Saline Sinus Rinses: What Good Are They? 1/4

Saline Nasal Rinses

saline nasal rinses for treating sinusitis and rhinitis

Saline Nasal Rinses are Analogous to Washing the Dust off Your Car

The concept is simple:

Rinsing your nose and sinuses out every day is a bit like rinsing the dirt off your car with a garden hose – particles are rinsed away by hydro-mechanical action.  The advantage: things that you are allergic to – allergens – are rinsed away so they do not continue to cause irritation, rhinitis.  In addition, other particles are rinsed away too:  bacteria, viruses, mold spores, and pollutants, in addition to allergens.  Finally, anyone with allergies can tell you that their nose produces too much mucus (SNOT); this is rinsed away too.

This is part 1 of 4, listed here:

Simple.  The end result is improved mucociliary clearance, the holy grail of healthy sinuses (go over to the search box on the right and type in “cilia” if you want more).

Results of Saline Nasal Rinses (all good!):

  • rinse away allergens
  • rinse away bacteria
  • rinse away viruses
  • rinse away mold
  • rinse away pollutants
  • rinse away acid from reflux
  • rinse away over-production of mucus

Osmotic Action:

A bit less simple is the concept of osmotic action of the saline formula that you use.  If you use hypertonic saline – meaning stronger salt concentration than in our bodies – the effect will be to draw fluid out of the swollen nasal and sinus lining.  This can be a good thing: reduce swelling, open the sinus passages.  On the other hand, medical studies have shown that too much hypertonic saline will make your sinus cilia unhappy.  Unhappy cilia, reduced mucociliary clearance.  That’s a bad thing.

When to Use Hypertonic Saline Nasal Rinses:

I recommend using hypertonic saline only during times of acute rhinosinusitis, or acute exacerbations (worsening) of chronic rhinosinusitis, and not for routine maintenance of healthy sinuses.


If you or your child have asthma, and also have rhinitis or sinusitis, doing saline sinus rinses will improve your life.  Give it a try.

Are you doing sinus rinses? For allergic rhinitis? For sinusitis? For your kids or for you?

Let us know in comments.

See you here over the next few weeks as we review how to make sinus rinses easier, and more effective.

Best health and success to you and your families.

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:  1 of 4 parts

Next time:  Medical Evidence to Support Sinus Irrigations


  1. Hi. Last Christmas I had the flu. I got so blocked up on one side particularly badly that it gave me panic attacks. My dr gave me a steroid spray to help. It did open my nose up so I could breathe. But since then my nose has never been right. It feels stuffy all the time and dry. Then in the spring my nose started to burn and got so dry. It has been very painful and uncomfortable. I did saline rinses with a neti pot but I found it made my nose drier. I use sesame Nozoil and the steroid spray but it didn’t help much. Now it is Autumn my nose is more comfortable but still dry. I just don’t seem to have much mucus in my nose. The ent doc said I have an allergy to something although came negative for my allergy tests. Is there anything u can recommend to help get more moisture into the nose. Yours hopefully.

    • Russell A. Faust, PhD, MD says:

      Hi Sally,
      Interesting idea, adding probiotics to nasal rinse. I have no experience with it, and hope that you will follow up to let me know how things go for you.
      My only comment is that some people with symptoms of allergic rhinitis, but with negative results on allergy testing, have reflux (GERD). The cause is reflux of gastric acid to the back of the throat and back of the nose at night, resulting in chronic irritation of the nasal lining. This can cause symptoms that are indistinguishable from allergic rhinitis.
      Thanks so much for sharing, and please keep me updated!

      • I am a 65 year old female who is also having dry sinus issues and in the mornings my mouth is extremely dry. I wonder if the GERD problem can cause nose bleeds? It would make sense with the irritation of the nasal lining. I am also using a nasal saline spray periodically during the day and a cold mist vaporizer at night. Thank you.

        • Russell A. Faust, PhD, MD says:

          Hi Dianne:
          The dryness and morning dry mouth are likely the result of mouth-breathing at night while sleeping. Nasal congestion, reducing your ability to breathe through your nose, may be contributing to that. The nose bleeds are most likely related to that, but chronic inflammation resulting from nasopharyngeal reflux can also contribute.

          PLEASE do not use a “cold mist” vaporizer: EVERYTHING that is in the water will be misted into the air. All virus, mold spore, bacteria, you name it – you’ll be breathing it. Please get one of the simple “steam vaporizers.” A steam vaporizer will create steam mist by boiling the water, thereby sterilizing it! Much safer. Especially if you have ANY sort of immuno-compromise (such as being age 65; or being on any medications that are immunsuppressive; or being in treatment for any cancer, since most cancer drugs are immunosuppressants). Be safe: get a steam vaporizer. Here is the boogordoctor Amazon affiliate link for the steam vaporizer that we use in our home.

          Please also take a look on this website for information on GERD and also on vaporizers – simply do a search over on the right column in the “Search This Site Here” box.

          Thank you for sharing, and please keep me updated.

  2. I am glad I found your website. I am a nail technician. Today while I was working, a piece of acrylic drilled from my clients nail I was drilling flew up into my nose. It was quick and I think I breathed it in. Probably the size of a toast crumb, little bigger. I am now nervous it has gone into my nasal or sinus passages. I tried blowing my nose but I didn’t see anything. I then went to the drug store and bought Simply Saline and have used that a few times. I think it was big enough that I would notice it is it came out of my nose or down my throat. I’m nervous. I don’t feel anything other than irritation from blowing and using the saline spray. What should I look out for? Or do you think I don’t have anything to worry about? I guess I’m not sure how the nose works to rid itself of foreign particles that fly up there. Any advise would be so much appreciated. Thank you.

    • Russell A. Faust, PhD, MD says:

      Hi Lori,
      As an ENT doc, I’ve found some pretty odd things in people’s noses – especially kid’s noses! If you think it’s in there, an ENT doc can take a look for you (and also easily remove it in clinic). Please let me know what happens.

  3. My 4 year old daughter has been sick for almost two months now. She is being treated for asthma and will see the pulmonologist in a few days. With her coughing under control she just cannot seem to get rid of the nasal stuffiness. The congestion never loosens up & seems to be stuck. There have been several times a large amount of mucus drains down the back of her throat which has made her choke, gag and even vomit. Very scary times to watch your child not be able to breath while chocking on mucus. Antibiotics, Flonase & Allegra have not worked . It seemed to have cleared up for a week, long enough to go back to school & start back up with the congestion. This time around she has dark circles under her eyes along with her swollen eyelids. I hate giving her all these medications & was glad to find your site with great, real medical sources. I am going to start the saline rinses on her tomorrow and see how it works.

    • Russell A. Faust, PhD, MD says:

      Hi Rebecca,
      Those symptoms are too familiar – sounds like our youngest son.

      Though I can’t offer medical advice here, I can recommend considering the various alternative remedies described in articles on this site – anti-inflammatory agents like Quercetin/Bromolain, and saline nasal rinses. It’s hard to improve on the benefits of saline nasal rinses – but that can be a challenge in a 4-year-old!
      Something you should note: despite children like your daughter’s, who conform to a text-book presentation of allergies (and other inflammatory upper airway disorders such as allergic rhinitis, asthma, sinusitis, otitis), the majority of these children have “negative” allergy test results.

      Those “negative allergy test” results can be very frustrating for both parents and physicians. I my experience, the allergy tests are only useful if they are positive, and tell me exactly what the child is allergic to. Otherwise, I assume that we (the parents and I) will need to do some sleuthing and figure out on our own what the allergen triggers are.

      For our son, we started with the usual suspects – dairy, wheat, things like that. An “elimination diet” is a real challenge in a 3- or 4-year-old, but it’s worth the effort if you can figure our what is triggering your child’s ailments.

      I look forward to hearing more about how your daughter does with her “specialists.”
      Thanks so much for visiting, and for sharing.
      Best success!

  4. I have had a sinus infection for over a year. Before that it had been over 15 yrs since I had one. I have been to 3 different ENT drs. taken multiple antibiotics water pic my sinuses 2x daily for over 6 months, put saline up my nose and turned upside down to clean out the top sinuses for over a month now. I take strong probiotics daily. Iam running out of hope. I seldom feel sick but occasionally I feel like the infection starts to overcome my system and will be sick for days. I do have a huge hole in my septum from a bad deveated septum surgery over 35 yrs ago. I use Flonase twice a day to keep the swelling down and passages open. I had a CT scan which showed fluid in the maxillary sinuses and I do show positive for staph. I took Amoxicillan for 3 months straight at a strong dose. I’ve tried Zylitol, high doses of salt. I use distilled water and none iodized salt. I will start the baby shampoo today. I have taken hundreds of rounds of antibiotics in my life as Iam a tetracycline teen ( I know). Going back to ENT this week. He wants to go in and scrape and suck everything out and treat with antibiotics heavily. Not my first choice but don’t know what else to do. Iam at a loss.

    • Russell A. Faust, PhD, MD says:

      Hi Candy:

      I feel your pain! (Been there).

      My only advice: be VERY cautious with the baby shampoo – more than a couple drops in the nasal saline rinse bottle will burn like heck! So go easy. I was finally able to eliminate my own chronic sinusitis using Manuka honey in my saline rinses. Xylitol is good too, to help increase the osmolarity of the rinses, but also because Xylitol has innate antimicrobial activity. Manuka honey has even stronger antimicrobial activity. But don’t over-heat it – you want to preserve the enzymatic activity in the Manuka (peroxidase etc).

      I’ve had great success with balloon sinuplasty to re-open sinus ostia (openings) that have scarred-down following prior surgery. You might ask about that approach.

      Thanks for taking time to share, and best success.

  5. Hello, I’ve had chronic sinusitis for about 30 years, since I was a teenager. I finally went to my ENT and the CT scan shows blockage in my frontal sinuses primarily. My ENT wants to do balloon sinuplasty but my insurance refuses to cover it. Instead they approved conventional FESS, which my ENT said is more risky for complications.
    I don’t want to go the surgical route just yet, but do you know of a way to rinse the frontal sinuses effectively? I am using Xylitol, baby shampoo, and saline cocktail using the SinuPulse irrigator, but it is not strong enough to reach the frontals. It seems to clean it but within 12 hours it would be back (I think the frontal mucous drips down to the other sinuses). My primary complaints are nasal congestion and a horrible purulent smell from the mucous build up. The rinsing helps get rid of the smell but recently I discovered Alkalol which is much more effective in getting rid of the smell. However, that is just as temporary, as I will need a rinse again in 12 hours.

    • Russell A. Faust, PhD, MD says:

      Hi Mel,

      The ignorance and short-sighted behavior of insurance “medical directors” never ceases to shock me! It makes no sense: compared to conventional FESS, the balloon sinuplasty will have a greater likelihood of success; will cost less; and will yield a healthier (less expensive to insure) patient in the long term.

      It sounds as though you have already optimized your management. Note that it’s okay to do the rinses a couple times per day (I do). Go easy on the baby shampoo – it can be very irritating to the cilia. You want your cilia to be as happy as possible so they can do their normal job of clearing your sinuses. Manuka honey added to regular saline rinses can have many benefits: increases osmolarity to help draw fluid out of swollen tissues (may help open frontal sinus ostea); and powerful innate anti-microbial activity; optimize nasal airway to minimize congestion.

      Sorry I don’t have a solution for the idiots at your insurance company, but you really don’t want to pay for sinus surgery out of pocket – even if it is the less-expensive sinuplasty version.

      Thanks so much for sharing, and best success.

      • Thanks Dr. Faust. I have since gone out and bought Manuka honey and have added it to my routine daily. It does seem to be more effective than xylitol in keeping the sinuses clear longer. However, I do have to do the rinse daily, which can get pretty expensive pretty fast with the cost of Manuka honey. How long did you have to do the Manuka treatment before you notice a big improvement in your condition? I’ve been using it for about two weeks but noticed its effects are fairly temporary, if I don’t do it frequently the same symptoms come back.
        As for the baby shampoo, I just put a couple drops per 8 ounce rinse so it does not irritate me much. The benefits seem to be fairly limited though, after a month’s twice daily use of the shampoo.
        After seeing the 3D CT images it really bugs me the “white stuff” that is present in my frontal sinuses. But based on what I have read, it seems that area is very hard to access without surgery?
        I’m also going to see my allergist this week to do a skin test.

        • Russell A. Faust, PhD, MD says:

          Hi Mel Liu,

          Yes, the cost of Manuka adds up if you use it daily. Now that I have eliminated my chronic sinusitis, I ONLY add Manuka honey to my rinses if I have an acute flare up, and then only for a few days. If I think that I need extra help over a longer period I use Xylitol. Xylitol is an excellent antimicrobial addition to saline rinses. And note that there are very few people who should do saline rinses every day for long term.

          Even a small amount of the baby shampoo can be irritating to your natural cilia if used over long term. Your goal should be to get your natural “muco-ciliary clearance” mechanism working again, and keep it healthy and working normally. Once you have experienced chronic sinusitis, or have chronic severe allergic rhinitis, that can be a difficult challenge, I know from personal experience.

          Yes, the openings (ostia) to the frontal sinuses are difficult to enlarge without surgery. However: “balloon sinuplasty” can be very successful opening frontal sinuses, and is a much more benign procedure than traditional “sinus surgery.”

          Thank you for visiting and sharing. Best success!

          • Hi Dr. Faust:
            Thanks for getting back to me. I paused on using baby shampoo after reading your response but I found my congestion worsened afterwards. I’m surprised that 1% baby shampoo concentration would be an irritant to my natural cilia… I read Dr. Grossan’s website and he seems to indicate that the 1% baby shampoo regime helps restore natural cilia function? Or am I not reading it correctly?

          • Russell A. Faust, PhD, MD says:

            I have great respect for Dr. Grossan. Actually, anything – even isotonic saline – can be irritating to cilia. Cilia are extremely sensitive and fragile. Any changes in salinity (osmolarity), temperature, etc., can affect their function. So even rinsing too frequently with normal saline can affect normal cilia function. In general, 1% and less of baby shampoo is not overly toxic to your cilia – unless they are already irritated (basically, everyone with chronic rhinitis or sinusitis), or unless done too frequently. What is “too frequently”? Anyone’s guess.
            Thanks for visiting and especially for sharing!

  6. Hi, I’ve been dealing with ongoing sinus inflammation for 5 years now, I’m now 29. I’ve had a CT scan done which showed I had a cyst and a deviated septum. The cyst was of no concern and I was told had nothing to do with the inflammation but was told that I should have my septum corrected. This was years ago and I have yet to return because the thought of surgical complications such as meningitis scared me. I started seeing another ENT and a GI because I’ve developed acid reflux and mild gastritis. I’m supposed to go on triple therapy to treat H. Pylori. My ENT told me about NeilMed Sinus Rinse which I bought today but I’m having some concerns about breathing this stuff in and drowning (I know sounds silly.) And what of Manuka Honey? Is there a possibility of breathing honey droplets into the lungs?

    Interesting to see Manuka mentioned as I’ve read that it’s a natural killer of H. Pylori. I’m now on the bench whether to try that vs the triple therapy.

    • Russell A. Faust, PhD, MD says:

      Hi Erica,
      Unfortunately, I cannot provide medical advice for you. Regarding of aspiration of rinse solution (breathing it into the lungs), I have not encountered that problem during three decades in medicine. If you have normal neuro-muscular function, and normal laryngeal function (voice-box) such that you do not frequently aspirate saliva or beverages into your lungs, I can’t see where nasal rinses will pose a particular problem for you. Best success.

  7. Michelle Freels says:

    For several years ,I have suffered with severe nasal swelling and congestion…I have taken several rounds of antibiotics for it.I use the neti pot with saline rinses ,but frequently feel full of junk .Sinus rinses that way may help some but between OTC and perscription meds coupled with trips to the DR I have spent a fortune.I think I have a severe sinus infection now but am trying to avoid yet another trip to the DRs office…..IS there anything you would know that will help better.???I also have been told I have Asthma symptoms ….PS anything you can offer is very much appreciated

    • Russell A. Faust, PhD, MD says:

      Hi Michelle:
      What can I say? You have stumbled onto this blog – representing most of my best educational material concerning rhinitis, sinusitis, and asthma. To provide more specific advice you would need to be my patient. And since I am retired from clinical practice that’s just not possible. My best advice: find a physician who follows a big-picture, holistic, and integrative approach to the ailments that you list, and work with them to find the root cause(s) of you ailments and eliminate them.
      Thanks so much for visiting and sharing. Best success.

  8. I am a huge proponent of sinus rinses! They changed the course of chronic sinusitis in my (then-5 YO) son. The poor kid had chronic sinus infections and was on antibiotics 9 months of every year and even FESS only provided a 3 month reprieve. When the next cold turned into yet-another sinus infection, I stumbled onto this website and read about rinses and began them on my son (I challenged him to a contest in order to get him to do them!). 4 weeks later, his cough went away, for the first time in years! The next cold came and…went away! I’m a believer! He continued to do them daily, in the shower, until he reached his teens (of course), but, thankfully, the sinusitis has not returned- although, we know what to do if it did! I work as a pharmacist and now highly recommend every patient I see getting prescriptions filled with nasal steroids and/or antibiotics about the value of routine saline rinses- after all, other than an initial strange feeling and a little time investment, they’re benign! I tell them it’s like washing a wound and if a 5 year old could do it, so could they! I think saline rinses are not stressed enough in the medical community, but ought to be! Thanks for the extremely valuable info!

    • Russell A. Faust, PhD, MD says:

      Hey Angela:

      Thank you for sharing that! I completely agree.

      And, for parents struggling to get their younger children to comply with nasal rinses, I refer them to the kid-videos from Nasopure. Here is the link to their YouTube video:

      Thanks again for your note!

  9. Jess Barkin says:

    How much manuka honey should be put with the saline rinse?i don’t know how to apply it to the nose.

    • Russell A. Faust, PhD, MD says:

      Hi Jess:
      I add a heaping tablespoon of Manuka honey to the adult-size squeeze bottle from Nasopure (500ml, I think). That seems to be about the right amount to make the rinse hyper-osmolar (draws out fluid from swollen tissues), and to add a little of the antimicrobial activity from the Manuka honey.
      Thanks for visiting!

Speak Your Mind