Recent studies prove the ancient practice of nasal irrigation is effective at fighting the common cold
Nasal irrigation, a practice rooted in ancient Ayurvedic medicine, has recently gained attention for its potential to alleviate the common cold’s symptoms and shorten its duration. The common cold, caused by viral upper respiratory tract infections, typically affects individuals three times a year and lasts around nine days. Unfortunately, antibiotics are ineffective against these viral infections, and over-the-counter medications often provide only limited relief. However, emerging research suggests that nasal saline irrigation can significantly reduce the duration of illness, decrease viral transmission, and lower the need for antibiotics, all while being an affordable and accessible option for patients.
Nasal saline irrigation involves rinsing the nasal passages with a saltwater solution, which can be administered using devices like a neti pot or a pump-action spray bottle. This method not only flushes out mucus, allergens, and viruses but also creates an environment that is less hospitable to viral replication. A recent study published in *The Lancet* found that individuals who began nasal irrigation at the onset of cold symptoms experienced a reduction in symptomatic illness duration by as much as two days, with some reports suggesting a decrease of up to four days. Moreover, nasal saline irrigation has been shown to help mitigate the spread of illnesses, including COVID-19, by reducing viral load in patients. Regular use of nasal saline can also help individuals with allergies, chronic congestion, and recurrent sinus infections, further enhancing its appeal as a holistic treatment option.
The benefits of nasal saline irrigation extend beyond symptom relief. By promoting a natural defense mechanism in the nasal passages and decreasing the reliance on antibiotics, this practice plays a crucial role in combating antibiotic resistance—a growing concern in modern medicine. With millions of unnecessary antibiotic prescriptions issued each year for viral infections, nasal saline irrigation presents a safe and effective alternative. For those looking to incorporate this practice into their routine, the process is straightforward: mix half a teaspoon of non-iodized salt with a cup of distilled or boiled water, and irrigate the nasal passages at the first sign of illness. This simple, cost-effective solution not only enhances patient well-being but also contributes to public health by reducing the spread of infections and minimizing antibiotic misuse.
Nasal irrigation can help shorten the duration of the common cold.
SimpleImages/Moment via Getty Images
It starts with a slight scratchiness at the back of your throat.
Then, a sneeze.
Then coughing, sniffling and full-on congestion, with or without fever, for a few insufferable days.
Viral upper respiratory tract infections – also known as the
common cold
– afflict everyone,
typically three times per year
, lasting, on average, nine days.
Colds don’t respond to antibiotics, and most
over-the-counter medications deliver modest results
at best.
In recent years, research has emerged demonstrating the effectiveness of the ancient practice of
nasal saline irrigation
in
fighting the common cold
in both adults and children.
Not only does nasal saline irrigation
decrease the duration of illness
, it also reduces viral transmission to other people,
minimizes the need for antibiotics
and could even
lower a patient’s risk of hospitalization
. Better yet, it costs pennies and doesn’t require a prescription.
I’m both an
adjunct assistant professor of medicine
and a practicing physician. As a family doctor, I see the common cold every day. My patients are usually skeptical when I first recommend nasal saline irrigation. However, they frequently return to tell me that this practice has changed their life. Not only does it help with upper respiratory viruses, but it also
helps manage allergies
, chronic congestion, postnasal drip and
recurrent sinus infections
.
What is nasal saline irrigation?
Nasal saline irrigation is a process by which the nasal cavity is bathed in a saltwater solution. In some studies, this is accomplished using a
pump-action spray bottle
.
In others,
participants used
a traditional
neti pot
, which is a vessel resembling a teapot.
This practice of nasal irrigation originated in
the Ayurvedic tradition
, which is a system of alternative medicine from India dating back more than 5,000 years.
The neti pot can be
traced back to the 15th century
. It garnered mainstream interest in the U.S. in 2012 after Dr. Oz
demonstrated it on the “Oprah Winfrey Show
.” But it’s not the only device that has historically been employed for such purposes. Ancient Greek and Roman physicians
had their own nasal lavage devices
. Such practices were even
discussed in medical journals
such as The Lancet over a century ago, in 1902.
A neti pot is one tool for irrigating your nasal passages.
swissmediavision/E+ via Getty Images
How does nasal saline irrigation work?
Nasal saline has a few key benefits. First, it physically flushes debris out of the nasal passage. This not only includes mucus and crust, but also the virus itself, along with allergens and other environmental contaminants.
Second, salt water is slightly lower on the
pH scale
compared with fresh water. Its acidity creates an environment that is
inhospitable for viruses
and makes it harder for them to replicate.
Third, nasal saline helps restore the actions of part of
our natural defense system
, which is composed of microscopic, hairlike projections called
cilia
that line the surface of the nasal passage. These cilia beat in a coordinated fashion to act like an escalator, propelling viruses and other foreign particles out of the body. Nasal saline irrigation helps keep this system running effectively.
What the research shows
A study of more than 11,000 people published in The Lancet in 2024 demonstrated that nasal saline irrigation, initiated at the first sign of symptoms and performed up to six times per day,
reduced the duration of symptomatic illness
by approximately two days. Meanwhile, smaller studies have reported that the reduced duration of illness could be
as high as four days
.
Research has also demonstrated that nasal saline irrigation can help prevent the spread of illness. A study in hospitalized patients showed that after detection of COVID-19 via nasal swab, nasal saline irrigation performed every four hours over a 16-hour period
decreased COVID-19 viral load by 8.9%
. Meanwhile, the viral load in the control group continued to increase during that time.
The benefits of nasal saline also extend beyond acute infectious illnesses. When performed regularly by patients with
allergic rhinitis
, also known as hay fever, a meta-analysis of 10 randomized controlled trials showed that nasal saline irrigation can enable a
62% reduction in the use of allergy medications
. It’s also effective for chronic congestion, postnasal drip and
recurrent sinus infections
.
Why it matters
Besides helping patients feel better faster, one of the most valuable benefits of nasal saline irrigation is that its use can help
decrease unnecessary antibiotic prescriptions
, which are a
major contributor to antibiotic resistance
.
It is well established that antibiotics
do not shorten the duration or reduce the severity
of respiratory tract infections. Despite this, studies have shown that patients are happier when they leave their doctor’s office
with an antibiotic prescription in hand
.
This may be why
10 million inappropriate antibiotic prescriptions
are given each year for viral respiratory tract infections. In one study of more than 49,000 patient encounters for respiratory infections,
antibiotics were unnecessarily prescribed
to 42.4% of patients.
One reason patients with upper respiratory viral infections tend to initially feel better with antibiotics is because of their
off-target, anti-inflammatory properties
. However, this benefit
can be better achieved with anti-inflammatory medications
such as ibuprofen or naproxen, that can be taken in conjunction with nasal saline irrigation.
Overall, nasal saline irrigation is a cheap, effective, evidence-based alternative that will not only shorten the duration of illness but also prevent its spread, minimize the need for unnecessary antibiotics and keep people out of the hospital.
How to do it
Irrigating your nasal passages as soon as you feel the first signs of illness is proven to reduce the duration and severity of the common cold.
For those who want to try it, you don’t need anything fancy. Even a neti pot is not necessary. Many pharmacies sell salt water in a container with a nozzle and even spray bottles that can be refilled with a homemade saltwater solution.
You’ll mix approximately half a teaspoon of non-iodized salt with 1 cup of water. It’s important for your safety that the water be either distilled water or boiled for at least five minutes and then cooled to destroy any harmful bacteria. You can also add a pinch of baking soda to reduce any potential sting.
Note that saltier solutions are
not more effective
. However, some studies have suggested natural seawater, due to its additional minerals such as magnesium, potassium and calcium, could
offer even greater benefits
. Saltwater solutions can also be purchased commercially, which might be worth a try for those with an insufficient response to saline alone.
You can use nasal saline irrigation after any potential exposure to an infectious illness. For best results, you’ll want to start irrigating the nasal passage at the first sign of an infection. You can repeat rinses throughout the day as often as needed for the duration of the illness. At minimum, you’ll want to irrigate the nasal passages every morning and evening. You can also consider gargling salt water as an adjunctive therapy.
Mary J. Scourboutakos does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
