Medication for a Deviated Septum: 6 Science-Backed Medications to Reduce Deviated Septum Symptoms

The main medications for a deviated septum aim to reduce inflammation in the nasal passage and help to flush it out:

Nasal Steroids for a Deviated Septum

Nasal steroids have anti-inflammatory properties. They reduce the swelling in the mucosa of the nose and sinuses by decreasing the inflammation causing cells (e.g., mast cells, cytokines, eosinophils).

Nasal steroids also reduce the inflammation of the sinus opening, allowing mucus drainage and clearing congestion. They are beneficial in individuals with deviated nasal septum and symptoms such as nasal obstruction, stuffy nose, runny nose, and sinus infections.¹Corey, J. P., Houser, S. M., & Ng, B. A. (2000). Nasal Congestion: A Review of its Etiology, Evaluation, and Treatment. Ear, Nose & Throat Journal, 79(9), 690–702. doi:10.1177/014556130007900908

Nasal steroids can be taken topically (i.e. applied to the skin), orally, or through injections. The topical form of nasal steroids is more effective than the oral, as it displays minimal side effects.

Inappropriate and prolonged use of nasal steroids can cause side effects such as irritation, burning sensation, and fungal infection (candidiasis). Nasal steroids may take several days to exhibit results.

Research suggests that use of topical steroids (e.g., budesonide) is more effective in relieving nasal congestion than antihistamine (e.g., terfenadine) medications.²Davis, S. S., & Eccles, R. (2004). Nasal congestion: mechanisms, measurement and medications. Core information for the clinician. Clinical Otolaryngology and Allied Sciences, 29(6), 659–666. doi:10.1111/j.1365-2273.2004.00885.x

Allergy Medications for a Deviated Septum (e.g. antihistamines/decongestants)

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Decongestants: Decongestants are considered the first line of treatment for nasal congestion. They relieve congestion in the nose by constricting the enlarged blood vessels (due to inflammation) in the mucosa (inner lining of nose), clearing the nasal airway. These medications can be used in topical and oral forms. Topical medication oxymetazoline is considered as the most effective decongestant.³Corey, J. P., Houser, S. M., & Ng, B. A. (2000). Nasal Congestion: A Review of its Etiology, Evaluation, and Treatment. Ear, Nose & Throat Journal, 79(9), 690–702. doi:10.1177/014556130007900908

Overuse of topical decongestants can cause swelling in the mucosa of the nose (rebound nasal congestion) and may reduce the effectiveness of the medicine.

Oral forms of decongestants are less effective than topical forms, but have

minimal rebound effects when compared to topical.⁴Schuman, T. A., & Senior, B. A. (2018). Treatment Paradigm for Nasal Airway Obstruction. Otolaryngologic Clinics of North America

Antiallergic medications: These are also known as antihistamines. They inhibit the release of chemicals such as histamines which cause inflammation in the nose and sinuses. The use of antiallergic medications reduce the symptoms such as nasal itchiness, nasal discharge, watery eyes, and sneezing. They are known to cause sedation.⁵Davis, S. S., & Eccles, R. (2004). Nasal congestion: mechanisms, measurement and medications. Core information for the clinician. Clinical Otolaryngology and Allied Sciences, 29(6), 659–666. doi:10.1111/j.1365-2273.2004.00885.x
Antihistamine and decongestant combinations. The combination of decongestants and antihistamines relieves nasal congestion and is effective against symptoms such as sneezing, runny nose, tears, and itchiness of the nose and eyes. Research suggests that the combination of these medicines is more effective than individual medicines.⁶Corey, J. P., Houser, S. M., & Ng, B. A. (2000). Nasal Congestion: A Review of its Etiology, Evaluation, and Treatment. Ear, Nose & Throat Journal, 79(9), 690–702. doi:10.1177/014556130007900908
Mast cell stabilizers: These medications are used to prevent allergic nasal conditions in individuals with deviated nasal septum. Mast cell stabilizers inhibit the release of inflammation causing agents (e.g., histamine) from the mast cells (cells of the immune system). This results in decrease in symptoms such as itchiness of nose, sneezing, nasal discharge, and obstruction of the nose. Mast cell stabilizers are more effective in topical forms and have minimal side effects. They have short duration of action, and are recommended to be used 4-6 times in a day.⁷Corey, J. P., Houser, S. M., & Ng, B. A. (2000). Nasal Congestion: A Review of its Etiology, Evaluation, and Treatment. Ear, Nose & Throat Journal, 79(9), 690–702. doi:10.1177/014556130007900908
Antibiotics and antimicrobials: Some individuals with deviated nasal septum may develop chronic rhinosinusitis (inflammation of the nose and sinuses), leading to sinonasal infections. Antibiotics and antimicrobials are prescribed to cure these infections. In individuals with acute rhinosinusitis, antibiotics are also prescribed to overcome fever and facial pain.⁸Mandal R, Patel N, Ferguson BJ. Role of antibiotics in sinusitis. Current opinion in infectious diseases. 2012 Apr 1;25(2):183-92.

Sources:

1
Corey, J. P., Houser, S. M., & Ng, B. A. (2000). Nasal Congestion: A Review of its Etiology, Evaluation, and Treatment. Ear, Nose & Throat Journal, 79(9), 690–702. doi:10.1177/014556130007900908
2
Davis, S. S., & Eccles, R. (2004). Nasal congestion: mechanisms, measurement and medications. Core information for the clinician. Clinical Otolaryngology and Allied Sciences, 29(6), 659–666. doi:10.1111/j.1365-2273.2004.00885.x
3
Schuman, T. A., & Senior, B. A. (2018). Treatment Paradigm for Nasal Airway Obstruction. Otolaryngologic Clinics of North America
4
Schuman, T. A., & Senior, B. A. (2018). Treatment Paradigm for Nasal Airway Obstruction. Otolaryngologic Clinics of North America