mucus. Nasal rinsing is effective at thinning and removing excess mucus. This alleviates congestion, making you more comfortable.

However, overuse or long-term use can be unsafe. That’s because your sinuses always need a protective lining of good mucus. This lining is sticky, so it can trap irritants and germs that enter your nostrils. It also contains proteins that kill bacteria before they can enter your lungs. Removal of the mucus lining leaves you vulnerable to illnesses such as sinus infections.

While rare, nasal rinsing can cause serious infections or become life threatening when unsterilized water, including tap water, is used. Tap water is safe for you to drink and wash with. However, it can contain lots of microscopic organisms, including amoebas, that can cause serious or life threatening infections in nasal passages. If you drink tap water, the acid in your stomach kills these organisms. Since there’s no acid in your sinuses, these organisms are able to grow and thrive there. They may also travel into the brain.

Once in the brain, primary amoebic meningoencephalitis (amoebic meningitis) can occur. This potentially life threatening condition is caused by Naegleria fowleri, a single-celled amoeba. Naegleria fowleri is found in fresh water and damp soil. It causes inflammation and destruction of the brain and brain lining. When not treated promptly, amoebic meningitis is usually fatal.

Symptoms of amoebic meningitis can occur between 1 and 7 days after infection. They include:

• intense, persistent headache
• high fever
• nausea and vomiting
• sleepiness
• sore throat

If you experience any of the symptoms above after nasal rinsing with an unsterilized solution, seek immediate medical attention.

Nasal rinses should not be done on infants or children under 2 years old. If your child has a stuffy nose, talk with their pediatrician about treatments and medications that can help.

Older children may be able to tolerate a sinus rinse, but talk with your healthcare professional first to make sure sinus rinses would be safe and effective for the condition it would be used for. Additionally, make sure to use a child-sized device designed specifically for their use.

To reduce the risk of infection, the FDA recommends that immunocompromised people speak with their doctor before using a sinus rinse device.

There are several at-home treatments that may help alleviate sinus congestion or infection. They include:

• taking over-the-counter decongestants
• sleeping with a humidifier in the room
• breathing in an essential oil, such as eucalyptus, from a diffuser
• using a mentholated chest rub

If you have a severe or chronic sinus infection that doesn’t respond to at-home treatments, a healthcare professional may be able to prescribe medications that can help.

Sinus rinses are safe for most people to use. They are effective for alleviating sinus congestion and eliminating allergens and irritants from the nasal cavity.

However, it’s important to use sterile water when you do a sinus rinse. Using unsterilized tap water can introduce harmful microorganisms into your sinuses. This can result in serious infections, so make sure you’re using the rinse device exactly as the directions describe.