As a Pediatric Ear, Nose and Throat Specialist, I have spent 15 years understanding little noses more than what was ever taught in school, residency and fellowship training. Let me be super clear: this blog is about the “stuffy” nose, not the “runny” nose. Yes, I learned terms like “allergic rhinitis,” which means runny nose due to an allergic reaction to something (dust mites, grass, pollen, weed, trees, etc.). Then there is the “non-allergic rhinitis,” which means the nose is “runny” but allergy tests came back normal. Frustrating right? Every parent and patient just want to know what is wrong with the nose and why it’s not “normal.” I would like to make a distinction—there is the wet stuffy nose, which is when one has a cold and mucous membranes are swollen so you can’t breathe, and then the DRY STUFFY nose, which is what this blog is about. Parents always tell me, “nothing comes out when he/she blows.”
Every day in clinic, I meet countless families who bring their beautiful medically healthy children to see me with the chief complaint and frustration over a “stuffy” nose that occurs daily (not because they have a cold), for weeks and months, and regardless of what season it is. It doesn’t matter where you live; I have practiced in 5 states (MN, KS, MO, IL, FL), and stuffy noses are everywhere.
Well intentioned pediatricians and doctors will often prescribe nasal steroid spray (Flonase), or antihistamines like Zyrtec, Claritin or Allegra, which actually will “dry” out the nose even more. Singulair is another medication—indicated for asthma. If your child is also coughing with a runny nose, then “post-nasal drip” will be likely be blamed, and the same medications will be prescribed.
Here is what no one is talking about: the dry kind of stuffy nose is “stuffy” because it’s DRY! It’s dry at school, in the house, outside, in the hospital, most of the time, no matter where you are! When I was practicing in the Midwest, I routinely advised families to use a humidifier in their kids’ bedrooms every night from October through March. Obviously, it’s because the heat is on daily and the air is dry. Little did I realize my own lack of awareness until now.
We moved to Florida 5.5 years ago and everyone knows it’s ridiculously humid here most of the year because we have daily thunder storm and rain showers from May until the end of October! What I never thought about until now is that as climate change has been happening over the past decade, temperature extremes occur with more hurricanes recently than I have ever experienced in my lifetime. The hotter it is outside (like in Florida) the colder the air conditioning is on inside. In our house, the AC has been on from March until now and, since it recently got cold, the heat is on. For areas that are cold and snowy, relative humidity drops with colder air.1 The mucous membrane has millions of “cilia” or little hairs that beat in unison and must have a “gel” and “sol” layer to move the mucous around. Mucociliary clearance is all “messed up” when the little hairs become desiccated (dried out) and stop beating. Do you know how many little nostrils I have looked up with dried boogers with edges like a dagger? Then causing nosebleeds? Have you ever checked into a hotel room so dry, with hot air blowing, that you had to get out to breathe? Not only is your nose stuffy, your entire mouth, throat and windpipe feel “sandpaper” dry as well.
Here is the secret I tell all parents: treat the nose like it’s an orchid, it LOVES humidity and it works well only in a very humid environment. Please invest in a diffuser or humidifier for your child’s bedroom (not the old kind with a filter you forgot to change from 2 years ago that’s growing a science experiment of mold and fungus). It only works if you (or someone) actually puts clean water (bottled, filtered, boiled) in it and turn it on. Place it next to your child’s nightstand to allow their nose to enjoy the cool mist all night and I promise you the nose won’t be “stuffy.”
Some other easy tips include taking a hot steamy shower or simply holding a hot wet towel close to the face and breathing in the warm air. Also, any steam, moisture or saline irrigation using a NeilMed “sinus rinse” irrigation bottle, Neti-Pot or an equivalent will help. The new rage is “Navage”2, a powered nasal irrigation device.
The world is extremely dry and I doubt schools will have the budget to put humidifiers in classrooms. Yes, do pack your kids with saline spray to use during school or anytime throughout the day. Parents used to ask me what setting their home humidifier should be on: it can’t be high enough! This does not apply to medically complex patients with cystic fibrosis, immune disorders or other issues. Your allergist may disagree with me, but I only claim to know the nose and I know it quite well. Our children are so dehydrated because they already drink so little water due to an addiction to juices and other sugary beverages. Please try the humidifier/diffuser trick, and if you do, you just may be able to get your child off of medications for that “dry stuffy nose.”1. https://sciencing.com/temperature-ampamp-humidity-related-7245642.html↩