Saline Sinus Rinses: What Good Are They? 4/4

Homemade Saline Nasal Rinses

homemade saline nasal rinses

Cooking Up Your Own Saline Recipe :)

This is part 4 of 4, listed here:

Ingredients for Homemade Saline Nasal Rinses:

  • Salt – pickling (“canning” salt) or Kosher salt are best because they are free of iodine and other preservatives.  Regular table salt is OK in a pinch if you can’t get pickling salt.
  • Water – use bottled, distilled water if possible.  Tap water or well water risk microorganisms, and are definitely NOT for anyone who is immunosuppressed.
  • Temperature – use the final saline solution at body temperature, or slightly luke warm.  NOT HOT.

The Recipe for Hypertonic Saline, for really stuffy noses, acute sinusitis:

  • 1 liter water (about 1 qrt)
  • 2-3 tsp salt
  • 1tsp baking soda
  • Mix, microwave to dissolve, allow to cool (don’t use it hot!!)

Mistakes to Avoid

  • If you make up a large quantity, store it in the fridg, warm-up only amount needed for each use – should last about 4 days.  Do not let sit at room temperature – refrigerate – or it will grow mold, fast.
  • If you add things like Manuka honey for antimicrobial benefit, don’t overheat – too much heat will kill active enzymes and proteins in the honey.  Don’t waste that expensive Manuka!

Last point:  use the saline misting sprays during the day – these will help keep your nasal epithelium moist and optimize nasal hygiene.  However, a study published in 2002 (Olson’s group) reported that these nasal nebulizers do not reach the sinuses.

To get the rinse into the sinuses where it can do some good, they found, requires active irrigation like that provided by the bulb syringe, the squeeze bottle arrangement, or the plug-in systems based on a small electrical pump.  Olson’s group did not compare the neti / netti pot, but I speculate that the n-pot might be a little less effective simply due to the passive nature of the flow of saline.  It doesn’t use a strong force to flush the sinuses out.  One the other hand, if that is all you or your child will tolerate, it is much better than nothing at all.

We’ll have more information about different additives to sinus rinses in future posts.


Together, in this series we reviewed the use of saline rinses to control allergic rhinitis, and to control sinusitis and chronic rhinosinusitis: the medical evidence that they make a difference, how to do the rinses, how to make your own, and some mistakes to avoid.

If you take a look at ealier post, Medical Evidence Supporting Saline Nasal Rinses, you will see some convincing evidence of the value of saline sinus rinses.  It has been my own experience with saline rinses over more than 10 years, and those of my patients, that have convinced me of the value of this natural remedy.

If you or your children are struggling with asthma, allergic rhinitis, or sinusitis, I urge you to give this a try.  This is a great alternative to swallowing more medications!  And WAY better than surgery.  Trust me: if you go with surgery, you MUST do the rinses.  So you might as well start with them – you might avoid surgery all together.

If this blog is helpful for you, please click here to subscribe for free email updates (did I mention it’s FREE):

Simply type your best email address (the one you actually use) into the orange-outlined box at the upper right of the page, and click the subscribe button. When you receive the confirmation email, click on the link to give your okay to receive weekly email updates.

No advertising, no spam.  It’s easy, it’s convenient, it’s free. You can un-subscribe any time.

Stay informed, stay healthy.

Best health and success to you and your families.

Thank you for visiting, and see you here again next week.  Please post a comment so that we can all learn to achieve sinus health, and healthy airways.  And please, “be excellent to one another.”

Until next time, remember … you can pick your friends, and you can pick your nose, but you can’t pick your friend’s nose (unless you’re a boogor doctor ;~D)

Saline Sinus Rinses: part 4 of 4


Nasal saline for chronic sinonasal symptoms: A randomized controlled trial.  Pynnonen, et al.  Archives of Otolaryngology-Head & Neck Surgery. Vol. 133(11): 1115-1120; 2007.

Nasal rinsing with hypertonic solution: An adjunctive treatment for pediatric seasonal rhinoconjunctivitis.  Garavello, et al.  International Archives of Allergy and Immunology.  Vol. 137(4): 310-314; 2005.

Radiographic comparison of three method for nasal irrigation.  Olson, et al.  The Laryngoscope. Vol. 112: 1394-1397; 2002.


  1. Doctor Faust,
    Just wanted to add the NeilMed product that you mentioned has an excellent website that has a video clip that actually shows you how to rinse your sinuses and tips for caring for the bottle. Definitely worth checking out.

    • Russell A. Faust, PhD, MD says:

      Dear L,
      Thank you so much for visiting, and for the great tip. Yes – NeilMed products are great (I have NO financial or other arrangements with them), and they have a very informative website. Thanks for reminding me, and I will add their site to my ‘Link Luv’ list. RF

      • Kim Diedrich says:

        I also use the saline rinse recommended by only 1 ENT out of 7! I thank God for that Doctor because it really helps! I seem to get a lot of mucas that is sticky and I also have red colored blood that comes with it since I developed a deviated septum from a blow to the nose. I now have numbness pain and blockage in my ears am am on nasal steroids. They want my to try Gabapentin but I might try Gaba the supplement first. NeilMed Saline rinse really helps!

  2. Great advice…i have found in my pediatric practive that children should begin with isotonic and work their way up to hypertonic.
    i have also witnessed that most will wash routinely if the wash does not enter the sinuses but simply washes the sinus ostia and ET ostia….thus allowing the discharge to drain naturally and un blocked.
    i have 2 yr old patients who love to wash those ‘buggers’ out with my nasal wash system. i have written a book on the subject ‘clearing the air one nose at a time’.
    let me know if you would like a sample of my product or book.
    Be Well, Dr hana

    • Russell A. Faust, PhD, MD says:

      Dear Dr. Hana,
      Thank you so much for visiting and sharing your experience and expertise.
      Of course, I agree with the points that you make about saline rinses opening the sinus ostia (natural openings). I am impressed that you have 2-year-olds in your experience who will tolerate this practice – I have many 4-year-olds who are doing this, and a couple 3-year-olds. Two is impressive – perhaps your particular recipe for saline is particularly gentle and well-tolerated? I have not personally used the Nasopure saline system, and I will make an effort to try it out.
      I am so flattered that you visited.
      I hope you visit and contribute to our little community of “boogor-heads” often.

  3. Hi two points:
    1. Although you gave the recipe to be used for severe sinusitis you did not give the amounts for the ‘regular’ solution. I think it’s absurd to buy a packaged product (the Neilmed packets) that can easily be mixed up at home. I agree with you about the plastic bottles but what about all that waste packaging (cardboard boxes and foil packets)?

    My second point is that anytime I have done these rinses I have found that after the procedure is over, water drains out of my nose for quite a long time afterward. An hour or so. So the rinse is not something you can just do and go on with your day. Am I using too much water?

    • Russell A. Faust, PhD, MD says:

      Hi Janet,
      Thanks for joining us, and for a great question. The “regular” recipe is the same, without the honey: [1 liter distilled water (distillation purifies and nearly sterilizes it), 2-3 tsp salt (kosher canning or pickling salt), 1 tsp baking soda (‘buffers’ it so it doesn’t burn as much)]. For chronic, just add the honey [3-7 tablespoons Manuka Honey]. You are also absolutely right about modern packaging – wasteful!! When making your own saline, just keep in mind that you will need to store it in the ‘frig so that it doesn’t grow mold – that would not be a good thing to rinse your nose with. To use, let it come to room temperature, or gently heat over the stove to luke-warm (NOT hot, NOT cold). To answer your second question: No, I don’t think you are using too much rinse. What I do is rinse, wait a few minutes and vigorously blow my nose. Any saline that comes out following that must be from the sinuses – that’s actually a good thing, since it demonstrates that they are open (“patent”). You will likely find that this will reduce the more you do the nasal rinses, as the swelling goes down, and the sinuses open up more – if the sinus openings are wide open, they should drain immediately, not over an hour or so afterward.
      Please let us know how things go, and thanks again for joining and sharing. Your participation is GREATLY appreciated!
      Best in health, RF

  4. Hello Doctor,
    Your link to the article on some of the benefits of Xylitol doesn’t work. I’m interested in learning more about adding xylitol to saline nasal rinses. Also, wonder if you could explain post nasal drip and the accumulation of excess secretions in the back of throat in the morning. Thank you.

    • Russell A. Faust, PhD, MD says:

      Hi Wendy,
      Thanks so much for taking the time to give me a heads-up: I can’t find that link. If you don’t mind, please email the link to me at boogordoctor [AT], and I will fix it pronto.
      Regarding post-nasal drip (pnd), it’s pretty straight-forward: the lining of your nose and sinuses don’t stop making secretions just because you lie down to sleep. You swallow some of those secretions during your sleep, but some of those secretions accumulate in the back of your throat (“nasopharynx”). That’s why many people need to do all that “clearing” when they first wake up in the morning. This pnd is worse for those with allergic rhinitis.
      Thanks again!

      • Hello Dr. Faust,
        I found the link in the article “What is Sinusitis?”. The text reads: “Read this article on the Benefits of Xylitol” and the link goes to:

        Thank you for answering my question. Now I have another. I have post nasal drip that is most apparent to me in the morning after awakening. Sometimes the drainage is very lightly blood tinged and occasionally the blood tinge is more noticeable. This occurs regardless of time of year, i.e. cold or hot temperatures. This drainage quickly resolves and is not noticeable the rest of the day. I have mentioned this once to an ENT when I was seen for another issue and he thought it might be due to a superficial blood vessel. However this possible explanation was not really investigated and confirmed. Should I be concerned? Should I go back to the ENT for a closer look? Thank you.

        • Russell A. Faust, PhD, MD says:

          Hi Wendy,

          Thanks so much for that specific link! I’ve been trying to “clean up” the many broken links on this site, but with hundreds of articles, it’s taking me a while!
          Please take a look at this link:
          Hope that helps!
          And please: feel free to send me any more broken links, and I promise to take care of them (eventually :))

  5. Dr. I have been suffering from sinus problems since 30years. I have tried almost everything from regular rinse, antibiotics, anti histamines, got operated few years back. With recent scans. I was told that I have developed polyps and surgery recommend. I read that people who went through surgery redevelop ploys in 1 to 2 years. Looking to your input that could help.

    • Russell A. Faust, PhD, MD says:

      Hi Dale,
      I’m sorry to say that my adult patients who have nasal and sinus polyps usually re-form them within 1-2 years, that’s correct. And as a sinus surgeon, I can say that every one of those surgeries becomes more challenging, and has a higher risk for the patient. That means you should be doing everything in your power to avoid that! Recommended regimen: daily nasal saline rinses; consider including Xylitol for its natural antimicrobial activity, and for helping to achieve hyper-osmlar saline without a salt concentration that would be toxic for your respiratory cilia; saline containing Manuka honey, for its antimicrobial activity; both of those additives can help eradicate chronic infections by biofilm-forming bacteria; daily anti-inflammatory – either a non-steroidal anti-inflammatory drug (NSAID) or (my preference) a natural alternative combination that includes Curcumin and Quercetin/Bromolain.
      It’s inconvenient to rinse your nose every day, and to remember to take your anti-inflammatory regimen; it’s pretty inconvenient to have a nose full of polyps and undergo surgery ever year. It would be an easy choice for me :-)
      Thanks so much for visiting, and for taking time to share. Best success, and please keep me updated.

  6. Mfon Frank says:

    Dear Dr Faust,
    Thank you for the post. I have suffered from this stuff for more than 10 years. Virtually all antihistamines are no longer working for me. I am about starting d saline rinse now. Will you advise me to start adding honey right away?

    • Russell A. Faust, PhD, MD says:

      I usually recommend using Manuka honey for folks with chronic rhino-sinusitis; it is especially helpful for those with chronic biofilm-forming bacterial infections. Otherwise, regular use of Manuka honey is pretty expensive. A less expensive way to achieve hypertonic saline for daily rinsing is to simply add less water to the rinse bottle after adding the packet of saline. Even reducing the amount of water by a couple milliliters will increase the saline concentration and help reduce swelling of the tissues. Long-term, daily rinsing with hypertonic saline will make you cilia unhappy, however; so the recommendation is to return to “normal saline” concentration as soon as your congestion resolves.

Speak Your Mind