Recent studies prove the ancient practice of nasal irrigation is effective at fighting the common cold
Nasal irrigation, a practice rooted in ancient medicine, has gained recognition in recent studies for its effectiveness in alleviating symptoms of the common cold. Characterized by symptoms such as scratchy throat, sneezing, and nasal congestion, the common cold affects individuals multiple times a year, typically lasting about nine days. Traditional treatments, including over-the-counter medications and antibiotics, often yield limited benefits, leading researchers to explore alternative remedies. Recent findings suggest that nasal saline irrigation can significantly reduce the duration of illness and even lower the risk of viral transmission. This method not only offers a cost-effective solution—often costing just pennies—but also helps manage other respiratory issues such as allergies and chronic sinus infections.
Nasal saline irrigation involves flushing the nasal cavity with a saltwater solution, which can be administered through devices like neti pots or spray bottles. This technique dates back over 5,000 years to the Ayurvedic tradition and has been used in various forms throughout history, including ancient Greek and Roman practices. Scientific studies have demonstrated that initiating nasal saline irrigation at the onset of cold symptoms can shorten the duration of illness by up to four days. For instance, a study published in The Lancet involving over 11,000 participants found that those who performed nasal irrigation six times a day experienced a reduction in symptomatic illness by approximately two days. Additionally, the practice has shown promise in decreasing the viral load of COVID-19, underscoring its potential in managing infectious diseases.
The benefits of nasal saline irrigation extend beyond acute infections. Regular use has been associated with a significant decrease in the need for allergy medications, making it a valuable tool for those suffering from allergic rhinitis. Importantly, this practice can help mitigate the overprescription of antibiotics, which is a growing concern due to antibiotic resistance. With studies indicating that a substantial percentage of antibiotic prescriptions for respiratory infections are unnecessary, nasal saline irrigation presents a safe and effective alternative to combat these issues. For those interested in trying this method, it’s simple: mix half a teaspoon of non-iodized salt with one cup of distilled or boiled water and use it to rinse the nasal passages, ideally starting at the first sign of illness. This easy-to-implement practice not only promotes faster recovery but also contributes to overall public health by reducing the spread of infections.
Nasal irrigation can help shorten the duration of the common cold.
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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.