Clear your head with this insider's guide to allergies, infections, and other nasal woes.

By Hallie Levine
Updated February 06, 2019

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.

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.

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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It's possible to overdo it on the neti pot

Some people swear by this teapot-like 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 microorganisms 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.

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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.

Most sinus infections don't require a prescription

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% of antibiotic prescriptions in the U.S. are written for these infections. But the reality is, more than 90% 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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Some noses run for no apparent reason

There's a name for this very real condition: nonallergic rhinitis. It affects up to 25% 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. Chronic congestion ups your risk of chronic sinusitis.

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.

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