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What's behind ongoing congestion?
- Most common cause
- Allergies (allergic rhinitis)
- Other triggers
- Irritants, weather, overused nasal sprays
- Best daily treatment
- Steroid nasal sprays for many people
- Contagious?
- No, unless caused by an infection
Nasal congestion happens when the tissues lining your nose swell. Short-term congestion usually comes from colds. When it hangs on or keeps returning, the most common cause is allergic rhinitis (hay fever), the immune system reacting to pollen, dust mites, mold or pet dander.
Nonallergic triggers such as smoke, strong smells, weather changes and overuse of decongestant sprays can cause the same symptoms.
Allergies, a cold or a sinus infection?
| Feature | Allergies | Cold | Sinus infection |
|---|---|---|---|
| Duration | As long as you're exposed | Usually under a week | Can last 10+ days |
| Itchy eyes and nose | Common | Rare | Rare |
| Mucus | Clear and watery | Clear, then thicker | Thick and discolored |
| Fever and aches | No | Sometimes | Sometimes |
| Facial pain | Uncommon | Mild | Common |
Symptoms of allergic congestion
Allergic rhinitis often causes:
- Stuffy or runny nose with clear mucus
- Sneezing, often in bursts
- Itchy nose, eyes, throat or roof of the mouth
- Watery, red eyes
- Postnasal drip and throat clearing
- Poor sleep and daytime tiredness
Treating nasal congestion and allergies
The best treatment depends on your symptoms and triggers. Many effective options are available over the counter, and your provider can help you choose and combine them.
| Steroid nasal sprays | Such as fluticasone. The most effective daily option for allergic congestion; work best used every day. |
|---|---|
| Non-drowsy antihistamines | Such as cetirizine, loratadine or fexofenadine. Help sneezing, itching and runny nose. |
| Antihistamine nasal sprays | Such as azelastine. Work quickly on nasal symptoms. |
| Saline sprays and rinses | Wash out allergens and mucus |
Decongestant nasal sprays like oxymetazoline should be used for no more than 3 days, because longer use causes rebound congestion. Oral decongestants can raise blood pressure, so check with a provider if you have heart disease or high blood pressure.
Reducing your exposure
- Keep windows closed on high-pollen days and shower after being outside
- Use dust-mite covers on pillows and mattresses
- Keep pets out of the bedroom if pet dander is a trigger
- Run a HEPA air filter and keep humidity moderate
Is an online visit right for you?
Online care is often a good fit if you:
- Have seasonal or year-round allergy symptoms
- Haven't found relief with over-the-counter products
- Think you've been overusing decongestant sprays
Get in-person care if you:
- Have congestion on one side only that doesn't go away
- Have frequent nosebleeds or blood in your mucus
- Have wheezing or shortness of breath
How PulseCareMD can help
A PulseCareMD visit lets a licensed provider review your symptoms and triggers and build a treatment plan that fits your routine. Your visit fee covers the consultation.
Describe your symptoms
Tell us when congestion happens, what makes it worse and what you've tried.
A provider reviews it
A licensed provider matches treatment to your triggers and symptoms. Many visits are reviewed within 2–3 hours.
Get your plan
Recommendations and a treatment plan from your provider, if appropriate.
Frequently asked questions
When to get urgent care
Get prompt in-person care if congestion comes with:
- Swelling around the eyes or vision changes
- A nosebleed that won't stop after 20 minutes of pressure
- Wheezing or difficulty breathing
