Why does the nose get stuffy?
Inside the nose, the turbinates (bony shelves covered in a spongy lining) warm and filter the air. When infection or allergy irritates them, blood vessels dilate and the lining swells, narrowing the airway. Mucus then adds to the blockage, but the swelling is usually the main culprit. That is why blowing the nose often does not clear a stuffy nose.
Common causes
- Common cold and flu (viral infections), lasting 7–10 days.
- Allergic rhinitis, seasonal or year-round.
- Sinusitis, acute or chronic.
- Nasal polyps, a deviated septum or enlarged turbinates.
- Non-allergic rhinitis: triggered by smells, temperature change, spicy foods, smoke.
- Decongestant overuse (rebound congestion).
- Pregnancy and hormonal changes.
- Enlarged adenoids in children.
- Rarely, foreign objects, tumours or medicines such as some blood pressure drugs.
Self-care for a stuffy nose
- Saline nasal sprays or rinses (using distilled, sterile or boiled-and-cooled water).
- Steam inhalation or a hot shower.
- Fluids and humidified air.
- Sleep with your head raised.
- A warm compress over the nose and cheeks.
- Blow gently, one nostril at a time.
- Avoid irritants: smoke, strong smells.
Medicines
Decongestant nasal sprays (oxymetazoline, xylometazoline) shrink swollen tissue within minutes, but should be used for no more than 3 days (up to 5, depending on product instructions): longer use can cause rebound congestion that is worse than the original problem. Oral decongestants (pseudoephedrine, phenylephrine) are less effective or have more side effects; they can raise blood pressure and heart rate, so avoid them if you have heart disease, hypertension, glaucoma or prostate problems unless advised.
Nasal corticosteroid sprays (fluticasone, mometasone, budesonide) are the best long-term treatment for allergic and persistent congestion; use daily and expect results in 1–2 weeks. Antihistamines help allergy symptoms such as sneezing and itching. Ipratropium nasal spray may help a runny nose.
Rebound congestion
Rhinitis medicamentosa develops when topical decongestants are used for more than a few days: the lining becomes dependent on the drug and swells when it wears off. The solution is to stop the spray (sometimes one nostril at a time), use saline and a nasal steroid spray, and ask a doctor or pharmacist for a plan. It can take days to a couple of weeks to settle.
Stuffy nose in babies and children
Babies are obligate nose-breathers, so a blocked nose can interfere with feeding and sleep. Use saline drops followed by gentle suction with a bulb or aspirator, keep the room humid and the baby upright when feeding. Do not use medicated decongestants in babies or over-the-counter cold medicines in children under six. See a doctor for fever in a baby under 3 months, laboured breathing or poor feeding.
When congestion is chronic
Congestion lasting more than 12 weeks may be chronic rhinosinusitis (with or without polyps), persistent allergic rhinitis, non-allergic rhinitis or a structural problem such as a deviated septum. An ENT specialist can examine the nose with a camera, arrange allergy testing or a CT scan and discuss treatments, including long-term nasal steroids, saline irrigations, biologic medicines for polyps and surgery in selected cases. See blocked nose at night for night-time problems.
When to see a doctor
- Congestion lasting more than 10 days without improvement.
- Facial pain, high fever or thick discoloured discharge for more than 3–4 days.
- One-sided blockage, bleeding, foul smell or loss of smell.
- Recurrent episodes or symptoms for 12 weeks or more.
- A baby with noisy breathing or feeding trouble.
- Swelling of the eye, vision changes or neurological symptoms (urgent).
Three common situations
Stuffy nose with sore throat and cough on day 3: typical cold; saline, fluids and rest; a decongestant spray for up to 3 days if needed.
Stuffy nose with sneezing and itchy eyes in spring: likely allergy; a nasal steroid and antihistamine.
One side blocked for years: consider a deviated septum or polyps; see an ENT.
How to do a saline rinse safely
Use distilled or sterile water, or tap water that has been boiled for at least one minute and cooled to lukewarm, with a premixed saline packet. Lean over a sink, tilt your head to the side and let the solution run in one nostril and out of the other with your mouth open. Clean the bottle or pot after each use and let it air dry. Never use untreated tap water: rare but serious infections have been reported.
Key points to remember
A stuffy nose is caused by swelling. Use saline, steam and the right medicine for the cause, avoid prolonged decongestant sprays and seek help if it is persistent, recurrent or one-sided.
This guide is for general information and does not replace an assessment by your own doctor or ENT specialist.
Questions about a stuffy nose
These answers are general information and do not replace an examination or individual medical advice.
What is the fastest way to unblock a stuffy nose?
A saline rinse, steam and, for no more than 3 days, a decongestant nasal spray give the quickest relief.
How long does a stuffy nose last with a cold?
Usually 7–10 days.
Is it safe to use nasal decongestant spray every day?
No. Use it for no more than 3–5 days to avoid rebound congestion.
Why is my nose stuffy but nothing comes out?
Because the lining is swollen; congestion is often from swollen tissue rather than mucus.
Do nasal strips work?
They can help with nasal valve collapse or a mild blockage, but they do not treat the cause.
When should I see an ENT?
For congestion lasting more than 12 weeks, one-sided blockage, polyps, or recurrent sinus infections.
Sources
- NHS · Common cold
- NHS · Allergic rhinitis
- AAO-HNSF · Clinical practice guideline: Allergic rhinitis (update), 2015
- AAO-HNSF · Clinical practice guideline: Adult sinusitis (Rosenfeld et al., 2015)
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.