At 15, after one too many complaints about a blocked nose – and one too many nosebleeds in the middle of class – my mum booked me in to see an ENT specialist. I don’t remember every detail of the appointment, but I do remember the diagnosis. I had a naturally-occurring deviated septum.
If you’re not familiar with the term, it’s when the thin wall of cartilage and bone dividing your nostrils is crooked or off-centre. For me, it was noticeably shifted to the left – something you wouldn’t be able to tell from looking at my nose, but very obvious on the scans.
Some people with a deviated septum never experience any symptoms. I wasn’t so lucky.
Breathing through my nose has always been a struggle. My left nostril feels almost permanently blocked, so I rely heavily on mouth breathing. I also get frequent nosebleeds, likely because the airflow imbalance dries out and irritates the nasal lining.
Then there are the migraines – caused by pressure building up in my sinuses – and, worst of all, the sinus infections. These come with facial pain, pressure and thick mucus, and they have a habit of knocking me out for weeks at a time.
Charlotte was diagnosed with a deviated septum at the age of 15
At the same appointment, I was also diagnosed with chronic sinusitis. In simple terms, my nose is blocked more often than not. And when I catch a cold, things escalate quickly – more inflammation, more pressure, worse headaches and overwhelming fatigue. It’s not unusual for me to feel ill for a couple of weeks, often needing antibiotics to clear it.
Safe to say, my nose and I have always had a difficult relationship.
At one point, surgery was on the table. A septoplasty – a procedure to straighten the septum – would have taken around 30 to 45 minutes and left no visible scars. At 15, I wasn’t thrilled about the idea, but I agreed to it. Then, unexpectedly, my ENT changed course.
Instead of surgery, I was prescribed a corticosteroid nasal spray. Then another. And another.
These sprays are designed for long-term use. They reduce inflammation gradually and are often prescribed for chronic sinus issues, allergies or structural problems like mine. They don’t provide instant relief, and importantly, they aren’t addictive.
For a while, they worked brilliantly. I could breathe through both nostrils again, my migraines improved and I had fewer sinus infections. But when I stopped using them, everything came back. That’s when I turned to over-the-counter decongestant sprays like Otrivine and Sudafed.
Steroid sprays can offer long-term relief, while decongestants are faster-acting – but addictive
Unlike steroid sprays, these offer relief almost instantly. ‘They work by shrinking swollen blood vessels in the nasal lining, which quickly relieves blockage,’ explains Dr Suzanne Wylie, GP and medical adviser for IQdoctor. ‘However, if they are used beyond the recommended short duration, they can actually worsen the original congestion.’
The relief is immediate – and that’s where the problem starts. Used for more than a few days, they can actually make congestion worse. Your nose begins to rely on them, leaving you feeling even more blocked up without them.
‘With repeated use, the blood vessels in the nose begin to adapt and rely on the medication to remain constricted,’ says Dr Wylie. ‘When the effect wears off, the nasal passages can feel even more blocked than before, prompting further use just to breathe comfortably.’
That’s exactly what happened to me. I became dependent on that instant relief. I carried a spray everywhere and used it far more often than was recommended by the manufacturer. It felt harmless at the time – just a quick fix to help me breathe.
‘This cycle can feel difficult to break, which is why many people describe it as an ‘addiction’,’ Dr Wylie adds, ‘even though it lacks the psychological craving seen with true substance dependence.’
Looking back, I can see I was caught in that cycle. Eventually, I quit cold turkey. I don’t remember it clearly, but my nose felt more blocked for a while after I stopped – a temporary rebound rather than anything more serious.
Now the only spray Charlotte uses is a simple salt-water solution, such as Stérimar
‘If someone feels they have become reliant, it’s important not to panic,’ says Dr Wylie. ‘Stopping suddenly may make symptoms feel worse at first, so it can help to seek advice from a pharmacist or GP about gradually reducing use.’
Now, the only spray I use is a simple salt-water solution, like Stérimar, when my sinusitis is particularly bad. My left nostril is still blocked, and I’ve almost forgotten what it feels like to breathe completely freely – but at least I’m no longer relying on medicated sprays.
‘Supportive options such as saline rinses or steroid nasal sprays can help the nasal lining recover,’ Dr Wylie explains. ‘Unlike decongestant sprays, these do not cause rebound effects and are commonly recommended once the decongestant is discontinued.’
Breaking the cycle, she says, takes patience. ‘For many people, it can take a couple of weeks. Symptoms may feel frustrating, but avoiding repeated return to the decongestant is key,’ she says. ‘If congestion continues, or there are additional symptoms like facial pain, loss of smell or frequent infections, it’s sensible to see a GP.’
For me, that cycle is firmly in the past – but it’s a habit that crept up quietly, disguised as a quick fix. And one I wish I’d understood sooner.
