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Nasal irrigation is one of those wellness habits that makes perfect sense to some while completely baffling others. Although it has roots in ancient Ayurvedic rituals, the use of neti pots has only increased in popularity as a secular practice, with the teapot-like implements finding their way into bathrooms around the world. And while the idea of letting water flow through one's nose sounds more uncomfortable to some than the issues it's supposed to alleviate, others swear by it. If you've wondered what a neti pot actually does — and whether it's safe — we totally understand your curiosity, particularly in the winter when you'll try literally anything to unstuff a plugged nose.
According to the U.S. Food & Drug Administration (FDA), nasal irrigation can help loosen and remove dust, pollen, and thick mucus while relieving the symptoms of sinus infections, allergies, colds, and the flu, especially when saline or saltwater is used. Holistic nutritionist Joy McCarthy wholeheartedly agrees. "There are so many benefits to nasal irrigation with saltwater but the biggest one would be providing relief from sinus congestion," she tells Allure. "It really clears your nasal passageways, especially when your sinuses are all blocked up and you can't blow your nose."
However, despite how long neti pots have been around and how popular they are, not everyone fully understands how they work, which can unfortunately lead to some dangerous outcomes. For instance, in one recent case, a woman died after using water that hadn't been properly treated and ended up containing infectious amoebas. "They tread up into the brain and kill the person," says Mark Widick, a board-certified otolaryngologist based in Boca Raton, Florida.
We spoke to experts to get clear answers on nasal irrigation so you can decide whether it's right for you and learn how to practice it safely.
How does a neti pot work?
According to the FDA, the correct way to perform nasal irrigation is by leaning over a sink, tilting your head sideways, and breathing through your open mouth as you insert the spout of the neti pot into your upper nostril. The liquid will drain through your lower nostril clearing it out in the process (it won't come out of your mouth if your forehead and chin are level). You then switch sides and repeat to flush out the other nostril.
"The dynamics of how water flows through your nose is very different than that of air," explains Widick. Nasal irrigation allows water to flow into one nostril, through the nasal cavity, and out the other nostril, ideally flushing out the nose in the process — something Widick says some people can't do just by forcefully exhaling.
"I think for some people, it's comfortable. It can get maybe some material out of their nose when just blowing the nose is ineffective," Widick tells Allure. "If you have a crust in your nose and it's driving you a little crazy, it may sweep it away for you. Some people have very thick mucus; it will help hydrate it and make it easier to deal with."
What kind of water is safe to use in neti pots?
A report in the International Journal of Infectious Diseases made headlines recently, sharing the case of a 69-year-old woman who died of an amoebic infection she contracted in her brain by using nonsterile tap water in her neti pot. Understandably, this caused alarm among many neti-pot users.
The U.S. Environmental Protection Agency requires that water systems test and treat for a variety of pathogens in order to ensure that water is safe for drinking. But drinking and passing through the nasal cavity are very different things, the agency states. The Centers for Disease Control and Prevention website advises that to "make your water safe for sinus rinsing and ritual nasal rinsing, it is safest to use boiled, sterile, or filtered water."
The FDA echoes this recommendation, advising on its site that neti-pot users should buy distilled or sterile water, or use water that has "passed through a filter designed to trap potentially infectious organisms." To avoid amoebic infections, tap water should only be used once boiled for three to five minutes and then cooled to lukewarm. The FDA also notes that previously boiled water can be stored in a clean, closed container for use within 24 hours.
Are there any other risks?
Although the amoebic infections are rare and by far the most devastating consequence of using a neti pot improperly, even nasal irrigation with sterile water has its risks. "In general, I have stopped recommending it to my patients because I think too much fluid goes through the nose, which can get trapped in some of the sinuses," Widick tells Allure. He says nasal irrigation can allow too much moisture to pool in the cheek sinuses, leading to more common kinds of infection.
In fact, he has seen patients come in with ear complaints, only to find that it was likely caused by nasal irrigation. "I have seen many cases where the fluid, when it flushes through the back of the nose, refluxes up the Eustachian tube and into the middle ear," Widick says. "People will present after using the neti pot with fluid in their ear."
McCarthy says it's also of utmost importance to make sure the neti pot itself is very clean. "Otherwise, it's the perfect environment for bacteria to thrive and multiply," she tells Allure. "Be sure to wash it thoroughly with soap and water after every use and let it dry completely before using it again."
Do the benefits outweigh the potential dangers?
Although Widick no longer recommends neti pots as frequently as he once did, there are still cases where he and his colleagues advise certain patients to use one. For example: people who have chronic infections, those who have recently had surgery on their nose, and even some allergy situations can call for a neti pot in some physicians' opinions. Those recommendations align with a 2002 University of Wisconsin study that found nasal irrigation improves sinus-related quality of life and decreases symptoms in people with frequent sinusitis.
That said, Widick notes, "We certainly survived, or at least most of us survived, for a very long time without neti pots." And while dying of an amoebic infection as a result of using a neti pot is very rare, the incident that occurred in Seattle is not the first of its kind. An investigation published in the medical journal Clinical Infectious Diseases found that, in 2011, two people in Louisiana died of primary amoebic meningoencephalitis, a fatal brain infection, after using nonsterile tap water in their neti pots.
The verdict: Flush if you feel you must, but do it carefully.
In addition to adhering to the water standards stated by various agencies, if you still want to try or continue to use nasal irrigation as a means to clear our your nose, make sure you thoroughly read the instructions that came with your neti pot before using it. McCarthy, who prefers to add salt to the sterile water she uses, says, "If it stings your nose, then reduce the amount of salt you're using." She recommends pre-portioned packets of saline, which make it easy to use just the right amount.
If you'd prefer to try a different way to flush our your nose, Widick says he typically advises patients to use an over-the-counter nasal saltwater spray. "It does much of the same thing without any of the risk because it comes in a sterile bottle," he says. Furthermore, "Since it's not a stream of water — it's a mist — it's not going to flood the sinus cavities and create an environment like a swamp that might cause an infection."
More ways to deal with allergies:
- 7 Life-Changing Products to Relieve Allergy Symptoms
- How to Conceal Your Seasonal Allergy Symptoms With Makeup
- Here's How Your Allergy Meds Could Be Messing With Your Skin
Now check out Miranda Kerr's luxurious bathroom:
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