Health experts are warning of a quiet but growing problem affecting millions of people across the UK: dependence on over-the-counter nasal decongestant sprays that can cause long-term, and sometimes irreversible, damage to the airways.
Widely sold in high street chemists for just a few pounds, these sprays are commonly used to relieve blocked noses during colds, flu, allergies, and winter illnesses. For many, they are viewed as harmless, everyday remedies—quick fixes that restore breathing within minutes. But specialists now say that perception is dangerously misleading.
New research suggests that a significant proportion of users are unknowingly placing themselves at risk of a condition that can trap them in a cycle of worsening congestion and reliance on the very products meant to help them breathe.
A Little-Known Risk Few People Recognize
Recent polling conducted by ITV in partnership with Ipsos found that nearly 60 percent of people were unaware that nasal decongestant sprays should not be used continuously beyond a short period. Medical guidance generally limits use to no more than seven days.
Despite this, more than one in five adults who have used these sprays admitted they continued using them for longer than a week. That translates to an estimated 5.5 million people across the UK who may have unknowingly put themselves at risk.
Experts say this lack of awareness is at the heart of the problem.
According to the Royal Pharmaceutical Society, prolonged use can irritate the delicate blood vessels lining the nose. Instead of reducing congestion, the sprays can trigger swelling, making nasal blockage worse over time.
This leads many users to increase their dosage or frequency—creating a vicious cycle of dependency.
The Condition Behind the Addiction
The medical term for this phenomenon is rhinitis medicamentosa, often referred to as rebound congestion. It occurs when nasal tissues become inflamed due to excessive use of decongestant sprays containing active ingredients such as oxymetazoline or xylometazoline.
Symptoms can include:
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Persistent nasal congestion
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Runny nose
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Sneezing
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Irritation and inflammation
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Difficulty breathing without the spray
In severe or long-standing cases, patients may experience structural changes in the nasal passages. Some individuals with a history of chronic misuse have even required surgery to correct airway damage caused by prolonged swelling, which can lead to breathing difficulties and facial changes.
Calls for Clearer Warnings
The Royal Pharmaceutical Society is now urging regulators and manufacturers to take stronger action by making warnings far more visible on packaging.
Professor Amira Guirguis, chief scientist at the RPS, said many users continue spraying simply because they do not realize they are prolonging their own symptoms.
“Our research shows that many people are unaware of this risk,” she said. “We’d like to see clearer warnings on the packaging which you can’t miss and greater awareness of the seven-day limit.”
She added that the response must be proportionate to the risk, but emphasized that clearer front-of-pack warnings are an immediate and necessary step.
Lives Disrupted by Dependency
For some, the issue goes far beyond mild discomfort. One such case is Charlotte Johnstone, 30, who first began using nasal sprays at just seven years old.
Over more than two decades, what started as occasional use turned into a daily necessity. At the height of her dependency, she was using decongestant spray up to eight times a day.
“I can’t sleep without it,” she said in a recent interview. “I wake up and the first thing I do is use my nasal spray.”
Her reliance has caused severe anxiety. She avoids situations where she might not have immediate access to the spray and has recurring dreams about being unable to breathe.
The habit costs her roughly £30 a month, but the emotional toll has been far greater. She fears the long-term impact on her health, including periods where she temporarily loses her sense of smell.
“I know it’s doing something, but I don’t know what,” she said. “But for the sake of having a clear nose and avoiding that claustrophobic feeling, I just keep taking it.”
A Gap in Medical Awareness
Perhaps most concerning, according to Johnstone, is that even some healthcare professionals appear unfamiliar with the condition.
She claims that on more than one occasion, doctors appeared unsure about her symptoms, even searching for information during appointments. While most general practitioners are aware of rebound congestion, experts acknowledge that it is not always recognized quickly, especially when patients present with chronic nasal symptoms.
This has fueled calls from some patients for nasal decongestant sprays to be made prescription-only, allowing doctors to monitor usage and prevent long-term misuse.
Treatment and Recovery
The good news, experts say, is that many people can successfully stop using decongestant sprays without permanent damage—particularly if the issue is identified early.
For some patients, gradually reducing use allows nasal tissues to recover naturally. Others may require temporary treatment with steroid-based nasal sprays to reduce inflammation and help restore normal breathing.
However, the process can be daunting.
“Going cold turkey is very scary,” Johnstone admitted. “I’d have to take time off work. You’ve got to be really brave.”
Health professionals stress that saline sprays and steroid sprays do not cause rebound congestion and can be safer alternatives when used correctly.
Industry Response
The Proprietary Association of Great Britain (PAGB), which represents manufacturers of over-the-counter medicines, said nasal decongestants are clearly indicated for short-term use.
The organization noted that packaging and patient information leaflets already state the seven-day limit and outline the risks of prolonged use.
Critics argue, however, that warnings buried in leaflets are often overlooked, especially when the products are perceived as routine remedies.
A Growing Public Health Issue
As cold and flu season continues, health leaders are urging the public to rethink how they use nasal sprays—and to treat them with the same caution as other medications.
What may start as a simple solution to a blocked nose can, for some, become a long-term struggle affecting sleep, mental health, and quality of life.
Experts say better awareness, clearer warnings, and informed use could prevent millions from unknowingly sliding into dependence—before temporary relief turns into a lasting problem.
Emily Johnson is a critically acclaimed essayist and novelist known for her thought-provoking works centered on feminism, women’s rights, and modern relationships. Born and raised in Portland, Oregon, Emily grew up with a deep love of books, often spending her afternoons at her local library. She went on to study literature and gender studies at UCLA, where she became deeply involved in activism and began publishing essays in campus journals. Her debut essay collection, Voices Unbound, struck a chord with readers nationwide for its fearless exploration of gender dynamics, identity, and the challenges faced by women in contemporary society. Emily later transitioned into fiction, writing novels that balance compelling storytelling with social commentary. Her protagonists are often strong, multidimensional women navigating love, ambition, and the struggles of everyday life, making her a favorite among readers who crave authentic, relatable narratives. Critics praise her ability to merge personal intimacy with universal themes. Off the page, Emily is an advocate for women in publishing, leading workshops that encourage young female writers to embrace their voices. She lives in Seattle with her partner and two rescue cats, where she continues to write, teach, and inspire a new generation of storytellers.
