A stuffy nose is usually nothing to worry about; it's mostly just uncomfortable, with varying symptoms. "For some people, it's having a lot of mucus in the nose. For others, it's a feeling that the airways are blocked and there's a diminished sense of smell," says Dr. Ahmad Sedaghat, an otolaryngologist and director of Rhinology, Allergy and Anterior Skull-Based Surgery at the University of Cincinnati College of Medicine.
No matter which symptoms you're experiencing, the goal is getting rid of them. The most effective remedy depends on the cause of your condition.
Stuffy Nose Causes
Stuffy nose causes fall into two categories: temporary and fixed.
Temporary causes come and go (such as viral infections like a cold or allergic reactions to tree pollen or dust). They trigger a cascade of reactions from the immune system.
"The immune system recognizes a foreign invader and creates inflammation to fight it. That leads to mucus production and the swelling of structures on each side of the nose called inferior turbinates. The turbinates have a lot of vascular channels that fill with blood, causing swelling of the turbinates, which creates a feeling of obstruction," Sedaghat says.
Fixed causes of a stuffy nose are obstructions due to structural abnormalities. These can include:
-- A deviated (off-center or crooked) septum. The septum is the wall separating the right and left sides of the nasal cavity. "If your nose was broken, for example, a deviated septum can cause one side to be stuffy and the other side to be clear," says Dr. Rachel Franklin, a family doctor and physician executive for Community Health And Primary Care at OU Health in Oklahoma City.
-- Nasal valve collapse. This occurs in the soft tissue near the nostrils, making them too tight or narrow. "That might happen naturally over time as the cartilage becomes weak, especially if you've had a nose job," Sedaghat points out.
-- Growths. In rare cases, malignant tumors grow in the nasal cavities. More commonly, benign growths called polyps can develop. "They can occur on one or both sides. They grow, get bigger and block the airways," Sedaghat says.
In some cases, COVID-19 might cause a stuffy nose, although it wasn't on the original list of COVID hallmarks. Classic symptoms of the SARS-CoV-2 alpha variant included fever, a cough, body aches and pains, shortness of breath and a loss of taste and smell -- without nose congestion.
The delta variant is different. It's often associated with symptoms of a common cold, like a stuffy or runny nose and sore throat. And since a stuffy nose can also have a component of diminished smell, it can be hard to tell if the symptom indicates a minor or potentially major health condition. But there are two things to keep in mind.
One is that the delta variant still triggers the loss of taste and smell, and it's profound. "If you're eating a chili pepper and it tastes like cardboard, you may have a problem," Franklin says.
Sedaghat says that's because the COVID virus can infect the taste buds. "When you lose smell with a stuffy nose, you can still taste sweet, salty, bitter or savory. But that ability is wiped out with COVID. There's no taste at all," he says. (He and his colleagues were among the first in the world to make the connection between COVID and loss of smell and taste in the early days of the pandemic.)
Other things to consider in discerning COVID from a stuffy nose: vaccination, accompanying symptoms and health history. "If you're fully vaccinated against COVID and you have a known history of allergies, then a stuffy nose without any other symptoms is likely allergies. If you're not vaccinated, we are less sure. And anyone -- vaccinated or unvaccinated -- who's had a potential exposure to someone with COVID should monitor their symptoms closely, practice physical distancing, wear a mask around others, and consider getting tested for COVID," Franklin advises.
Stuffy Nose Fixes
You don't have to do anything to treat the stuffy nose of an allergy or a cold. "An allergy or cold will get better on its own. It won't cause any significant problem beyond decreased quality of life until you feel better," Sedaghat says.
But if you want relief, lots of remedies can help. They include:
-- Nasal steroid sprays. The sprays, such as triamcinolone (Nasacort) or fluticasone (Flonase), decrease inflammation on the inferior turbinates. "The sprays reprogram inflammatory cells. But it takes time to change their behavior. Give it at least a few weeks of consistent use," Sedaghat says. "And don't spray it toward the middle of your nose; that's the septum, which doesn't swell or shrink. Spray it toward the inside corner of the eye to get it on the turbinates."
-- Antihistamines. These are appropriate for people with allergies. Medications such as fexofenadine (Allegra) or loratadine (Claritin) block the production of histamine, a chemical involved in the body's immune response.
-- A short course of oral decongestants. These drugs, such as pseudoephedrine (such as Sudafed) and phenylephrine (most often found in combination cold medicines), shrink blood vessels in the nose and work well in the short term (two or three days). "In the long term, however, the medications can cause rebound congestions that's worse than the congestion you started with," Franklin warns. "And they can raise blood pressure."
-- A short course of decongestant sprays. Like oral decongestants, sprays are a quick fix. But they come with a steep risk. "If you use them for more than two or three days, they can become addictive," Sedaghat says. "I tell people patients to avoid them if possible."
-- Mucolytics. These medications, such as guaifenesin (Mucinex), thin mucus secretions, which can help ease nasal congestion and discomfort.
-- Saline sprays. Rinsing out the nasal passages each day helps clear out mucus and toxins, which can lead to reduced stuffiness.
-- A hot shower. "A hot shower feels like it works for a while, but the heat itself cause blood vessels to open wider. So after a shower, you may have more congestion," Franklin says.
-- Aromatherapy. Inhaling the vapors of menthol, peppermint or rosemary may make your nose feel open. "Menthol activates nerves inside the nose that tell the brain your nasal passages are open," Sedaghat says. You can use a premade nasal inhaler (a tube that contains the ingredient inside, which you gently insert into your nostril) or place a few drops of liquid oil into a bowl of hot water or a vaporizer.
These remedies can also help ease stuffy nose symptoms due to a fixed problem, such as a deviated septum. But surgery is the only permanent solution for a fixed nasal obstruction.
Staving off a stuffy nose is an important strategy, especially since we're in a pandemic. Ways to do that include:
-- Using a saline rinse. "It keeps the lining of the nose moist, which helps prevent viral particles from getting in, and it helps rinse out viral particles that can accumulate in mucus particles over the course of the day," Sedaghat says.
-- Wearing a mask. "We've had a dramatic reduction in the number of cold and flu cases and even allergies because people have been wearing their masks. There's definitely a link there," Sedaghat says.
-- Staying away from triggers. If you know you're allergic to ragweed, for example, stay indoors when ragweed pollen counts are high.
Use all of those strategies in addition to following a healthy lifestyle:
-- Eat a healthy diet, such as the Mediterranean diet (rich in fruits, vegetables, legumes, whole grains, seeds, nuts and olive oil; and moderate amounts of dairy, seafood or poultry).
-- Aim for seven hours of sleep per night.
-- Exercise for 30 minutes at least five days per week.
-- Reduce stress (with meditation or yoga, for example).
-- Drink lots of water each day.
-- Limit alcohol intake to no more than one drink per day for women or two drinks per day for men.
-- Avoid smoking.
But if you do feel a stuffy nose coming on, pay attention. "If it's just a stuffy nose that lasts for more than a couple of weeks, contact your doctor for an evaluation," Franklin suggests. "And if it's a stuffy nose that's accompanied by any other symptoms, call you doctor as soon as possible in case it might be COVID."
Heidi Godman reports on health for U.S. News, with a focus on middle and older age. Her work has appeared in dozens of publications, including the Harvard Health Letter (where she serves as executive editor), the Chicago Tribune, Baltimore Sun, Orlando Sentinel and Cleveland Clinic Heart Advisor.
Godman spent more than 20 years as a TV news anchor and health reporter at ABC affiliate WWSB and more than five years as the host of a daily health talk radio show on WSRQ-FM. Heidi has interviewed surgeons in operating rooms, scientists in laboratories and patients in all phases of treatment. She's earned numerous awards for outstanding health reporting and was the first TV broadcaster in the nation to be named a journalism fellow of the American Academy of Neurology. Heidi graduated from West Virginia University with a degree in journalism.