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When you go to the drug store looking for relief from a stuffy nose, you find shelves full of different nose sprays. Many contain oxymetazoline or phenylephrine and are sold under the trade names Afrin® and Neo-Synephrine®, or as generic brands. If you have nasal congestion, they’re great drugs! But it is possible to over do it.

These drugs work by causing vasoconstriction in your nose. Vasoconstriction means that your blood vessels become smaller. The effect is the same as when you step on a hose, stopping the water flow. When your nasal tissues are swollen because of a cold or allergies, the nasal tissues are particularly full of blood. When we clamp down on the blood vessels in the nasal lining, the swelling goes away and you can breathe easier. By the way, these drugs also work great to stop nose bleeds for the same reason.

In the short term, these drugs can make you feel dramatically better. But be careful! With repeated use, your nasal tissues get used to having the medicine around. You end up needing to use it more and more often to get the same effect. Trust me, I used to be dependent on oxymetazoline spray! Over time, this can really damage your nose.

If you find yourself reaching for these medications frequently, it may mean that you have an underlying allergy or sinus problem that needs additional treatment. Prescrption nasal medications are safe for long term use and work just as well. Sometimes you may need surgery to correct a deviated septum or even a rhinoplasty to help your breathing.

So what does Cookie Monster have to teach us about the use of nasal sprays? You’ll recall that several years ago, partially in response to the childhood obesity epidemic, Cookie Monster told us that cookies should be a “sometimes food.”

Just like how cookies are delicious, over the counter nasal decongestant sprays are great! But, they are a “sometimes” medicine. For routine ailments, I recommend that you restrict use to no more than 3-5 consecutive days.