Most, if not all of us, have had a stuffy nose and received varied forms of advice from people around us. One family member might offer a decongestant, while another might suggest that simply eating an orange can ease it due to the antihistamine effects an orange has. While both aren’t wrong, it’s important to understand which will work best and when to take them.

Antihistamines and decongestants are common forms of medication that you can consume for a stuffy nose. With nasal congestion causing the same, tiresome symptoms, it’s easy sometimes to want to reach for the closest solution. But the big question is, which best suits your needs?

What’s causing your nasal congestion?

Nasal congestion, commonly referred to as a stuffy nose, is the obstruction to the flow of air in and out of the nose due to the blood vessels inside the nose becoming inflamed and the tissues inside the nose swelling. 

Nasal congestion is a very common condition. Nasal congestion can be caused by anything that irritates or inflames the tissues inside the nose. This includes minor illnesses like the common cold or sinus infection, which will typically improve within a week. 

If your stuffy nose has persisted for more than a week, it often indicates an underlying health issue that you need to look into and get appropriate treatment.

Some underlying causes of nasal congestion that lasts longer than a week are:

  • Allergies
  • Chronic sinusitis (a long-lasting sinus infection)
  • A deviated septum
  • Chemical exposure
  • Environmental irritants
  • Hay fever
  • Non-cancerous growth called nasal polyps, including benign tumours in the nasal passages

Nasal congestion may also occur during pregnancy due to hormonal fluctuations and a surge in blood supply. Pregnant women may experience this during the end of their first trimester. These changes may cause the tissue inside the nose to become inflamed, dry or even bleed.

Worried that your stuffy nose could be a symptom of COVID-19? Ease your fears, assess your risk and address your concerns with MyDoc’s COVID-19 Clinic. 

Treatment for a stuffy nose: Antihistamines or Decongestants?

Antihistamines and decongestants are both over-the-counter drugs that can relieve nasal congestion. 

They come in various forms, including tablets, nasal sprays, oral liquids and eye drops. Both have advantages and disadvantages, but more importantly, they work very differently and may tend to your needs differently. 

If you have fallen victim to uncontrollable sleepiness after taking one of those “drowsy pills” for your stuffy nose, you likely took an antihistamine. Mostly found in tablet and liquid form, antihistamines are good at relieving and preventing the symptoms of allergies, runny noses, itches and hay fever. 

If you have taken one of those nasal sprays that are somewhat uncomfortable but seem to work in an instant, you likely took a decongestant. Decongestants are good at providing instantaneous relief, freeing up a constricted nose. 

infographic on the difference between antihistamines and decongestants
While both antihistamines and decongestants can relieve nasal congestion, they cater to different needs.

Antihistamines for a stuffy nose

Antihistamines work by blocking histamines — a chemical found in the body cells, which causes swelling and irritation in your nasal tissues. This chemical also causes nose swelling, sneezing, runny nose, watery eyes and even itching.

While antihistamines can’t block every allergy symptom, they’re particularly effective at preventing nasal congestion and helping some of those uncomfortable symptoms ebb away. 

Do antihistamines have side effects?

A common side-effect of antihistamines is drowsiness. Though this side effect of antihistamines makes it inappropriate to consume at certain times, not all of them cause drowsiness. The newer second-generation of antihistamines are less likely to cause drowsiness.

  • First-generation antihistamines 

First-generation antihistamines have strong sedative action and would likely give you an unpleasant dry mouth after consumption. They are mostly used for allergic rhinitis and conjunctivitis, contact dermatitis, hay fever and even motion sickness. 

If your nasal congestion is keeping you awake, first-generation antihistamines may be a godsend for you. However, ensure that you do not take these before operating any machinery or driving.

  • Second-generation antihistamines 

On the other hand, second-generation antihistamines are non or less -sedative antiallergic agent. 

If you are dealing with nasal congestion at work, you may want to use a second-generation antihistamine so that you can remain alert. 

When you’re rifling through your drug cabinet, being able to differentiate between the first and second-generation antihistamines may save you a lot of time and distress. Here’s a table listing the different types and their side effects:

TypeFirst-generation antihistaminesSecond-generation antihistamines
Drugs– Chlorpheniramine 
– Hydroxyzine
– Diphenhydramine
– Promethazine
– Cetirizine
– Desloratadine
– Fexofenadine
– Levocetirizine
– Loratadine
Side effects– Strong sedative action
– Dry mouth and eyes
– Mild sedative action

Some of the other possible antihistamine side effects include the following:

  • Dizziness
  • Nausea and vomiting
  • Trouble urinating
  • Blurred vision
  • Confusion
  • Restlessness or moodiness in some children

If you take an antihistamine and experience the following rare, but life-threatening symptoms, do consult a doctor immediately:

  • Fast or irregular heartbeat
  • Convulsions
  • Hallucination
  • Shortness of breath or difficulty breathing

Things to note when taking an antihistamine

Unlike many other types of medicine, you can take antihistamines with or without food. However, you should not take it together with alcohol. 

You should also take extra precautions and consult a healthcare provider on any suspected allergies before consuming antihistamines. This is particularly important if the allergy is new to you, as recurrent allergies may have severe reactions that cannot be alleviated with antihistamines. In some severe cases, allergies can trigger a life-threatening reaction known as anaphylaxis, which occurs within seconds or minutes of exposure to something you are allergic to, and requires immediate medical attention.

If you are also on other medication, contact your doctor and ensure that the antihistamines you are taking can be combined with that medication. If not, your doctor will work with you to provide an alternative better suited for your needs.

Most of all, it is important to be responsible for yourself and the people around you. When taking antihistamines that induce drowsiness, make sure not to drive or operate any machinery. 

Decongestants for a stuffy nose

While antihistamines work to prevent and quell allergy symptoms by blocking the effects of histamine, decongestants work by narrowing your blood vessels, decreasing swelling and inflammation. Decongestants offer relief by helping to break the vicious cycle of continuous congestion and pressure. 

Decongestants come in various forms:

  • Nasal sprays and nose drops for direct nasal targeting
  • Tablets
  • Decongestant eye drops to reduce itching and other allergy symptoms in eyes

Decongestants take effect in just one to two hours and can offer you relief for up to 12 hours. But they don’t come without drawbacks. 

Decongestants do not treat the underlying cause of allergies. Rather, they’re almost like a cheat code. They temporarily alter your physicality to help make your nasal congestion more manageable so that you are able to breathe a whole lot better. 

Nasal spray dependence and the rebound effect

Woman blowing her nose to relieve nasal congestion, which is likely more severe due to the excessive use of a decongestant nasal spray.
Overuse of decongestant nasal spray can cause nasal congestion to worsen.

As the saying goes, too much of a good thing is never good. Once the effect of a decongestant nasal spray wears off, the nasal congestion that returns can be far more severe

This is called a “rebound effect”, and may occur if your nose becomes less responsive to the effects of a nasal spray due to excessive use. 

Excessive use of nasal sprays can lead to a tolerance build-up. If you’re heavy-handed with your use of nasal sprays, you might gradually find yourself requiring higher doses to help ease your congestion. Therefore, you should not use nasal sprays for more than five consecutive days. 

Doctors have termed this rebound congestion “rhinitis medicamentosa”. The phrase refers to congestion or rhinitis that is explicitly caused by medication. In this instance, the excessive use of nasal spray decongestants is the cause of congestion. 

Some symptoms of nasal spray overuse include:

  • Use of nasal spray for more than a week
  • Use of nasal spray more frequently than directed
  • Congestion upon skipping a dose 

With that said, prescription nasal sprays containing steroids do not cause a rebound effect and can be used on a daily basis for years. More often than not, these steroid sprays are not decongestants, but rather treatments for nasal allergies. 

Do decongestants have side effects?

Because they are stimulants by nature, decongestants have some related potential side effects. When used correctly, most people do not experience any of the side effects of decongestants. 

However, some potential side effects include:

  • Anxiety
  • Restlessness
  • Dizziness
  • Increased blood pressure
  • Abnormally rapid pulse
  • Irregular heartbeat

If you have high blood pressure, it is important that you consult your doctor before taking decongestants. 

This is because decongestants may constrict your blood vessels in a manner that exacerbates underlying health conditions. Seeking the advice of a doctor may help you to avoid any potentially life-threatening side effects. 

In general, nasal sprays decongestants tend to have fewer side effects as they’re topical. Since they are applied directly into your nose, nasal sprays are not absorbed into your bloodstream in significant amounts, unlike oral decongestants like pills. However, they come with the drawback of a risk of dependency. 

Things to note when using a decongestant

If you have health conditions such as high blood pressure, type 2 diabetes, heart disease, thyroid disease or an enlarged prostate, take note that your condition could be made worse by the use of decongestants. 

It’s best to seek the advice of a healthcare provider before you begin using it. 

Take special care to make sure you’re not consuming more than one decongestant. Multiple decongestants may have similar active ingredients that add up to be too much medicine and taking more than the recommended amount can be dangerous.

If you are taking any other medication, err on the safe side and ask your doctor if it is safe for you to use decongestants. Drugs from certain classes such as monoamine oxidase inhibitors (MAOIs) may cause dangerous drug interaction problems when consumed with decongestants. Thus, it’s best to get advice from your doctor. 

Read more about how you can protect your family from diabetes here. 

What are some home remedies to treat a stuffy nose?

Decongestants and antihistamines may do the trick for you, but you also shouldn’t underestimate the power of home remedies. 

They’re inexpensive, sometimes delicious, and they also don’t come with nearly as many potential side-effects. 

Not to mention, home remedies are a fantastic long-term control method for a stuffy nose, especially because you can’t take too many decongestants and antihistamines!

1. Use humidifiers 

Humidifiers are a highly recommended, effortless way to help relieve nasal congestion. 

By adding moisture to the air in your surroundings, humidifiers ensure that your nasal passage is filled with the moisture that it needs. This will help loosen up nasal secretions and soothe your inflamed nasal passageways, giving you some much-needed shut-eye.

It’s also worth noting that dry air prevents the regular draining of sinuses, causing nasal congestion. If that’s what’s causing your stuffy nose, then a humidifier is an easy fix! You can even add essential oils like eucalyptus oil to help reduce stuffiness. Eucalyptus oil contains cineole, an ingredient reputed to help with the treatment of acute sinusitis.

2. Elevate your head when sleeping

Congestion tends to be worse at night because it is difficult for the nose and sinuses to drain. Another simple remedy is to prop your head up on a few pillows when sleeping to help the sinuses drain more easily.

The elevated position will help ensure that your sinus doesn’t stagnate and build-up. It will also encourage mucus secretions to flow gently out of your nasal passages. 

While propping up your head may not free you of your nasal congestion, it will help make sure that your stuffy nose doesn’t rob you of precious sleep time!

3. Do exercises

Exercising may help you feel better by opening your nasal passages and temporarily relieving nasal congestion. Instead of making it harder for you to breathe, exercising can make breathing easier by improving blood circulation that clears sinus pressure. 

But that doesn’t mean you have to pant your way through a jog! Do lighter and less strenuous exercises like yoga, which have variations that cater to the unwell. A burst of rejuvenation can also help your body speed up the healing process if you have a cold or flu.

4. Do a steam treatment 

If you need a mood-booster, try using steam to relax your mind, body and specifically, your nose. 

For fast relief, consider covering your head with a towel and lean over a large pot of steaming hot water. Breathing in the steam will help dislodge thick mucus while relaxing your nasal passageway, reducing swelling. 

And if a gust of steam isn’t up your alley, you can stick to something as simple and comforting as a hot bath or a piping hot cup of tea. The mucus in your nose will thin and drain from your nose in no time.

5. Stay hydrated

You’ve probably heard this a thousand times, but it’s important to stay hydrated. 

Not only will the constant intake of fluids keep your body temperature in check, it will also help reduce blockage and swelling in your nose. It won’t be long before you feel the congestion in your nose and face start to dissipate. 

While water should be your primary source of hydration, you can also look toward comfort foods like broth soups, tea, and water-based fruits and vegetables. 

If all of that sounds too tiresome for your sick palate, suck on ice cubes and let them melt in your mouth!

Read more about how you can fight a cold effectively here.

When should you see a doctor for a stuffy nose?

Woman taking decongestants and orange slices for her nasal congestion.
If over-the-counter antihistamines and decongestants don’t work, you should seek help from a doctor as soon as possible.

Home remedies may not always prove useful. Certain scenarios may mean that your stuffy nose indicates health conditions like sinusitis or even severe allergies. 

If you start to feel that your symptoms could be caused by another health condition, it’s time to speak with your doctor. 

Here are some clear signs on when to see your doctor:

  • When congestion lasts for over 10 days
  • When congestion is accompanied by high fever for over three days
  • When sinus pain and fever is accompanied with green nasal discharge 
  • If you have a weakened immune system
  • If you have respiratory conditions like asthma or emphysema
  • If the patient is an infant

If your infant has a stuffy nose, it is important that you see a doctor as soon as possible. This is because nasal congestion may be indicative of potentially fatal breathing problems. 

Nasal congestion might also interfere with infant feeding and can cause choking and aspiration, which is when fluid ends up in a child’s lungs. 

Getting your infant prompt medical attention by a certified healthcare practitioner can also help make sure that normal speech and hearing development is unaffected. 

Get relief from a stuffy nose with MyDoc’s digital healthcare service

The last thing you want to do with a stuffy nose is to be sniffling while waiting in a line. You can now see a doctor easily through video-consultation. Visit MyDoc’s Patients page to find out more.

Leave a Reply