Actress Kaley Cuoco recently discussed her prior addiction to decongestant nose spray on the Ellen show.
Cuoco revealed that her recent nose surgery was not a rhinoplasty (as many people have rumored) but actually was septoplasty needed to correct her nasal function after years of over-the-counter decongestant nose spray use. These sprays (such as Afrin or Dristan to name a few) work to bypass the body's normal regulation of the internal nasal blood flow leading to a constriction of these blodd vessels and less nasal congestion.
This is a suitable treatment for limited use, for sure. I tell my patients that it is ok to use these types of nose sprays twice a day for up to three days to help with temporary nasal congestion symptoms (such as what you would have with a upper respiratory cold). The problem with prolonged use is that the body loses it's ability to regular the nasal blood flow properly leading to severe rebound congestion. This may result in people using more of the spray just to maintain some nasal opening for breathing. This nasal spray addiction isn't a true addiction or craving, like one would have with cocaine, but rather is just a snowballing effect of trying to maintin more normal nasal airway patency.
Another issue that can occur with prolonged decongestant spray use is that the small blood vessels to the nose can be damaged leading to skin lining ulceration and even a septal perforation. A septal perforation occurs when there is a hole through a portion of the entire septum. This can be repaired if not too big. Additionally, some patients may also get turbinate hypertrophy or overgrowth. You can learn more about enlarged turbinate treatment here.
The medical name for this nose spray addiction is Rhinitis Medicamentosa. The main treatment for patients with this condition is weaning off of the decongestant spray and focusing on safer long term treatment options. Often this involves switching to a nasal steroid spray which is safe for long term use. Some people are able to wean one nostril at a time whereas others just go cold turkey on both sides at once. I also find that many people with chronic nasal congestion have pre-existing nasal septal deviations that need to be addressed to fully correct the blocked breathing. A visit with a nasal surgeon is needed to determine the health of the inside of the nose.
You can learn more about Kaley Cuoco's experience of years of Afrin abuse here.