Stuffy nose: what causes it and how to get relief

Your nose gets stuffy when the tissue lining it swells. It often comes with a runny nose or mucus dripping down the back of the throat, which causes a cough or sore throat.

According to MedlinePlus, congestion from a cold, the flu or a sinus infection usually goes away by itself within a week. Other causes are allergies, using an over-the-counter decongestant nasal spray for more than 3 days (which can make it worse), nasal polyps and pregnancy.

These clues help you narrow down the most likely cause:

• Cold: stuffy nose with sneezing, a runny nose and sore throat, sometimes a low fever; improves in a few days. See common cold.
• Sinus infection: facial pain or pressure, thick mucus and symptoms that last more than 10 days or get worse after getting better. See sinus infection.
• Allergies: itchy nose and eyes, sneezing fits, clear mucus, no fever; comes back with dust, mold or seasonally. In Puerto Rico, Saharan dust can make it worse too. See allergies.
• Flu: sudden high fever, body aches and exhaustion on top of the congestion.

MedlinePlus recommends:

• Drinking plenty of clear fluids to keep mucus thin
• Using a saline (salt water) rinse or spray 3 to 4 times a day
• Breathing warm steam, for example in the bathroom with the shower running (not hot steam), or using a humidifier
• Putting a warm, moist washcloth on your face several times a day
• Sleeping with your head raised, because congestion is worse lying down

Decongestants shrink the swollen tissue in your nose and can relieve a stuffy nose, but they are not for everyone.

Decongestant nasal sprays: according to MedlinePlus, don’t use them more than 3 days on and 3 days off unless a doctor tells you to. Using them longer can leave your nose more blocked than before, and overuse can also cause a nosebleed.

Decongestant pills (such as pseudoephedrine): MedlinePlus says to tell your doctor before using them if you have or have had high blood pressure, glaucoma, diabetes, trouble urinating from an enlarged prostate, or heart or thyroid disease, and if you are pregnant or breastfeeding. If you have high blood pressure, see high blood pressure.

Children: according to the FDA, children under 2 should not be given any cough and cold product with a decongestant or antihistamine, and labels say not to use them under age 4. Read labels carefully: many products combine several medicines.

In babies, a stuffy nose can make feeding and sleeping hard. Saline drops and a bulb syringe to clear mucus usually help. If your baby is under 3 months old and has a fever (38 °C / 100.4 °F or higher), go to the ER. For colds in children, see cough and cold in children. If the patient is under 21, a parent or legal guardian stays on camera for the whole visit and shows ID.

You see Dr. Diana Nieves Castro, a Puerto Rico-licensed general practice physician with several years of emergency-department experience, in English or Spanish. She asks how long your nose has been stuffy, whether you have fever, facial pain or mucus from one side only, whether you have allergies, which medicines you take and whether you have high blood pressure.

We evaluate, diagnose and treat: colds, sinus infections and allergies. If appropriate, the doctor prescribes, for example an allergy nasal spray, and we send your prescription to your pharmacy. An online doctor visit costs US$79, the same price for every age.