Hi

Thanks for the query

After going through the history, I do feel that you are suffering from Allergic Rhino sinusitis with Rhinitis Medicamentosa.

The burning and tingling sensation in the nose, along with the sensation of the water up in the nose with pressure, which is worsening on bending over or lying down are all the features of Allergic Rhinosinusitis. Using Oxymetazoline (Afrin) nasal spray has added on to your problems. Oxymetazoline should not be used for more than 5 days, if so it will develop into a condition called Rhinitis Medicamentosa. Rhinitis medicamentosa (or RM) is a condition characterized by rebound nasal congestion brought on with long term use of topical decongestants (such as Oxymetazoline or Xylometazoline).

Added on to it, you are using both Benadryl (diphenhydramine) and Zyrtec (Cetrizine) wherein both of them are antihistaminics which will worsen the dryness of the nose.

First of all, I would suggest you to stop using Oxymetazoline nasal spray and to use either Diphenhydramine or Cetrizine and not both of them. Secondly, you need to use saline nasal spray (to keep the nasal mucosa moist) and Steroid nasal spray (such as Fluticasone or Momentasone) to reduce the nasal allergy and the congestion. A mucolytic (such as ambroxol or bromhexine) is required to reduce the viscosity of the nasal secretions and clearing of the sinuses and the nose.

All the above medications should be altered only after consulting your Physician or ENT specialist.

Also, you need to drink plenty of warm water to keep the mucosa hydrated and do steam inhalation 3-4 times every day to reduce the nasal congestion and opening up of the nasal sinuses.

Hope I have answered the query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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Hi

Thanks for writing back.

The hot and burning sensation in the nose is a vasomotor response (pooling of the blood in the blood vessels of the nasal mucosa) to the emotions added with nasal allergy causing irritation of the nerves in the nose.

Sinus pressure is due to blocking of the sinuses following nasal congestion and nasal allergy.

Thank god, you have used Oxymetazoline nasal spray for only 3-4 days. Hence, Rhinitis Medicamentosa is ruled out and it is only Allergic Rhinosinusitis.

Please do follow my suggestions as mentioned in my earlier post, you will definitely feel better. Also, you need to understand one thing, there is no cure for the allergy, till you take the medicines you will be alright but once you stop them it will recur again. So, the best way to get rid of this is to prevent from getting exposed to the allergens. The preventive measures include changing of the pillow covers, every day before going to bed, not to lie down straight under the fan or in front of the blower of the air conditioner and finally, to cover the nose when exposed dust or smoke.

Wish you good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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Hi,

Welcome back.

I do not think so, that you will still continue to have this hot and burning sensation once you change the medicines.

Yes, allergic rhinosinusitis, emotions, acne rosacea, atopy, etc. can give rise to flushing of the facial skin in fair skinned individuals. A proper history and a thorough examination will be able to diagnose the actual cause.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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Hi.

Thanks for writing back.

I have examined the photos as well as discussed with a renowned dermatologist regarding the lesion. The rashes you are having could be either Allergic contact dermatitis (if it is of a short duration) or Urticaria (if it is a recurrent lesion).

You can use emollients (such as calamine lotion) to reduce the burning sensation as well as local application of a steroid based cream to reduce the allergy.

Hope, this answers your query. Please accept my answer in case you have no follow up queries.

Wish you good health.

Regards.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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