Last updated: Mar 04, 2015
nose-sinus-guide
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Let's face it: You don't think much about your nose—except when you're battling allergies or a cold and it's tough to think about anything else (gesundheit!). But from controlling your sense of taste and smell to providing a steady stream of mucus that helps filter the air you breathe, your nose and sinuses do some pretty impressive work—which is why you feel so miserable when they're all stuffed up. Read on to learn what you really ought to know about your beak.


Secret no. 1: Humans are designed to be nose breathers
When you breathe through your nose, "turbinates—spiraling ridges inside your nasal cavity—force air deeper into your lungs than when you breathe through your mouth," says women's health specialist Christiane Northrup, MD. "That means the air reaches more of the blood vessels that carry oxygen to the rest of your body." Another perk: Nerves in your nose activate the parasympathetic nervous system, which slows your heart rate and reduces stress hormones. If you're not in the habit of inhaling nasally, Dr. Northrup recommends leaving Post-its around your home to remind yourself to do it more often. Stick one in your sneakers, too: Nose breathing is also helpful when you're exercising, especially outdoors, where your nose filters pollen and pollutants.

Secret no. 2: A deviated septum is actually a thing
In most people, the wall dividing the nasal cavities is slightly off-center; usually, that's no big deal. But if your septum is severely shifted, it could increase your risk of nosebleeds and sinus infections, explains Richard Lebowitz, MD, director of the division of rhinology at NYU Langone Medical Center. You may be able to manage your symptoms with a nasal rinse and steroid spray and a decongestant when you have a cold. If not, you might be a candidate for a septoplasty, an outpatient surgery with a two-day recovery. One rare but troubling complication: Some patients experience a permanent decline in their sense of smell.

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Secret no. 3: It's possible to overdo it on the neti pot
Some people swear by this teapotlike device, which has been used for centuries to get rid of sinus gook. But while it does thin out mucus, flushing your sinuses could have a detrimental effect if done too often, research suggests. "It's possible that too-frequent washings remove not only mucus but also protective bacteria," says Michael Benninger, MD, chair of the Head and Neck Institute at the Cleveland Clinic. Rinse only when you're battling allergies or mild congestion from a cold—not every day. Use distilled or boiled (and then cooled) water; tap water may contain micro-organisms that are potentially deadly when they enter your body through your sinuses. And after each use, wash your pot with soap and distilled water, then let air-dry.

Secret no. 4: We are mucus machines
The average American produces a liter a day. Cells in the lining of your nasal passages and sinus cavities (known as goblet cells) secrete the slimy stuff. When you have a cold, your immune system floods your mucus with white blood cells, which contain an enzyme that causes snot to thicken and turn yellowish, then green, Dr. Benninger says. If your mucus gets too thick, it may gunk up your sinuses, creating a breeding ground for bacteria. You can loosen it with a saline rinse and open your airways with an over-the-counter decongestant spray.



Secret no. 5: Most sinus infections don't require an RX
The eight sinus cavities in your skull are lined with tissue and usually filled with air. (Their main job is to filter and moisturize each breath you take.) But when sinus tissue swells in response to a pathogen, allergen or some other irritant, the cavities can fill with fluid and become infected. As many as 20 percent of antibiotic prescriptions in the U.S. are written for these infections. But the reality is, more than 90 percent of cases are caused by viruses, which means antibiotics have no effect on them. "Most patients would respond well to conservative measures like saline rinses and nasal steroid sprays," says John Krouse, MD, chair of the department of otolaryngology--head and neck surgery at Temple University School of Medicine. You probably don't need anything stronger than that unless your symptoms last longer than a week, or you've got a fever higher than 101.5 degrees and feel severe pain and pressure above your eyes and behind your cheekbones. In that case, you should check with your doctor to see if a first-line antibiotic treatment might be helpful, Dr. Krouse says.

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Secret no. 6: Some noses run for no apparent reason
There's a name for this very real condition: nonallergic rhinitis. It affects up to 25 percent of people. The congestion and drip may get worse around your period, thanks to surges in hormones that inflame blood vessels in the nose and make them more sensitive to irritants. Other triggers include odors (think fragrances and household chemicals) and some meds. Whatever the cause, it's important to treat the symptoms (see right). Chronic congestion ups your risk of chronic sinusitis.

Secret no. 7: You need to match your sinus med to your symptoms
The right OTC drug depends on the cause of your stuffed-up snout. Here's what to use when.
PROBLEM TRY WHAT IT DOES WARNING
You've got a cold. A decongestant such as pseudoephedrine or phenylephrine Shrinks swollen blood vessels in nasal membranes, opening air passages Because they're chemically related to adrenaline, decongestants act as stimulants. Skip these drugs if you have high blood pressure.
You've got allergies. An antihistamine like Clarinex or Allegra Blocks a chemical that triggers allergic symptoms, like a runny nose and sneezing Don't pop one when you're sick. "It will dry up your head, which actually makes it harder for your nose to get rid of mucus," Dr. Lebowitz says.
You've got nonallergic rhinitis. A nasal steroid spray such as Nasonex or Flonase Reduces mucus production and inflammation. (It can also treat allergy symptoms and nasal polyps.) Don't confuse nasal steroid sprays with decongestant sprays (like Afrin); overuse of those have been linked to rebound congestion after the drug wears off.


Nose 911!
How to handle these three common emergencies, stat.

Nosebleed: Use your thumb and index finger to pinch your nostrils shut for 5 to 10 minutes, Dr. Lebowitz says. That should do it. If not, spritz both nasal passages with a decongestant spray containing oxymetazoline (like Afrin) and pinch again for 10 minutes. Still bleeding? Get to your doc's office or the ER.

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Foreign body: Cheerios, marbles, crayons—pediatricians and ER docs have seen it all. If you think your little one has shoved something strange up her nose, gently press the empty nostril closed and ask your kid to blow gently. If that doesn't work (or she doesn't understand), call her doctor immediately or simply head to the hospital.

Banged-up nose: Dial 911 if the bleeding won't stop, clear fluid is draining out, you have difficulty breathing or your nose looks crooked or misshapen, Dr. Lebowitz says. Otherwise, apply a cold compress for 10 to 15 minutes four to six times a day, and pop ibuprofen for the pain and swelling.

6 Natural Runny-Nose Remedies
These remedies worth trying, according to Melinda Ring, MD, medical director at the Osher Center for Integrative Medicine at Northwestern Medicine in Chicago.

Acupuncture: Hay fever sufferers who had 12 sessions over eight weeks experienced mild improvement in symptoms, a 2013 German study found.

Butterbur: The herb works just as well as the OTC allergy med cetirizine, according to a BMJ study. (Participants took 8 milligrams four times a day.) "It blocks the action of inflammatory chemicals released in response to an allergen," Dr. Ring explains.

Saline rinses: Either via a neti pot or a spray, rinses help flush out excess mucus and reduce eosinophils, white blood cells that cause nasal inflammation, Dr. Ring says.

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Capsaicin: This compound, found in chili peppers, seems to help fight congestion when used in a nasal spray. An OTC product called Sinus Buster offered significant relief to participants in a 2011 University of Cincinnati study.

Leafy greens: Research published in Public Health Nutrition revealed that people who ate the most carotenoid-rich foods (like spinach, kale and collard greens) suffered the fewest nasal allergy symptoms.

Eucalyptus oil: It acts on receptors in your nasal mucous membranes to reduce congestion, says Dr. Ring, who recommends adding a few drops to a cup of boiling water and breathing in the steam for 5 to 10 minutes.

Q: Why can't I taste anything when I'm stuffed up?
A: Your perception of flavor comes from your senses of both taste and smell. When you eat or drink, aroma compounds are released in your mouth. Those molecules pass through an opening that connects your throat to your nose, where they stimulate a patch of olfactory receptor neurons that communicate with your brain. "But if the channel is blocked by mucus, olfactory signals can't get to your brain," Dr. Lebowitz says, "and everything tastes a little like wood."