Patient Information Handout

Nasal Rinses for
Chronic Sinus Problems

How to safely use nasal irrigation — including how to make saline at home, how to rinse correctly, and what the research shows.

💧
Daily use
recommended

Nasal irrigation means gently flushing salt water through your nose and sinus cavities. For chronic sinusitis, it is one of the best-supported non-surgical treatments — but it works best with a large-volume rinse (squeeze bottle or neti pot), not just a nasal spray.

🌬️Washes out mucus, allergens, and germs
🔻Reduces swelling and congestion inside the nose
Improves breathing, postnasal drip, and sinus drainage

1 How to Make Saline at Home

If your clinician agrees, you can make a simple isotonic (0.9%) saline solution at home. Isotonic means it has about the same salt concentration as your body's own fluids — gentle and comfortable for rinsing.

Recipe — 1 Liter (about 4 cups)

You Will Need

  • 1 liter distilled, sterile, or boiled-then-cooled water
  • 9 g non-iodized table salt (about 1½ tsp)
  • Optional: ¼ tsp baking soda (less irritating)
  • Clean container with lid

Important — Water Safety

Never use plain tap water directly in your nose. Always use distilled, sterile, or boiled-then-cooled water. Tap water may contain organisms that can cause serious sinus infections.

Small batch (½ liter): 250 ml (1 cup) boiled, cooled water + ½ tsp non-iodized salt + optional ⅛ tsp baking soda. Use the same day.

2 Step-by-Step Preparation

1Clean your equipment — wash hands, container, and spoons with hot soapy water and rinse well
2Boil the water (if not using pre-sterile or distilled) — rolling boil for at least 1 minute to kill germs
3Cool the water to room temperature or lukewarm — do not use very hot or ice-cold water in your nose
4Add salt (and optional baking soda) — measure 1½ tsp non-iodized salt, stir until fully dissolved with no grains visible at the bottom
5Store in the clean container with the lid on — label with the date made

3 Storage

🌡️
24 hours
At room temperature
❄️
3 days
In the refrigerator
🚫
Discard
If cloudy, smells odd, or past expiry

4 How to Do the Rinse

🛁 Equipment

Use a neti pot, squeeze bottle, or powered irrigator designed for nasal rinsing.

📐 Position

Lean over a sink. Tilt your head slightly to one side so the rinse flows through rather than straight back.

💧 Rinse

Gently pour or squeeze into the upper nostril and let it flow out the lower nostril. Most adults use 120–240 ml (4–8 oz) per side.

🔄 After

Switch sides. Then gently blow your nose to clear any remaining fluid. Clean and air-dry equipment after each use.

5 Safety Tips & Common Mistakes

🚫Never use plain tap water — always distill, sterilize, or boil then cool it first
🧂Use only non-iodized salt with no additives — avoid iodized salt or sea salt with anti-caking agents
🌿Do not add essential oils or fragrances — they can damage the delicate sinus lining
🫙Keep solution covered, clean equipment after every use, and air-dry before storing
🗑️Throw away solution that looks cloudy, smells off, or has passed its storage window
💊Never add prescription medications to your rinse unless your ENT specifically instructs you to

6 Types of Saline Solution

Not all saline rinses are the same. Your provider will recommend the right type for your situation.

✓ Isotonic (0.9%)

  • Same salt level as body fluids
  • Used in most research studies
  • Best tolerated long-term
  • First-line choice
Best for: daily maintenance, sensitive noses

↑ Hypertonic (2–3%)

  • Stronger salt concentration
  • May help more with thick mucus
  • More likely to sting or cause dryness
Best for: flares, thick congestion (if tolerated)

~ Buffered (+ baking soda)

  • Saline plus sodium bicarbonate
  • Less "stingy" and more comfortable
  • Helps thin mucus
Best for: patients who find plain saline irritating

7 Advanced Additives (Specialist Use)

Some patients may be recommended additives by their ENT specialist. Do not use these unless specifically prescribed.

💊 Budesonide (Steroid Rinse)

  • Steroid added to rinse bottle
  • Delivers medication directly to sinus lining
  • Typically 0.5–1 mg in 240 ml saline, once or twice daily
  • Especially helpful for nasal polyps or after sinus surgery

🌱 Xylitol Rinses

  • A sugar alcohol (not table sugar)
  • May help prevent bacteria from sticking in sinuses
  • Small studies show symptom improvement
  • Generally well tolerated; mild stinging possible
  • Usually an optional add-on, not a first treatment
Specialist-supervised only — do not start these on your own:
  • Antibiotic rinses (mupirocin, tobramycin) — for proven difficult infections such as MRSA or Pseudomonas
  • Antifungal rinses — for confirmed fungal sinus infections
  • Surfactant rinses (dilute baby shampoo) — for stubborn biofilm in refractory cases

! When to Contact Your Doctor

Call your clinician or ENT if you experience any of the following:

🩸Repeated or heavy nosebleeds with rinsing
😣Severe or worsening pain, burning, or pressure
🌡️Fever, swelling around the eyes, or vision changes
📅Symptoms not improving after several weeks of regular rinses