Nasal polyps are small, teardrop-shaped, noncancerous growths in the nose and sinuses. They commonly occur in people with chronic rhinosinusitis (CRS), asthma, and aspirin sensitivity. About 4% or more of the population may have nasal polyps, but many don’t realize they have them because they have no symptoms. Other people may have noticeable symptoms such as a runny nose, stuffy nose, or sneezing but do not realize polyps are the cause, especially if they have allergies, hay fever, or frequent infections. Large polyps can cause more serious symptoms like pressure, pain, headaches, and nasal airway blockage. Some people may be unable to breathe through their noses because of the blockage. Symptoms can be severe enough to interfere with sleep and generally reduce the quality of a person’s daily life. Additionally, nasal polyps can make people more vulnerable to sinus infections, so chronic sinusitis may be a warning sign. People won’t know for sure until a doctor examines them. Because nasal polyps form in the nasal and sinus cavities, they usually can’t be seen without special instruments.
Nasal polyps are a common health condition mainly affecting people with allergies, asthma, aspirin sensitivity, cystic fibrosis, vasculitis, and nasal fungal infections. Find updated allergy statistics here.
Early signs of nasal polyps include typical cold or allergy symptoms such as nasal congestion, runny nose, sneezing, and postnasal drip.
Nasal polyps may not require immediate medical attention, but complications such as sinus infections or severe sinus pain may require immediate medical attention.
Nasal polyps are caused by chronic inflammation of nasal passages and sinuses. You may be at risk for developing nasal polyps symptoms if you have inflammatory conditions such as allergies, chronic sinusitis, sinus inflammation, aspirin-exacerbated respiratory disease, cystic fibrosis, or vasculitis. Other risk factors include fungal infections of the nasal passages and vitamin D deficiency.
Nasal polyps require a medical diagnosis.
Nasal polyps generally require treatment. Nasal polyp symptoms typically resolve within weeks of medical treatment and hours of surgical treatment.
Treatment of nasal polyps may include nasal saline irrigation, nasal corticosteroids, oral corticosteroids, and, for severe cases, monoclonal antibodies or surgical removal.
Untreated nasal polyps could result in complications like complete nasal obstruction, sinus obstruction, sinus infection, poor sleep, sleep apnea, chronic fatigue, and irreversible loss of smell.
Use coupons for nasal polyp treatments like Flonase Allergy Relief (fluticasone), Rhinocort Allergy (budesonide), and prednisone to save up to 80%.
The early signs of nasal polyps are often no signs at all. Many people will not know they have nasal polyps, especially if the polyps are small in size. In some people, the early signs may seem more like allergy or cold symptoms, such as:
Stuffy nose
Runny nose
Sneezing
Postnasal drip
The most common symptoms of nasal polyps are:
Nasal congestion
Nasal obstruction
Runny nose
Postnasal drip
Sneezing
Facial pressure
Facial pain
Loss (or reduced sense) of smell
Loss (or reduced sense) of taste
Itching in the area around the eyes
Chronic sinus infections
Nasal polyps often occur with chronic rhinosinusitis, a persistent inflammation of the nasal and sinus membranes. About 25% to 30% of people with chronic rhinosinusitis will develop nasal polyps. For both CRS and nasal polyps, symptoms are chronic. On the other hand, acute rhinosinusitis symptoms come on suddenly and eventually recede. The symptoms are very similar, but the onset and duration are different. The causes are also different. Nasal polyps are usually due to allergies or sensitivities. A viral or bacterial infection usually causes acute rhinosinusitis.
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RELATED: Sinus infection symptoms: what are the early signs of sinus infection?
Healthcare professionals distinguish between two major types of nasal polyps. Ethmoidal polyps, which are more common, develop from the ethmoidal sinuses (between the nose and eyes). Antrochoanal polyps, which are less common, develop in the maxillary sinuses (above the teeth/below the nose and cheeks). However, the only way to tell the difference is to look at them through special instruments. The symptoms and treatments are largely identical.
See a healthcare professional if any nasal polyp symptoms are experienced, particularly if breathing through the nose becomes difficult. Nasal polyps can be successfully treated, and complications like sleep disturbance, snoring, sleep apnea, loss of smell, and quality of life issues can be avoided. Nasal polyps don’t require emergency treatment unless breathing is difficult or there’s severe pain.
Clinicians diagnose nasal polyps through a medical history, a physical exam, and sometimes a CT scan of the sinuses. However, the centerpiece of diagnosis is an endoscopic exam of the nasal cavities and sinuses. In this procedure, the clinician inserts a small tube into the nose. At the end of the tube is a light and a camera or magnifier that allow the doctor to see the inside of the nose and the sinus cavities. If the polyps are too deep, a CT scan may be needed. If the doctor spots a growth that may be cancerous, a sample will be cut off for biopsy.
After diagnosing nasal polyps, the clinician will move on to the next step: figuring out the cause. This part of the diagnosis is important. Nasal polyps frequently come back after treatment unless the cause of the polyps is treated, too. In this stage, other tests may be necessary, such as blood tests, a skin-prick test (allergy test), a biopsy to identify a fungal infection, or a sweat test to diagnose cystic fibrosis.
Untreated nasal polyps can result in complications such as:
Sleep disturbances
Obstructive sleep apnea
Fatigue due to poor sleep
Sinus infections
Permanent loss of smell
Reduced quality of life
Nasal polyps can be shrunk or removed with treatment. The first line of treatment is nasal corticosteroid sprays like Flonase Allergy Relief (fluticasone) or Rhinocort Allergy (budesonide). Sometimes, this is all that’s needed to shrink the polyps. Nasal steroids have minimal side effects, usually just stinging, dryness, and occasional nosebleeds. To be successful, however, nasal steroids also require regular saline irrigation to clean the nasal passages.
If the steroid sprays don’t succeed, the clinician may also prescribe an oral corticosteroid. Oral steroids are more powerful at shrinking polyps, but they can have more serious side effects. Biologic drugs such as Dupixent (dupilumab) may be used if steroids don’t work or polyps keep growing back. These drugs are injected every two to four weeks.
If medications don’t work or there’s a significant blockage, surgery may be warranted. A specialist in ear, nose, and throat diseases called an otolaryngologist will remove the polyps using a procedure called endoscopic sinus surgery. It’s a minimally-invasive outpatient procedure performed with a nasal endoscope and tiny surgical tools.
Nasal polyps often grow back unless the allergy, infection, or medical condition that causes them is treated. For allergies, that may mean avoiding allergens and using antihistamines and/or steroids to control inflammation. If nasal polyps are due to fungal infection, then treatment will include antifungal medications to clear the infection. Cystic fibrosis is a serious and lifelong illness that will require an entire team of healthcare professionals and a system of interrelated treatments.
Even after successful treatment, nasal polyps often return. The best way to prevent recurrence is to prevent inflammation of the sinuses and nasal passages:
Take all medications as instructed
Avoid allergens
Avoid anything that irritates the nose or sinuses, like smoke, dust, or pollution—wearing a face mask can help
Use saline irrigation, with distilled or (cooled) heat-sterilized water, regularly to clean out irritants, dust, debris, and other foreign objects
Use an air purifier to clean allergens and irritants from the air
Even if there are only minor symptoms, have a healthcare professional try to determine the cause. Certain conditions like allergies and chronic swelling in the nasal passages mean a risk for polyps. They can’t be seen, so ongoing or recurring symptoms of nasal problems such as congestion, runny nose, allergic reactions, or infections are an indication that a doctor needs to examine the nasal passages. Nasal polyps can cause pain, discomfort, and other problematic symptoms as they grow. However, nasal polyps are easily treatable. Sometimes, all it requires are nasal steroid sprays and saline washes to make them go away.
Nasal polyps form in the sinuses directly below the eyes. If they grow out of control, they can block the nasal passages and put pressure on the bone below the eyes, increasing the pressure within the eyes. More worrisome is the increased risk of sinus infections. If a sinus infection spreads upward to the area around the eye, it can cause swelling around the eyes or vision changes.
Runny noses and postnasal drip are common symptoms of nasal polyps. If the polyps are a long-term consequence of a fungal infection, the discharge can be thick and brown, like peanut butter.
When mucus and fluid can’t drain because nasal polyps block the way, the fluid can fill with bacteria. It's likely to have an unpleasant aroma. If it drips down the back of the throat, the breath won’t smell good, either. On the other hand, nasal polyps affect a person’s sense of smell. People have a reduced and sometimes distorted sense of smell as polyps grow. Things that generally don’t smell bad may start smelling wrong or simply bad.
Nasal endoscopy, Cleveland Clinic
Nasal polyps, StatPearls
Nasal polyps clinical update, Consultant360
Chronic rhinosinusitis, American Family Physician
Nasal polyps, American Academy of Allergy Asthma & Immunology (AAAAI)
Nasal polyps, Merck Manual
A review of nasal polyposis, Therapeutics and Clinical Risk Management
Asthma treatments and medications, SingleCare
Allergy treatments and medications, SingleCare
Cystic fibrosis treatments and medications, SingleCare
Sinus infection treatments and medications, SingleCare
After receiving her doctorate from the University of Pittsburgh School of Pharmacy, Karen Berger, Pharm.D., has worked in both chain and independent community pharmacies. She currently works at an independent pharmacy in New Jersey. Dr. Berger enjoys helping patients understand medical conditions and medications—both in person as a pharmacist, and online as a medical writer and reviewer.
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