Chronic Sinusitis Treatment with Flonase

You can help yourself by trying chronic sinusitis treatment with Flonase or other nasal steroid sprays. I use these in my practice to help control symptoms and prevent recurrence of chronic sinusitis. If you have tried these medications and they have failed, there is chronic sinusitis treatment available. If you are like me you have struggled with chronic sinusitis your whole life. Maybe you are looking for solutions and this journey is what eventually drew me to specialize in treating patients with sinus and allergy symptoms.  I only see the worst patients now in my office and if you are wondering what you can try at home so you don’t have to come see me or another sinus specialist, you have reached the right place!

In this 3rd installment of a four part series I am going to outline the various over-the-counter Nasal Steroids available to help improve and in some cases eliminate chronic sinusitis symptoms.  Let’s get to it!

Nasal Steroids

• The second category of over-the-counter treatment you should try after you are already using nasal saline spray and/or nasal saline irrigation are nasal steroids. Chronic sinusitis treatment with Flonase or other nasal steroids can be very effective for some patients. (i.e. Nasacort, Flonase, Sensimist, Rhinocort)
• The unique thing about nasal and sinus inflammation as opposed to inflammation you may have in your knee joint is that you can more easily use direct application of medication at the source to try to reverse disease in your nose.  Many other parts of your body require an injection.  Reducing inflammation with a topical application or spray is how nasal steroids work.  You may have used a steroid cream on a rash to get rid of itching and swelling.  Nasal steroids do the same thing but inside your nose.  By using them daily they slowly reduce the inflammation and swelling you are having and by reducing the inflammation our hope is that your symptoms also improve.
• There are many over the counter brands available in the allergy aisle of your local pharmacy and all of the one’s available are about equally effective in published studies. I recommend starting with the lowest cost nasal steroid available and then find one that is effective and has little to no side effects.  Some have tastes or smells you might not like so a little experimentation will go a long way.
• Finally a couple things about nasal steroids are important to understand.  They work best after you have used them daily for one to two weeks so they are much less effective when used as needed.  If you are using saline spray or irrigation like I have recommended then use the saline first and then blow your nose.  The nasal steroid spray is much more effective when you do this as the mucosal surface has been prepped to receive the spray for better penetration of the medication. 
• Also, many of my patients have fears about steroid side effects like weight gain and moodiness.  There have been many studies published verifying that nasal steroids are safe and effective for use long-term with a very small incidence of side-effects.  They are a typically a great main-line treatment for chronic sinusitis in most individuals and I recommend you try them if you are having persistent symptoms or are thinking of searching for a sinus specialist near you.

Best Strategies

So your best things to try when it comes to reverse nasal and sinus inflammation to stop chronic sinusitis is to follow this effective strategy:

• Identify and avoid your triggers in your home, work and where you play.
• Identify and avoid any foods that may be triggering inflammation.
• Start nasal saline spray several times a day and especially after you do a triggering activity.  This may help wash out the things in your nose that are making you sick.
• For you over-achievers out there try using nasal saline irrigation once or twice a day until your symptoms improve.  If you have a dirty job or dirty hobbies this one can be a very effective approach to feeling better and it does not involve extra medication use.  Many patients like that.
• Move on to medication trials when saline does not work.  If you are having nasal congestion, headache, facial pain and pressure or thick mucus/post-nasal drainage your best option is to do a trial of chronic sinusitis treatment with Flonase or other nasal steroid sprays.  As mentioned, these have been shown to be effective at reversing nasal sinus inflammation and may give you good relief.  Nasal steroids are also a good option to control allergy when you can’t find an oral antihistamine that works without side effects.
• If you are having itching or watering of the eyes, nose or throat or having excessive clear nasal drainage you should try using an oral antihistamine to control symptoms.  The better you control your allergies the better you will control that root cause of your sinus symptoms… Inflammation!

What to do if all these things don’t help?

When medications fail that’s when you want to consider searching for a sinus specialist near me on google.  We are out there and we are here to help.  

Click HERE if you want to start an immediate discussion with me about your nasal sinus symptoms and options for care.

I sincerely hope you found this article helpful.  Have a great day!

Dr. B

Frequently Asked Questions About Flonase for Sinusitis

How long does it take for Flonase to work for sinusitis? Flonase and other nasal steroid sprays need one to two weeks of daily use before you’ll feel their full effect. They aren’t designed for as-needed relief the way a decongestant might be. Consistent, daily use is what allows the medication to gradually reduce the inflammation and swelling inside your nasal passages. That’s why most sinus specialists recommend committing to a full two-week trial before deciding whether a nasal steroid is working for you.

Is Flonase safe to use long term? Yes. Multiple published studies have confirmed that nasal corticosteroid sprays like Flonase are safe for long-term use with a very low incidence of side effects. Unlike oral steroids, topical nasal sprays deliver medication directly to the nasal tissue, which minimizes the systemic effects people often worry about — such as weight gain or mood changes. For patients managing chronic rhinitis and ongoing nasal inflammation, nasal steroids are often a cornerstone of daily symptom control.

Which nasal steroid spray is the best — Flonase, Nasacort, or Rhinocort? Published research shows that all of the over-the-counter nasal steroids — including Flonase, Nasacort, Sensimist, and Rhinocort — are roughly equal in effectiveness. Dr. Bichey recommends starting with the lowest-cost option and then adjusting based on personal preference, since some sprays have a slight taste or scent that may bother certain users. The important thing is finding one you’ll actually use every day.

Should I use saline spray before or after Flonase? Use saline first. Rinsing with a saline spray or irrigation system clears out mucus and debris, which preps the mucosal lining so the nasal steroid can penetrate more effectively. Blow your nose after the saline rinse, then apply the Flonase. This two-step approach — saline followed by steroid — is a strategy that sinus specialists consistently recommend for getting the most out of your medication.

Can Flonase cure chronic sinusitis? Flonase can significantly reduce — and in some cases eliminate — chronic sinusitis symptoms by controlling the underlying nasal inflammation. However, it doesn’t address structural issues like a deviated septum or nasal polyps that physically block your sinus drainage. If your symptoms persist after several weeks of consistent nasal steroid use along with saline irrigation, it may be time to see a sinus specialist for further evaluation, including imaging to determine whether a procedure like balloon sinuplasty could help.

When should I see a doctor instead of using Flonase? If you’ve followed a full at-home treatment plan — trigger avoidance, daily saline rinses, and a consistent trial of nasal steroid spray — and your symptoms haven’t improved, that’s the signal to seek professional care. Persistent facial pressure, thick discolored mucus, or recurring infections that don’t respond to antibiotics are signs that over-the-counter treatment alone may not be enough. A sinus specialist can use CT imaging and nasal endoscopy to identify what’s driving your symptoms and recommend targeted treatment options beyond medication.