Decongestant sprays shouldn’t be used for more than a week – but those who don’t realise can become trapped in a cycle of dependency, ITV News’ Sam Holder reports
When Georgia Hardacre first unblocked her nose with nasal spray, she had no idea she’d still be using it – four times a day, without fail, ten years later.
She showed us around her home in Fleetwood, Lancashire, revealing bottles of nasal spray in every room. One on the mantelpiece, another in her bedside draw, and more in her bathroom, kitchen, handbag, and car.
But why not just stop using it?
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“It’s horrible,” she said.
“You just feel like you’re suffocated. I get really bad headaches if I don’t unblock myself.”
Georgia is suffering from the effects of rebound congestion, or rhinitis medicamentosa – and so is her mother Celia Hardacre, who has been using the spray for 20 years.
Rebound congestion can happen when decongestant nasal sprays are used for longer than seven days. Prolonged use irritates the inside of the nose, causing it to swell up and feel blocked – relieved only by continued use of the spray.
It’s only caused by excessive use of decongestant nasal sprays containing oxymetazline and xylometazoline, rather than saline or steroid sprays.
Packaging contains warnings not to use it long-term, but many – like Georgia and Celia – miss the small print. They have tried to stop over the years, but say quitting feels impossible.
“If i don’t have it, I can’t breathe, my mouth’s dry, and eating is hard as well,” Celia told us.
They thought they were alone in their dependence, until Georgia came across someone posting about their experience on TikTok.
The comments on the video were flooded with those in the same boat – sharing stories of years of relying on the spray to unblock their nose, after using this kind of nasal spray longer than the packaging recommends.
One read: “Using it since I was a child, I’m 52 now.”
It was among some of these TikTok comments where we found Hannah Brumpton, from Lincoln – whose dependence resulted in surgery.
She began using decongestant nasal sprays when she had colds, which were worsened by her deviated septum and enlarged adenoids.
“During the day, I’d be sat in the office working, and I would realise again that I didn’t have it in my handbag,” she told us.
Hannah said her cycle of relying on nasal spray to breathe through her nose left her “tired” and “angry”
“I’d be panicking… I could nearly cry. It was so frustrating.”
Her overuse cost her thousands of pounds over the years, bringing anxiety, disrupted sleep, and sometimes unbearable discomfort.
“It would feel so heavy within my face – not just my nose, but all underneath my eyes. They would feel all puffed up,” she said.
“The only way I could describe it is I either wanted to punch myself in the face, or pull my nose off my face.”
She underwent surgery at a private hospital, known as turbinate reduction. Turbinates are structures in the nose which moisten and warm air as it’s breathed in.
Repeated use of decongestant nasal spray had left Hannah’s turbinates inflamed and enlarged, causing the constant blocked up feeling. The surgery helped her quit the sprays, but the recovery was a struggle.
“It was probably one of the worst surgeries that I’ve been through. It was just so painful,” she said.
“I cried, and cried, and cried for weeks.”
It’s a problem Professor Claire Hopkins, consultant ENT surgeon and rhinologist and sinus specialist at OneWelbeck in London, sees regularly.
She told us the risk of severe damage from overusing nasal sprays is small, and those using them regularly shouldn’t be alarmed – but they should try to gradually reduce usage, with a plan to wean off.
One or two of her patients in any clinic struggle with rebound congestion, and one in five of those are recommended surgery.
“It’s probably becoming more common, as people’s access to healthcare is becoming more restricted,” Professor Hopkins said.
“We know it’s very difficult for patients to be seen in primary care, or ENT clinics. So I think they’re more likely to turn to over-the-counter remedies.”
One expert in Norway estimated 700,000 people are overusing decongestant nasal sprays – that’s approximately 13% of the total population of 5.5 million. But in the UK, it’s impossible to know how many people are affected.
Professor Hopkins said: “I think it’s underreported because it’s not prescription only, and it’s not captured anywhere. People purchasing these sprays from the chemist and the supermarket, are hidden from the healthcare.
“We have no idea how many bottles of these sprays are sold in the UK.”
Curtis Arnold-Harmer, from Hastings, had surgery through the NHS after excessive use of decongestant sprays for 18 months.
At the height of his dependency, he was spraying his nose every hour of the day to relieve a sensation he described as having “cement” filling his nostrils.
When doctors looked at the inside of his nose, they asked Curtis how long he’d been using cocaine for – despite having never taken the drug.
He later made a video about his experiences on TikTok, which quickly gained millions of views.
“I was ready for a few comments calling me an idiot and saying, ‘you should have read the box’ – what I wasn’t ready for was tens of thousands of comments in the same situation as me,” he said.
Curtis said he became “a different person” when he couldn’t get hold of the spray
Georgia, Celia and Hannah all believe the sprays should become a pharmacy-only medication – still available over-the-counter, but sold by someone who can warn of the dangers of rebound congestion.
However, overwhelmed by thousands of people sharing their stories and messaging him for advice, Curtis has gone a step further – starting a petition calling for the products to be made prescription-only.
“If me starting this petition can stop what happened to me happening to other people, then I will be over the moon,” he told us.
Asked whether his idea was proportionate, and if people should just be further encouraged to read the box, Curtis said: “You can put the responsibility on the consumer if you like, but the problem will not go away.”
Decongestant nasal sprays should not be used for longer than seven days. If you’re struggling with dependence on them, contact your GP.
In response, PAGB, the consumer healthcare association representing the manufacturers of branded over-the-counter medicines in the UK said: “As an over-the-counter medicine, nasal decongestants are indicated for short-term relief of symptoms and the products state on the packaging and patient information leaflet that they should not be used continuously for more than seven days.
“As such, the medicines should only be taken as needed and not for longer than instructed on the product’s packaging and in the patient information leaflet.
“The patient information leaflet which accompanies all nasal decongestant sprays, outlines the risks of taking the medication for longer than its indicated use.”
Dr Alison Cave, Chief Safety Officer at the Medicines and Healthcare products Regulatory Agency (MHRA), said: “Patient safety is our top priority.
“These medications have been available as over the counter medicines for many years which allows the public to treat symptoms of nasal congestion without requiring a prescription from a doctor.
“These medicines are safe and effective when used in accordance with the instructions provided on the packaging and patient information leaflet.
“Both the patient information leaflet that comes with the medicine, as well as information on the outer packaging, states that nasal sprays containing oxymetazoline or xylometazoline should not be taken for more than seven consecutive days.
“Additional details in the leaflet explain that use for longer than seven days can worsen congestion.”
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