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8 Reasons for a Nasal Congestion

Did you know that a stuffy nose isn’t just a symptom of the common cold or hay fever? Are you constantly blowing your nose, using nasal sprays, and hovering above the humidifier but nothing seems to work? Then keep on reading. In this article, we tell you about the eight most common reasons for nasal congestion and how to treat them.

Illustration depicting 8 common reasons for nasal congestion.

We’ve all been there: you wake up one morning and can’t breathe normally because your nose is blocked. At times like these, we marvel that we usually take breathing freely for granted. For some of us, a stuffy nose lasts only a few days and clears up on its own, while other people struggle with chronic nasal congestion.

Is it hay fever, a viral infection, or something to do with your anatomy? Which of these conditions causes the nasal congestion you experience?

What happens when the nose gets congested?

Before we get into the possible reasons for nasal congestion, let’s look at how it happens. When an irritant or a pathogen enters your nasal passages, your body’s protective immune response kicks in with increased mucus production, tissue swelling, and inflammation to create an environment that prevents the problem from spreading.


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In many cases, nasal congestion is accompanied by watery eyes, a scratchy throat, a mild fever, and other uncomfortable symptoms. These are all aspects of your body’s immune response to a foreign invader such as a bacterium, a virus, or an allergen.

However, nasal congestion can also be caused by polyps or enlarged adenoids that physically block the nasal pathways. The treatments for these conditions are very different, so it’s important to determine which one is causing your symptoms.

Below, we’ve listed eight illnesses and conditions that can cause nasal congestion together with their associated symptoms and treatments. The good news is that, in most cases, a blocked nose can be alleviated with simple home remedies or over-the-counter medicines.

Eight common reasons for nasal congestion

1. Allergies and Hay Fever

Spring arrives and breathing suddenly becomes difficult. What’s more, your nose and eyes will feel itchy until pollen season is over. If you have seasonal allergies, you know how rough certain times of the year can be. The fine, powdery pollen released into the air by plants, trees, and grasses at the start of a new growth cycle makes breathing a chore for people who suffer from hay fever or allergic rhinitis.

While spring is the most common time for hay fever, seasonal allergies can appear any time of year depending on where you live and when the plants you react to release their spores. Other allergens, such as pet dander, mould, and dust can cause symptoms year-round.

Allergy symptoms

Allergic rhinitis and allergic reactions to animal fur, dust, or pollen usually manifest as a congested or runny nose, difficulty breathing, and itchy, watery eyes. Sometimes, an allergic reaction can appear on the skin as a rash, blisters, or eczema.

Many of us now also suffer from food allergies, the most common culprits being nuts, shellfish, soy, and dairy products. A mild reaction can cause digestive upset, itchy eyes, and swelling of the airways. Severe cases can cause anaphylactic shock, which is life threatening and requires immediate action.

How to treat allergies?

The best way to avoid allergies is to identify the allergens your immune system reacts to and avoid them as much as possible.

Start by tracking when your symptoms appear and what you are doing or eating at the time. Then, talk to your doctor about allergy testing, which can be done as a skin prick, blood test, or patch test.

Once you know what causes your symptoms, you can take steps to protect yourself and manage your environment. For example, if you react to pet fur, avoid places where pets are present. If you have a food allergy, be the person who asks about ingredients. Unfortunately, not all allergies are easy to avoid. If you suffer from hay fever, you can’t keep the trees from pollinating but there are medications you can take to relieve your symptoms.

Illustration showing methods for treating allergies.

Medicines for allergic rhinitis:

  • Antihistamines such as cetirizine, loratadine, and fexofenadine block histamine, a chemical released by your immune system during an allergic reaction.
  • Nasal corticosteroid sprays reduce inflammation and congestion in the nasal passages. Some are available over the counter while others are prescription medications.
  • For a more long-term solution when the above medications don’t work well enough or you suffer from perennial allergies, your doctor might prescribe allergy shots to help desensitize your immune system. This is a form of immunotherapy in which each shot contains enough of the allergen to stimulate your immune system, but not enough to bring on a full-blown allergic reaction. Allergy shots can be a solution if you suddenly develop an allergy, for example, to your cat.

2. The Common Cold

Many different viruses can cause mild to moderate symptoms in the upper respiratory tract (the nose, throat, and sinuses). This is what we call catching a cold—the most common illness among both children and adults. Although we catch more colds in the cold season, it is not the temperature that makes us more susceptible but rather the fact that we spend more time indoors near people who are coughing and sneezing and spreading airborne particles. Kids get an average of 6 to 10 colds per year, while adults get only 2 to 4 as they have more fully developed immune systems.

Symptoms of a common cold:

  • Nasal congestion
  • Sore throat
  • Cough
  • Sneezing
  • Tearing and itchy eyes
  • Low-grade fever
  • Mild headache

How to treat a common cold?

Cold symptoms usually start 2 or 3 days after infection and resolve on their own within a few days or weeks. While they can be uncomfortable and annoying, there’s little you can do to speed up healing apart from drinking plenty of fluids, eating nutritious foods, and resting. OTC medicines such as nasal sprays, paracetamol, and cough drops can help manage symptoms. Aspirin is no longer recommended for children with fever as it has been associated with the potentially dangerous Reye syndrome.

The best way to prevent colds is to avoid close contact with people who are sick and to wash your hands frequently. Dry air can make the lining of your nose more fragile and susceptible to infection; in that case using a humidifier can help.

3. Chemical Irritation

Every day we are exposed to many chemicals and irritants in the environment—from household cleaning products containing ammonia, bleach, synthetic fragrances, and phthalates to heavy duty industrial chemicals such as formaldehyde, sulphur dioxide, and sulfuric acid. They can block and irritate your nose

Chemical irritation symptoms:

  • Nasal congestion, runny nose, sneezing, itching, and increased mucus production
  • Eye redness, itching, burning, tearing, and light sensitivity
  • Sore throat, throat dryness, hoarseness, or coughing
  • Wheezing, chest tightness, shortness of breath, and difficulty breathing
  • Skin redness, itching, rash, or dermatitis
  • Headaches
  • Dizziness and nausea
  • Fatigue, weakness, and lethargy

How to treat chemical irritation?

The first step in treating chemical irritation is to eliminate damaging chemicals from your environment. Identify what is causing your symptoms and take steps to protect yourself. If you’re exposed to chemicals at work, wear protective gear to prevent toxins from getting onto your skin or in your airways.

The treatment for most chemical irritation is to flush the affected area with water until all traces have washed away, then pat the area dry. Some chemicals cannot be removed with water and will need special treatment depending on the chemical and the severity of the symptoms. Chemical burns can be very painful, and you may need urgent medical help. Call your local poison control centre or emergency helpline for instructions and get to the doctor ASAP.


4. Dry air

If you use air conditioning in the summer or a heater in the winter, you know how dry the air can get. When our nasal passages dry out, they can’t produce enough mucous to lubricate the sinuses. This can lead to irritated and inflamed nasal and sinus tissues, weakening the immune system, increasing the risk of nosebleeds, and leaving the nose and sinuses susceptible to viruses and bacteria.

If your nose is congested due to dry air, you may experience:

  • Nasal congestion
  • Nasal irritation and pain when inhaling
  • Itchy throat
  • Dry eyes
  • Dry skin and lips
  • Dry cough

How to treat nasal congestion due to dry air?

The best way to treat nasal congestion due to dry air is to humidify the air you breathe and moisten the nasal passages. If you need to heat or cool your house, you can use a humidifier in the bedroom to improve the moisture content of the air. You can also try irrigating your nose with sterile saline using a neti pot or similar device, breathing in steam when you shower, and using OTC moisturizing gels and nasal sprays. As always, remember to hydrate from the inside.

5. Nasal polyps

Nasal polyps are soft, benign growths in the nasal passages or sinuses. They can cause nasal congestion by physically obstructing the flow of air through your nose. As they grow larger or multiply, they make breathing more difficult.

Nasal polyp symptoms:

  • Nasal congestion
  • Decreased sense of smell or taste
  • Runny nose/postnasal drip
  • Sinus pressure/pain
  • Snoring or sleep apnea

How to treat nasal polyps?

Treatment for nasal polyps depends on their size and location. Sometimes a short course of corticosteroids is enough to reduce inflammation. Steroid medications reduce inflammation and shrink the polyps. Antihistamines can also help if the polyps worsen or grow due to allergies.

In more severe cases, when the polyps become a daily concern, making it difficult to breathe and smell, surgery is the way to go. People with allergies, asthma, autoimmune conditions, and chronic sinusitis are more likely to develop nasal polyps.

During endoscopic sinus surgery, your surgeon will remove the polyps to open the sinus passages and allow you to breathe normally again. However, in some cases the polyps grow back over time, making repeat surgery necessary.

To reduce the chances of this happening, you can take steps to manage your asthma or allergies, avoid nasal irritants, practice good hygiene, and use a humidifier and a nasal rinse to improve the flow of mucus from your sinuses.

6. Sinus infection

A sinus infection, or sinusitis, is an inflammation of the tissues lining any of the moist, hollow cavities in the bones around the eyes and nose. When the sinuses become inflamed or infected, they swell, causing nasal congestion.

Sinusitis can be short and acute, lasting about 2 weeks, or chronic, lasting longer than 12 weeks.

Sinusitis symptoms:

  • Facial pain or pressure around the forehead, cheeks, and eyes
  • Nasal congestion
  • Yellowish or greenish nasal mucus
  • Postnasal drip
  • Lack of sense of smell and taste
  • Fatigue
  • Headache
  • Fever
  • Ear pressure

How to treat a sinus infection?

  • Saline irrigation to clear mucus to reduce inflammation and unclog the nose.
  • Humidifier or steam inhalations to moisten the nasal passages.
  • Applying warm compresses to the face to soothe the pressure.
  • Ibuprofen or other OTC painkillers to alleviate pain and reduce fever.
  • Antihistamines and steroids to reduce swelling and inflammation.
  • Antibiotics if the sinusitis is bacterial.

It’s important to treat sinusitis quickly because it can become chronic or cause other complications.

7. Deviated septum

When the nasal septum that separates your two nostrils is displaced or shifted away from the midline, it can cause breathing problems. Some people are born with a deviated septum, but displacement usually happens due to physical trauma or aging.

Deviated septum symptoms:

  • Nasal congestion, particularly on one side
  • Difficulty breathing through one or both nostrils
  • Recurrent nosebleeds
  • Frequent sinus infections
  • Facial pain or pressure
  • Loud breathing or snoring

Can you treat a deviated septum?

Yes! The treatment for a deviated septum depends on the severity of the symptoms. Sometimes using a nasal decongestant spray is enough to alleviate the symptoms. If not, the deviation can be corrected surgically by means of septoplasty.

Septoplasty strengthens the nasal septum, improves airflow, and alleviates the symptoms of nasal obstruction. 

8. Enlarged adenoids

Enlarged adenoids, or adenoid hypertrophy, is the enlargement or swelling of the adenoid glands. These glands, located at the back of the throat, behind the nose, are an important part of the body’s immune system in childhood.

Adenoids grow to their full size between the ages of 3 and 5 and start to shrink around age 7 or 8. By adulthood they will have completely disappeared.

While the immune system is still developing, the adenoids serve as an extra line of defence, trapping viruses and bacteria before they have a chance to infect the body. When a child is fighting off an allergy or an ear or upper respiratory infection, or has frequent nosebleeds, the adenoids can almost double in size from ~ 6 to 12 mm. Once the lymphocytes have eliminated the problem, they return to their normal size again. However, sometimes the adenoids become too big and end up doing more harm than good.

Symptoms of enlarged adenoids

  • Nasal congestion or stuffiness
  • Difficulty breathing through the nose
  • Mouth breathing
  • Snoring
  • Sleep apnea

How to treat enlarged adenoids?

The first-line treatment for enlarged adenoids is to treat the root cause of the swelling, either with antihistamines or corticosteroids for allergy, or with antibiotics for an infection.

If the swelling can’t be resolved with non-surgical methods and troublesome symptoms persist, surgery may be recommended. Adenoidectomy is a fairly simple outpatient procedure performed under anaesthesia to remove the enlarged tissue and restore normal breathing. Patients usually recover within a few days and do not experience more frequent illness after the procedure.

Final words about nasal congestion

No one enjoys having a stuffy nose. Enduring the discomfort for a few days is very different from chronic nasal congestion. If you notice that your nose regularly feels blocked, you struggle to smell and taste, you feel pressure inside your face, or you experience other symptoms associated with nasal congestion, consult your doctor for a diagnosis. Sometimes all it takes is a simple OTC medicine to help you breathe normally again, and if your condition turns out to need a more serious intervention it’s best to get started on a treatment plan as soon as possible.

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