I hate Afrin. Here's why.

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Why Afrin is an over the counter drug is beyond me.  It always has been - at least as long as I have been a doctor, but it’s the devil. The devil I tell you.  Why is it so bad? 

It causes a disease called “rhinitis medicamentosa”. 

Basically, that’s where your nose gets addicted to the stuff. 

It’s not only Afrin either. It’s any nasal decongestant sprays like it. Brands like: Sinex and Four Way and anything that contains oxymetazoline or phenyephrine in it.

So these sprays are decongestants, which means that when your nose is all stuffed up (like during a cold or during allergy season), they make it easier to breathe.  BUT, the problem is that after about 3-5 days of consistent use, your nose starts to get addicted. For the sake of this post, I’ll use the word Afrin, but know that the same applies to any product I just described above.

When you stop using the Afrin, the passages in the nose go through “rebound” swelling and they feel even worse than before you started it. 

So, you have to use it again to treat the blockage that stopping it caused!  Just like any street drug, patients have to use more and more to keep their noses from getting stuffed up. I see patients several times a month who have to use Afrin or other sprays like it several times a day just to be able to function.  

So just add this to my list of things I hate and do not recommend. I wish they made posters in schools like “Kids, just say NO to Afrin.” Before you call me a hypocrite, or accuse me of malpractice, there are the rare exceptions that I actually do recommend using Afrin. One of which includes the common nosebleed. Check out my instructions on how to use it in this case. Otherwise, please just … don’t.

We can manage nasal congestion with other, non-crack-cocaine-like, treatments.  For some patients, its as easy as a nasal steroid spray (see this post).  For others, simple in-office procedures can make a difference.  Other people need surgery, and I can talk about that later. 

 
 
 

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Nose, Daily LifeErin Shellenbergerafrin, nose