Nasal steroid sprays. Biologics. Surgery. These are some of the treatments your doctor may have recommended to manage your nasal polyps.
In other words, if you feel like your nasal polyp treatment isn’t working, you’re not alone. Here are some common reasons your treatment may not be working, plus what you can do to get relief.
1. You’re Not Being Monitored Properly
After you’ve been prescribed medication to treat your polyps, it’s important that you receive proper follow-up care, says Dr. Yao. In his practice, his patients come in for a computed tomography scan three or four weeks after the initial appointment to see how large the nasal polyps are and how well the medication is working.
If your doctor determines that your current medication is not effective — or is no longer as effective as it once was — they may talk to you about adjusting your treatment or other things you can do, including considering surgery, says Yao.
2. Your Medication May Not Be Reaching Your Polyps
Another reason your nasal polyps symptoms may persist despite treatment: not taking the medication as directed — or using it ineffectively.
For instance, if a nasal polyp is large, it’s possible that you’re only getting at the front surface of the polyp with the spray, says Yao. “You’re attacking it little by little, but the medicine may not be reaching the root of the polyp,” he says. “Another possibility is that there is a lack of space for the medication to get into the nose [due to the polyp].”
To work around this problem, try to aim toward your ears rather than straight up into your sinuses when you aim the nasal spray, he says. Aiming up — rather than to the side — will shoot the medication up into the middle of your nose toward your septum, missing the polyps, which grow from the sides of the nasal cavity. Alternatively, your doctor may recommend a steroid nasal wash to help you access hard-to-reach polyps.
3. You’re Not Treating Your Allergies
Environmental allergies can trigger swelling in your nasal passages, promoting the development of polyps. An undiagnosed allergy could be the reason your nasal polyp treatment may not be working. “It’s important to assess for allergies, as this is the cause of inflammation and polyps in some cases,” says Jesse Ryan, MD, associate professor of otolaryngology and communication sciences at Upstate University Hospital in Syracuse, New York.
If allergies are indeed the culprit, treating them with a medication like cetirizine (Zyrtec) can help control nasal polyps too, adds Yao. In addition, removing allergens from your home (such as by vacuuming regularly to reduce particulates and washing bedding regularly to cut down dust mites) can help reduce the likelihood of polyps returning, says Dr. Ryan.
4. You’ve Stopped Your Treatment
It’s important to stick to nasal polyp treatment plans, but many do not use their steroid nasal spray consistently, says Yao. “Nasal polyps are a chronic thing,” he explains. “You have to use your medication daily — there are no cheats or secrets around it.”
If you’re experiencing side effects or other problems that are interfering with your ability to stick to your nasal polyp treatment, talk to your healthcare provider, who may be able to work with you to find other options. “Effective treatment can be a trial-and-error process,” says Ryan.
5. Your Polyps May Need to Be Removed
If your nasal polyp symptoms persist despite you following your treatment plan, your doctor may recommend surgery to remove the polyps. Surgery may “improve nasal congestion, sense of smell, reduce risk of infection, and help allow medications to get deeper in the sinuses,” says Ryan.
And thanks to surgical advancements, you can now have polyps removed through an endoscopic procedure under local anesthesia. “Many procedures that used to be done in the operating room can now be done right in the office with a short recovery time,” notes Ryan.
That means it’s still important to monitor your sinus health and practice healthy habits to reduce inflammation in your body, which, in turn, lowers your risk of polyps.
6. You May Need a Step-Up in Treatment
When to See Your Doctor ASAP
It’s important to tell your doctor if your symptoms get worse or are recurrent. And be sure to call your doctor or go to the emergency room right away if you experience any of the following:
- Vision changes
- An altered mental state
- Eye swelling
“Polyps can cause a blockage of the sinus, making you more prone to infections,” says Yao. “[While rare], a bad infection can get into the eyes and progress to the brain.”
The Takeaway
- Nasal polyps treatment typically involves medication, but surgery may also be recommended.
- If symptoms persist despite treatment, there are several potential reasons why, including using nasal steroid sprays incorrectly or inconsistently. Or you may have undiagnosed and untreated allergies.
- Treatment can be a trial-and-error process and may involve combinations of treatments and/or medications. It’s important to maintain communication with your doctor and attend follow-up appointments, so that you can successfully manage your nasal polyps.
