Rebound congestion is whennasal congestiongets worse because you have overused a nasaldecongestantspray likeAfrin (oxymetazoline)to treat your symptoms. Rebound congestion is also known as rhinitis medicamentosa, chemical rhinitis, nasal spray addiction.
Your nasal passages can develop a dependence to these medications rather quickly. That’s why prescribers and product labels say to limit use to three days.
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How Decongestants Work
When the blood vessels in your nasal passages become swollen due to acold, allergies,sinusitis, exercise, or hormonal changes, congestion occurs. However, when the blood vessels constrict, there is more space in the airways and your symptoms subside.
Causes of Rebound Congestion
Diagnosis
When evaluating you for rebound congestion, your healthcare provider will take a thorough medication usage history as well as perform a nasal exam. Typically with rebound congestion, your nasal passages will appear to be red with a thicker than the normal nasal mucous membrane.
Treatment
If you are already addicted to a nasal spray, talk to your healthcare provider. Some healthcare provider may recommend a gradual decrease in the use of the medication until you are completely weaned off it. This may be preferable than trying to quit the medication outright, which may result in severe congestion for a number of days.
Another class of medications, callednasal corticosteroids, may also be helpful during the process of weaning off of nasal decongestants.Oral steroids are also sometimes used but only as a last resort. The first week is usually the most difficult and you may experience severe congestion andheadacheswhich then begin to subside.
Treating the underlying condition for which nasal decongestants were originally used is also an important part of the treatment process.
What Type of Congestion Do You Have?
4 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.Morris S, Eccles R, Martez SJ, Riker DK, Witek TJ.An evaluation of nasal response following different treatment regimes of oxymetazoline with reference to rebound congestion. Am J Rhinol. 1997;11(2):109-15. doi:10.2500/105065897782537197Ramey JT, Bailen E, Lockey RF.Rhinitis medicamentosa.J Investig Allergol Clin Immunol. 2006;16(3):148-55.Varghese M, Glaum MC, Lockey RF.Drug-induced rhinitis. Clin Exp Allergy. 2010;40(3):381-4. doi:10.1111/j.1365-2222.2009.03450.xVaidyanathan S, Williamson P, Clearie K, Khan F, Lipworth B.Fluticasone reverses oxymetazoline-induced tachyphylaxis of response and rebound congestion. Am J Respir Crit Care Med. 2010;182(1):19-24. doi:10.1164/rccm.200911-1701OCAdditional ReadingRhinitis Medicamentosa. Medscape website. http://emedicine.medscape.com/article/995056-overview#a5. Updated November 17, 2015.
4 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.Morris S, Eccles R, Martez SJ, Riker DK, Witek TJ.An evaluation of nasal response following different treatment regimes of oxymetazoline with reference to rebound congestion. Am J Rhinol. 1997;11(2):109-15. doi:10.2500/105065897782537197Ramey JT, Bailen E, Lockey RF.Rhinitis medicamentosa.J Investig Allergol Clin Immunol. 2006;16(3):148-55.Varghese M, Glaum MC, Lockey RF.Drug-induced rhinitis. Clin Exp Allergy. 2010;40(3):381-4. doi:10.1111/j.1365-2222.2009.03450.xVaidyanathan S, Williamson P, Clearie K, Khan F, Lipworth B.Fluticasone reverses oxymetazoline-induced tachyphylaxis of response and rebound congestion. Am J Respir Crit Care Med. 2010;182(1):19-24. doi:10.1164/rccm.200911-1701OCAdditional ReadingRhinitis Medicamentosa. Medscape website. http://emedicine.medscape.com/article/995056-overview#a5. Updated November 17, 2015.
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.
Morris S, Eccles R, Martez SJ, Riker DK, Witek TJ.An evaluation of nasal response following different treatment regimes of oxymetazoline with reference to rebound congestion. Am J Rhinol. 1997;11(2):109-15. doi:10.2500/105065897782537197Ramey JT, Bailen E, Lockey RF.Rhinitis medicamentosa.J Investig Allergol Clin Immunol. 2006;16(3):148-55.Varghese M, Glaum MC, Lockey RF.Drug-induced rhinitis. Clin Exp Allergy. 2010;40(3):381-4. doi:10.1111/j.1365-2222.2009.03450.xVaidyanathan S, Williamson P, Clearie K, Khan F, Lipworth B.Fluticasone reverses oxymetazoline-induced tachyphylaxis of response and rebound congestion. Am J Respir Crit Care Med. 2010;182(1):19-24. doi:10.1164/rccm.200911-1701OC
Morris S, Eccles R, Martez SJ, Riker DK, Witek TJ.An evaluation of nasal response following different treatment regimes of oxymetazoline with reference to rebound congestion. Am J Rhinol. 1997;11(2):109-15. doi:10.2500/105065897782537197
Ramey JT, Bailen E, Lockey RF.Rhinitis medicamentosa.J Investig Allergol Clin Immunol. 2006;16(3):148-55.
Varghese M, Glaum MC, Lockey RF.Drug-induced rhinitis. Clin Exp Allergy. 2010;40(3):381-4. doi:10.1111/j.1365-2222.2009.03450.x
Vaidyanathan S, Williamson P, Clearie K, Khan F, Lipworth B.Fluticasone reverses oxymetazoline-induced tachyphylaxis of response and rebound congestion. Am J Respir Crit Care Med. 2010;182(1):19-24. doi:10.1164/rccm.200911-1701OC
Rhinitis Medicamentosa. Medscape website. http://emedicine.medscape.com/article/995056-overview#a5. Updated November 17, 2015.
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