Table of ContentsView AllTable of ContentsNasal SpraysOral SteroidsSteroid InjectionsNonsurgical TreatmentSurgeryFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Nasal Sprays
Oral Steroids
Steroid Injections
Nonsurgical Treatment
Surgery
Frequently Asked Questions
Nasal polypsare soft growths that can occur on the inside of the nasal canal or sinuses.Small nasal polyps can be harmless, but if a nasal polyp blocks the sinuses or airway, it can lead to infections, difficulty breathing, and othersymptoms. Treatment is recommended in these cases.
Learn more about nonsurgical nasal polyp treatment, including prednisone for nasal polyps.
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Nasal Sprays for Polyps
Examples of corticosteroid nasal sprays for polyps include:
Nasal sprays are typically used long term, because if the spray is discontinued then the polyps may return.Studies show that long-term use is very safe.
Short courses of oral corticosteroids, such as prednisone, may also be given to treat nasal polyps.Evidence shows that this can improve symptoms, such as returning sense of smell and improving nasal air flow, and can also reduce the size of nasal polyps.
However, polyps and symptoms may return after just three to six months of a short course.With that in mind, it’s important to consider the significant risk ofside effectswith systemic (throughout the body) oral steroids, which are in pill form.
These side effects can include:
Long-Term Use of Oral CorticosteroidsLong-term use of prednisone can lead to even more significant side effects, including:OsteoporosisGlaucomaCataractsType 2 diabetesNote that in the treatment of nasal polyps, usually only short courses are prescribed. However, evidence shows that even just four short courses of oral corticosteroids across a lifetime can significantly increase these side effects.
Long-Term Use of Oral Corticosteroids
Long-term use of prednisone can lead to even more significant side effects, including:OsteoporosisGlaucomaCataractsType 2 diabetesNote that in the treatment of nasal polyps, usually only short courses are prescribed. However, evidence shows that even just four short courses of oral corticosteroids across a lifetime can significantly increase these side effects.
Long-term use of prednisone can lead to even more significant side effects, including:
Note that in the treatment of nasal polyps, usually only short courses are prescribed. However, evidence shows that even just four short courses of oral corticosteroids across a lifetime can significantly increase these side effects.
Due to the risk of side effects, systemic oral steroids are usually a second-line treatment reserved for when nasal sprays are ineffective. Healthcare providers are encouraged to prescribe prednisone for nasal polyps cautiously. They should give you full informed consent on the benefits and potential side effects of their recommendations before prescribing.
One study examined the effectiveness and safety of short-term oral corticosteroids for people withchronic rhinosinusitiswith nasal polyps.Similar results in reducing nasal polyp size and symptoms were found across dosages.
However, they noted that people receiving more than 50 milligrams per day of prednisone reported more insomnia and gastrointestinal symptoms. As such, prednisone doses of less than 50 milligrams per day are recommended.
A 2020 review found that treatment withintrapolypsteroid injection decreased the total number of polyps and symptoms.Dosages ranged from 10 milligrams to 40 milligrams oftriamcinolone acetonide, which is a type of synthetic corticosteroid used to treat skin conditions.
Other studies have compared intrapolyp steroid injection to oral short-term steroid treatment and found that steroid injections were similarly effective as oral steroids in reducing polyps and symptoms.
Side Effects of Steroid InjectionsThere have been extremely rare cases of temporary visual complications reported from nasal polyp steroid injections.This has not been linked to any specific dosage. One study observed mild bleeding at the injection site in 3% of injections.
Side Effects of Steroid Injections
There have been extremely rare cases of temporary visual complications reported from nasal polyp steroid injections.This has not been linked to any specific dosage. One study observed mild bleeding at the injection site in 3% of injections.
The evidence implies that steroid injection is a similarly effective but safer treatment option than oral steroids for some people with nasal polyps. The exception is very extensive or bulky nasal polyps that might be better treated with surgery.
Other Nonsurgical Treatments for Nasal Polyps
There are additionalnonsurgical treatments for nasal polypsthat don’t include steroids. These include:
Biologics
Nucala (mepolizumab)is a monoclonal antibody directed against IL-5, a growth factor for eosinophils (allergic white blood cells). It is given as an injection every 4 weeks. It is approved as an add-on medication for chronic rhinosinusitis with nasal polyps.
Xolair (omalizumab)is a monoclonal antibody directed against IgE, the allergic antibody. It is given every two or four weeks depending on a person’s weight and serum IgE level. It is approved for add-on maintenance treatment of chronic rhinosinusitis with nasal polyps.
When Surgery May Be Needed
An endoscopicsurgery to remove nasal polyps(called a nasalpolypectomy) may be recommended if nonsurgical treatments are ineffective or if the nasal polyps are very large.This typically is an outpatient procedure, meaning you can go home the same day as long as you have no complications.
During the procedure, your surgeon will insert a thin tube into your nasal passage. The tube has a light on the end as well as surgical instruments to help your surgeon cut out the polyps.
Surgery to remove nasal polyps can treat symptoms and help you breathe more easily. However, keep in mind that unless the underlying cause (such as with chronicsinus infectionsor aspirin sensitivity) is under control, then nasal polyps can recur.
Summary
Corticosteroids are the gold standard for treating nasal polyps. They are effective at reducing polyp size and alleviating symptoms. There are different methods of delivery, including topical, oral, and injection. In some cases in which the nasal polyps are particularly large or not responding to medication, surgery may be recommended.
A Word From Verywell
It’s understandable to want to avoid surgery for nasal polyps. Depending on the size and symptoms of your nasal polyps, it’s likely that your healthcare provider will recommend medical treatment options first before surgery. There are benefits and drawbacks to each type of treatment, but together you and your healthcare provider will decide what is right for you.
Frequently Asked QuestionsNasal polyps generally do not go away unless they are treated. There are many treatments for nasal polyps that do not involve surgery. Some nasal polyps are small and do not cause symptoms, so they may not require any treatment.Yes, nasal polyps can come back after treatment. They can even recur after surgery. It’s important to treat and manage the underlying cause of nasal polyps to prevent their recurrence.
Nasal polyps generally do not go away unless they are treated. There are many treatments for nasal polyps that do not involve surgery. Some nasal polyps are small and do not cause symptoms, so they may not require any treatment.
Yes, nasal polyps can come back after treatment. They can even recur after surgery. It’s important to treat and manage the underlying cause of nasal polyps to prevent their recurrence.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Nasal polyps.Johns Hopkins Medicine.Nasal polyps.Ranford D, Hopkins C.Safety review of current systemic treatments for severe chronic rhinosinusitis with nasal polyps and future directions.Expert Opinion on Drug Safety. 2021;20(10):1177-1189. doi:10.1080/14740338.2021.1926981American Academy of Allergy, Asthma & Immunology.Nasal polyps.Zhang Y, Wang C, Huang Y, Lou H, Zhang L.Efficacy of short-term systemic corticosteroid therapy in chronic rhinosinusitis with nasal polyps: a meta-analysis of randomized controlled trials and systematic review.Am J Rhinol Allergy. 2019;33(5):567-576. doi:10.1177/1945892419851312Zamzam SM, Elshazly M, Salah M, Enayat A.Comparative study between intrapolyp steroid injection and oral steroid for treatment of sinonasal polyposis in Egyptian patients.The Egyptian Journal of Otolaryngology. 2020;36(1):59. doi:10.1186/s43163-020-00062-wHansen MB, Alanin MC.Injection of steroid in nasal polyps: a systematic review.Am J Rhinol Allergy. 2020;34(6):838-845. doi:10.1177/1945892420936198Kırıs M, Muderris T, Yalçıner G, Bercin S, Sevil E, Gul F.Intrapolyp steroid injection for nasal polyposis: Randomized trial of safety and efficacy.Laryngoscope. 2016;126(8):1730-1735. doi:10.1002/lary.25945Bachert C, Han JK, Desrosiers M, et al.Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52): results from two multicentre, randomised, double-blind, placebo-controlled, parallel-group phase 3 trials.The Lancet. 2019;394(10209):1638-1650. doi:10.1016/S0140-6736(19)31881-1DailyMed.Label: NUCALA- mepolizumab injection, powder, for solution, NUCALA- mepolizumab injection, solution.DailyMed.Label: XOLAIR- omalizumab injection, solution. XOLAIR PFS- omalizumab injection, solution, XOLAIR- omalizumab injection, solution.
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Nasal polyps.Johns Hopkins Medicine.Nasal polyps.Ranford D, Hopkins C.Safety review of current systemic treatments for severe chronic rhinosinusitis with nasal polyps and future directions.Expert Opinion on Drug Safety. 2021;20(10):1177-1189. doi:10.1080/14740338.2021.1926981American Academy of Allergy, Asthma & Immunology.Nasal polyps.Zhang Y, Wang C, Huang Y, Lou H, Zhang L.Efficacy of short-term systemic corticosteroid therapy in chronic rhinosinusitis with nasal polyps: a meta-analysis of randomized controlled trials and systematic review.Am J Rhinol Allergy. 2019;33(5):567-576. doi:10.1177/1945892419851312Zamzam SM, Elshazly M, Salah M, Enayat A.Comparative study between intrapolyp steroid injection and oral steroid for treatment of sinonasal polyposis in Egyptian patients.The Egyptian Journal of Otolaryngology. 2020;36(1):59. doi:10.1186/s43163-020-00062-wHansen MB, Alanin MC.Injection of steroid in nasal polyps: a systematic review.Am J Rhinol Allergy. 2020;34(6):838-845. doi:10.1177/1945892420936198Kırıs M, Muderris T, Yalçıner G, Bercin S, Sevil E, Gul F.Intrapolyp steroid injection for nasal polyposis: Randomized trial of safety and efficacy.Laryngoscope. 2016;126(8):1730-1735. doi:10.1002/lary.25945Bachert C, Han JK, Desrosiers M, et al.Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52): results from two multicentre, randomised, double-blind, placebo-controlled, parallel-group phase 3 trials.The Lancet. 2019;394(10209):1638-1650. doi:10.1016/S0140-6736(19)31881-1DailyMed.Label: NUCALA- mepolizumab injection, powder, for solution, NUCALA- mepolizumab injection, solution.DailyMed.Label: XOLAIR- omalizumab injection, solution. XOLAIR PFS- omalizumab injection, solution, XOLAIR- omalizumab injection, solution.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus.Nasal polyps.Johns Hopkins Medicine.Nasal polyps.Ranford D, Hopkins C.Safety review of current systemic treatments for severe chronic rhinosinusitis with nasal polyps and future directions.Expert Opinion on Drug Safety. 2021;20(10):1177-1189. doi:10.1080/14740338.2021.1926981American Academy of Allergy, Asthma & Immunology.Nasal polyps.Zhang Y, Wang C, Huang Y, Lou H, Zhang L.Efficacy of short-term systemic corticosteroid therapy in chronic rhinosinusitis with nasal polyps: a meta-analysis of randomized controlled trials and systematic review.Am J Rhinol Allergy. 2019;33(5):567-576. doi:10.1177/1945892419851312Zamzam SM, Elshazly M, Salah M, Enayat A.Comparative study between intrapolyp steroid injection and oral steroid for treatment of sinonasal polyposis in Egyptian patients.The Egyptian Journal of Otolaryngology. 2020;36(1):59. doi:10.1186/s43163-020-00062-wHansen MB, Alanin MC.Injection of steroid in nasal polyps: a systematic review.Am J Rhinol Allergy. 2020;34(6):838-845. doi:10.1177/1945892420936198Kırıs M, Muderris T, Yalçıner G, Bercin S, Sevil E, Gul F.Intrapolyp steroid injection for nasal polyposis: Randomized trial of safety and efficacy.Laryngoscope. 2016;126(8):1730-1735. doi:10.1002/lary.25945Bachert C, Han JK, Desrosiers M, et al.Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52): results from two multicentre, randomised, double-blind, placebo-controlled, parallel-group phase 3 trials.The Lancet. 2019;394(10209):1638-1650. doi:10.1016/S0140-6736(19)31881-1DailyMed.Label: NUCALA- mepolizumab injection, powder, for solution, NUCALA- mepolizumab injection, solution.DailyMed.Label: XOLAIR- omalizumab injection, solution. XOLAIR PFS- omalizumab injection, solution, XOLAIR- omalizumab injection, solution.
MedlinePlus.Nasal polyps.
Johns Hopkins Medicine.Nasal polyps.
Ranford D, Hopkins C.Safety review of current systemic treatments for severe chronic rhinosinusitis with nasal polyps and future directions.Expert Opinion on Drug Safety. 2021;20(10):1177-1189. doi:10.1080/14740338.2021.1926981
American Academy of Allergy, Asthma & Immunology.Nasal polyps.
Zhang Y, Wang C, Huang Y, Lou H, Zhang L.Efficacy of short-term systemic corticosteroid therapy in chronic rhinosinusitis with nasal polyps: a meta-analysis of randomized controlled trials and systematic review.Am J Rhinol Allergy. 2019;33(5):567-576. doi:10.1177/1945892419851312
Zamzam SM, Elshazly M, Salah M, Enayat A.Comparative study between intrapolyp steroid injection and oral steroid for treatment of sinonasal polyposis in Egyptian patients.The Egyptian Journal of Otolaryngology. 2020;36(1):59. doi:10.1186/s43163-020-00062-w
Hansen MB, Alanin MC.Injection of steroid in nasal polyps: a systematic review.Am J Rhinol Allergy. 2020;34(6):838-845. doi:10.1177/1945892420936198
Kırıs M, Muderris T, Yalçıner G, Bercin S, Sevil E, Gul F.Intrapolyp steroid injection for nasal polyposis: Randomized trial of safety and efficacy.Laryngoscope. 2016;126(8):1730-1735. doi:10.1002/lary.25945
Bachert C, Han JK, Desrosiers M, et al.Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52): results from two multicentre, randomised, double-blind, placebo-controlled, parallel-group phase 3 trials.The Lancet. 2019;394(10209):1638-1650. doi:10.1016/S0140-6736(19)31881-1
DailyMed.Label: NUCALA- mepolizumab injection, powder, for solution, NUCALA- mepolizumab injection, solution.
DailyMed.Label: XOLAIR- omalizumab injection, solution. XOLAIR PFS- omalizumab injection, solution, XOLAIR- omalizumab injection, solution.
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