In the United States, the incidence of rhinitis remains high, especially allergic rhinitis. Affected by allergens such as pollen and dust mites, many patients suffer from symptoms such as nasal congestion, runny nose, and sneezing all year round. As a tool to relieve symptoms by flushing the nasal cavity with saline, the nasal washer has gradually become a standing item in American family medicine cabinets. However, there is always controversy about whether the nasal washer can be used every day: some people believe that it can effectively clean the nasal cavity and reduce allergens, and should be used for a long time; others worry that frequent use will damage the nasal mucosa and even cause infection. This article will analyze the frequency of use of the nasal washer from a scientific perspective to help readers find a nasal care plan that suits them.
The "self-cleaning system" of the nasal cavity and the auxiliary role of the nasal washer
The surface of the nasal mucosa is covered with tens of thousands of cilia, which push the inhaled dust, bacteria and allergens to the throat through regular swinging, and finally excrete them from the body through coughing or swallowing. This physiological mechanism constitutes the "self-cleaning system" of the nasal cavity and is the first line of defense for the human body against respiratory diseases.
The function of the nasal washer is to assist in clearing secretions and allergens deep in the nasal cavity through external force flushing, especially suitable for the following scenarios:
Allergic rhinitis: During pollen season or when exposed to dust mites, nasal secretions increase, and nasal washing can quickly relieve nasal congestion and runny nose;
Chronic rhinitis/sinusitis: Long-term inflammation causes swelling of the nasal mucosa, and nasal washing can reduce purulent secretions and improve ventilation;
Postoperative recovery: After nasal polypectomy or sinus surgery, nasal washing can prevent crust formation and promote mucosal healing.
However, the self-cleaning function of the nasal cavity is the result of long-term evolution, and over-reliance on nasal washers may weaken this ability. The American Association of Otolaryngology (AAO-HNS) pointed out that the nasal cavity of healthy people does not need to be flushed daily, and patients with chronic rhinitis also need to adjust the frequency according to symptoms to avoid "over-cleaning".
Potential risks of using a nasal washer daily
- Mucosal damage and infection risk
The thickness of the nasal mucosa is only about 0.1-0.5 mm, and frequent flushing may cause mucosal damage due to water pressure, water quality stimulation or improper operation. For example, using tap water for flushing may cause infection due to excessive chlorine content or microorganisms; water temperature that is too high or too low may irritate the mucosa, causing nose bleeding or pain.
Case: A California patient used a nasal rinser three times a day for one month and developed persistent nasal congestion. Examination revealed pale edema of the nasal mucosa and diagnosed it as "nasal dysfunction caused by excessive flushing." The doctor recommended that he stop using the nasal rinser and use saline spray instead. After two weeks, the symptoms improved significantly.
- Disordered nasal environment
The nasal mucosa maintains a moist environment by secreting mucus and regulates the temperature and humidity of the air. Long-term high-frequency flushing may destroy the pH and microbial balance of the mucus layer, leading to nasal dryness, abnormal ciliary movement, and even "drug-induced rhinitis."
Research data: A study published in the Journal of the American Medical Association (JAMA) showed that among patients who used a nasal rinser more than twice a day, 32% experienced nasal dryness and 15% reported hyposmia, while only 8% of patients who used it 2-3 times a week experienced similar symptoms.
- Risk of ear infection
If the posture is not appropriate when washing the nose (such as leaning back), the water may enter the middle ear cavity through the Eustachian tube and cause otitis media. Children are at higher risk because of their shorter and straighter Eustachian tubes. According to the US CDC data, about 10% of cases of otitis media in children are related to improper nasal washing each year.
Operation specification: lean forward, lower your head, breathe with your mouth open, avoid swallowing or holding your breath, and blow your nose lightly after washing (one side at a time).
Scientific frequency recommendations for using nasal washers
- Develop plans for different groups of people
Healthy people: No need to wash daily. If you are in a dusty environment for a long time (such as a construction site or farm), you can use it 2-3 times a week as an auxiliary cleaning.
Allergic/chronic rhinitis patients: 1-2 times a day (once in the morning and once in the evening) during the symptom onset period, and adjust to once every other day after relief; when there is a lot of secretions, it can be increased to 2 times a day for a short period of time, but continuous use should not exceed 1 week.
Children: Children under 3 years old are recommended to use it under the guidance of a doctor to avoid excessive force that may damage the mucosa; school-age children can choose an electric spray nasal washer (such as Deepcozy), which has a softer water flow and reduces the risk of choking.
- Combined with drug treatment
The nasal washer can only relieve symptoms, but cannot cure rhinitis. For moderate to severe patients, combined nasal hormones (such as Flonase budesonide nasal spray), antihistamines (such as Claritin loratadine tablets) or decongestants (such as Afrin oxymetazoline hydrochloride nasal drops) are required for treatment.
- Dynamic adjustment of frequency
Flexible adjustment according to symptom changes:
Acute phase of cold or respiratory infection: 2-3 times a day, gradually reduce the dosage after relief.
Postoperative recovery period: Use as directed by the doctor, usually for 1-2 weeks.
If nasal pain, ear stuffiness or persistent nosebleed occurs: stop using immediately and seek medical attention.
Alternatives and daily care
- Physical protection
Wearing a mask can reduce the inhalation of allergens, especially in pollen season or polluted environments. The US FDA recommends that N95 masks have a filtration efficiency of more than 95% for pollen, making them the first choice for patients with allergic rhinitis.
Maintaining indoor humidity (40%-60%) can relieve nasal dryness. When using a humidifier, it needs to be cleaned regularly to avoid mold growth.
- Diet and lifestyle habits
Avoid spicy and irritating foods, quit smoking and limit alcohol, and reduce irritation to the nasal mucosa. Regular work and rest and moderate exercise can enhance immunity and reduce the frequency of rhinitis attacks.
Research support: A study by the Harvard School of Public Health found that people who exercised 150 minutes of moderate intensity (such as brisk walking and swimming) per week had a 27% lower incidence of rhinitis than those who sat for a long time.
- Traditional therapy assistance
Salt water gargle: Gargling with warm salt water every day can reduce bacteria in the throat and relieve sore throat caused by rhinitis.
Nasal massage: Use the index finger to gently press the Yingxiang points on both sides of the nose, 3 times a day, 1 minute each time, to promote blood circulation.
The core principle of using nasal washers for patients with rhinitis is "use as needed, avoid excessive use". Healthy people do not need to rinse daily, while patients with chronic rhinitis or allergic rhinitis can use it regularly under the guidance of a doctor, but they must strictly follow the operating specifications and choose appropriate rinsing solutions (such as 0.9% saline or special nasal wash salts) and frequency. If symptoms persist or worsen, seek medical attention in time to avoid delaying treatment.
Nasal health requires scientific care, and excessive cleaning may be counterproductive. Balance and moderation are the key to keeping the nasal cavity unobstructed.
