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When allergy season arrives, you don’t want to be trapped inside avoiding pollen. That’s where nasal sprays with allergy-fighting ingredients come in. However, with so many different types of nasal sprays on the market, it can be hard to choose the best one to treat your symptoms. Learn how popular over-the-counter (OTC) nasal sprays work, including decongestant, steroid, saline and antihistamine sprays, with this helpful guide.

10. RICHMOND, VA

Improving from its number eight spot last year, Richmond scored "better than average" on its allergists to patients ratio but remains "worse than average" in terms of its pollen/mold score.

9. PROVIDENCE, RI

Despite its coastal location Providence was rated “worse than average” on all measures (pollen/mold score, amount of patients using allergy medication, and allergist to patient ratio). 

8. DAYTON, OH

Moving up from its number eleven spot last year, Dayton was rated "worse than average" on both its pollen/mold score and the amount of patients using allergy medication.

7. WICHITA, KS

From number twelve last year to number seven this year, Wichita is “worse than average” in terms of its pollen/mold score but has an “average” number of allergists to patients.

6. MCALLEN, TX

Part of the Rio Grande Valley and therefore subject to seasonal "Cedar Fever."2 McAllen scored "worse than average" on all measures (pollen/mold score, amount of patients using allergy medication, and allergist to patient ratio). 

5. KNOXVILLE, TN

For a city rated “worse than average” on its pollen/mold score and amount of patients using allergy medication, Knoxville is “better than average” in terms of its allergists to patients ratio.

4. MEMPHIS, TN

Not far from its number two spot last year, Memphis continues to be “worse than average” in terms of its pollen/mold score and the amount of people using allergy medication.

3. OKLAHOMA CITY, OH

For being "worse than average" on its pollen/mold score and amount of patients using allergy medication, Oklahoma City is "better than average" in terms of its allergists to patients ratio.

2. LOUISVILLE, KY

From the number one spot last year to number 2 this year, Louisville has—unsurprisingly—a “worse than average” pollen/mold score. Luckily, the city is doing “better than average” in terms of its allergists to patients ratio.

1. JACKSON, MS

With its "worse than average" pollen/mold score and amount of patients using allergy medicine, the AAFA found Jackson to be the worst city for spring allergy sufferers this year.

What Are Steroid Nasal Sprays?

Steroid nasal sprays, also known as corticosteroid nasal sprays, help reduce inflammation when sprayed in the nose. They’re used to treat hay fever, sinusitis, non-allergic rhinitis and nasal polyps. Betamethasone or fluticasone are common active ingredients in steroid nasal sprays.

Steroids are a man-made version of the hormones secreted by your adrenal glands, the two small glands above your kidneys. When used correctly, steroids help reduce inflammation and swelling from a sneezy, runny or stuffy nose.

Steroid nasal sprays can be used as needed or over a longer period. If you have symptoms when you start using the spray, it may take a few days before you feel the full effects of the medication. Using the product regularly, as per the label’s instructions, is important—pausing treatment because your allergies have subsided may cause them to return. Steroid nasal sprays typically have few side effects.1

What Are Antihistamine Nasal Sprays?

When your body is fighting allergies, it releases a chemical called histamine that make your blood vessels expand and swell. If you suffer from allergies, your body can recognize something harmless, such as dust, pollen or pet hair, and mistakenly start producing histamine. This can cause a stuffy or blocked nose, runny nose, watery eyes and other allergy symptoms.2,3

Antihistamine nasal sprays block the effects of histamine and contain anti-inflammatory properties to prevent and treat your allergies. Antihistamine nasal sprays such as azelastine are available over the counter like other steroid and saline sprays.2,3 Unlike steroid nasal sprays, azelastine’s side effects include drowsiness, a common side effect of some antihistamines, and a bitter taste in your mouth.4

What Are Saline Nasal Sprays?

Saline nasal sprays moisturize your nasal passages and loosen up any hardened mucus in the nose. These simple, over-the-counter sprays provide temporary relief from an irritated nasal lining. They’re useful in the winter when you’re susceptible to colds and a dry nose. They can also be used to flush out pollen or other irritants that accumulate throughout the day.2,5

How Do Nasal Decongestant Sprays Work?

Nasal decongestant sprays help relieve a congested, stuffy nose. When you come down with a cold or flu, the blood vessels and tissues in your sinuses become inflamed and swollen, making it harder to breathe. Decongestants provide short-term relief from stuffiness and open your airways by reducing the swollen blood vessels and tissues in your nose. Unlike steroid nasal sprays, nasal decongestant sprays shouldn’t be used for more than three days at a time, as this can cause irritation. Possible side effects of nasal decongestants include drowsiness and a dry mouth.6

How Does Flonase Work?

Flonase is a corticosteroid nasal spray that helps fight inflammation caused by hay fever or allergies to pollen, mold, dust or pets.7

When you encounter allergens, your body reacts by producing substances that cause allergy symptoms. Many allergy pills only block one out of six of these substances, but Flonase products block six (including histamine) to give you 24-hour allergy relief.*

*Mechanism vs. most OTC allergy pills. Flonase acts on multiple inflammatory substances (histamine, prostaglandins, cytokines, tryptases, chemokines and leukotrienes). The exact number and precise mechanism are unknown.

Source Citations:

  1. Steroid nasal sprays. NHS. https://www.nhs.uk/conditions/steroid-nasal-sprays/. Accessed 7/12/22.
  2. Nasal Sprays for Allergies. Cleveland Clinic. https://health.clevelandclinic.org/nasal-spray-for-allergies/. Accessed 7/12/22.
  3. Antihistamines. NHS. https://www.nhs.uk/conditions/antihistamines/. Accessed 7/12/22.
  4. Azelastine (Nasal Route) Side Effects. Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/azelastine-nasal-route/side-effects/drg-20068252. Accessed 7/12/22.
  5. Saline Nasal Sprays and Irrigation PDF. OHSU. https://www.ohsu.edu/sites/default/files/2019-03/Saline-Nasal-Sprays.pdf. Accessed 7/12/22.
  6. Decongestants. NHS. https://www.nhs.uk/conditions/decongestants/. Accessed 7/12/22.
  7. Fluticasone Nasal Spray. MedlinePlus Drug Information. https://medlineplus.gov/druginfo/meds/a695002.html. Accessed 7/12/22.