How-to guide
How to Do a Nasal Saline Rinse
Quick answer: A nasal saline rinse washes the inside of your nose with salt water: it flows in one nostril and out the other, carrying mucus, allergens and irritants with it. Use a squeeze bottle or neti pot that holds about 8 ounces (240 mL), a saline packet, and only distilled, sterile, or boiled and cooled water, never water straight from the tap. Lean over the sink, breathe through your mouth, and rinse each side once or twice a day. For ongoing sinus or allergy symptoms, give it 4 to 8 weeks of regular use to judge how well it works.
What do I need?
Look in the sinus and allergy aisle, or the cold aisle, of any pharmacy.
- A rinse device. A squeeze bottle or a neti pot that holds about 8 ounces (240 mL). Large-volume rinses work better than small saline sprays: in a randomized trial of adults with chronic nasal and sinus symptoms, people who used a large-volume rinse bottle improved more than people who used a saline spray (Pynnonen et al., 2007).
- Saline packets. Pre-measured salt and baking soda. Most kits come with some, and refill boxes are sold separately. You can also make your own solution.
- Safe water. See below. This is the one step you cannot skip.
Use Safe Water Only
Never use water straight from the faucet. Tap water is safe to drink, but it is not sterile, and the CDC advises against using it to rinse your nose. Use one of these instead:
- Distilled or sterile water, sold in jugs at the store
- Tap water boiled for 1 minute (3 minutes above 6,500 feet), then cooled until lukewarm
- Water run through a filter labeled NSF 53 or NSF 58, or labeled “absolute pore size of 1 micron or smaller”
Use lukewarm or room-temperature water, never hot or cold.
Why rinse?
Rinsing your nose can:
- Thin and clear out mucus
- Wash away allergens such as pollen and dust, along with irritants and germs
- Reduce congestion so you breathe more easily
- Soothe dry, crusted nasal passages
- Help your nasal sprays work better (rinse first, then spray)
We often recommend it for chronic sinus problems, allergies, post-nasal drip, and healing after nasal and sinus surgery. It is inexpensive and has few side effects.
Reviews of the research found that large-volume saline rinses may ease the symptoms of chronic sinusitis (Chong et al., 2016) and of nasal allergies (Head et al., 2018), with no serious side effects reported, although the studies were small.
Watch how it is done
The #1 Sinus Habit ENTs Recommend
A short video from our team on nasal saline rinses.
How do I do it?
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Wash your hands and mix the rinse
Fill the clean bottle with lukewarm safe water (distilled, sterile, boiled or filtered), add one saline packet (or your own solution), and mix until the powder is fully dissolved.
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Lean over the sink
Bend forward and tilt your head down and slightly to one side. Keep your mouth open and breathe through your mouth.
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Seal the spout against the upper nostril
Place the tip gently in the nostril that is higher, snug enough to form a seal.
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Squeeze gently, or tip the neti pot
Let the water flow into the top nostril and drain out of the lower one. If some reaches your mouth, spit it out. Do not swallow it.
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Keep breathing through your mouth
Breathe through your mouth the whole time. Do not sniff, and do not pinch your nose.
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Blow gently
When that side is done, gently blow your nose. If you have had nasal or sinus surgery in the past week, skip this step and let the water drain on its own.
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Repeat on the other side
Tilt your head the other way and rinse the other nostril the same way.
A little stinging, or water dripping from your nose a while later, is normal. Lean forward and blow gently to clear any leftover water. If you use a medicated nasal spray, use it after you rinse.
How often should I rinse?
- Ongoing sinus or allergy symptoms: once or twice a day is typical.
- During a cold or flare-up: you can rinse more often for comfort.
- Chronic sinus conditions: the benefit builds over time. Rinse daily for at least 4 to 8 weeks before you judge how well it works.
- Long term: it is safe to keep rinsing daily if you have an ongoing condition.
If your provider gave you a specific schedule, follow that one.
Do and don’t
Do
- Use distilled, sterile, or boiled and cooled water
- Use lukewarm or room-temperature water
- Lean forward over the sink and breathe through your mouth
- Rinse first, then use your nasal spray
- Wash the bottle with soap and let it air-dry after each use
Don’t
The most common mistakes:
- Using water straight from the tap
- Tilting your head back instead of forward over the sink
- Sniffing the water in, or breathing through your nose while you rinse
- Using hot or cold water instead of lukewarm
- Using your nasal spray before the rinse instead of after
- Keeping mixed solution longer than 24 hours, or putting the bottle away wet
What changes after nasal or sinus surgery?
After surgery, follow your own post-op instructions; they take priority over this page. A few things are different while you heal:
- After endoscopic sinus surgery or balloon sinuplasty, rinses are a big part of healing. Your instructions will ask you to rinse several times a day until your first post-op visit, using room-temperature distilled water. The more you rinse, the less crusting there is to clean out at that visit.
- After septoplasty, turbinate reduction and several in-office nasal procedures, your instructions call for a saline spray every few hours instead of a rinse until your follow-up visit.
- Do not blow your nose for 1 week after any nasal or sinus surgery. Let the rinse drain out on its own.
- Some bleeding is common after nasal or sinus surgery. See When should I call? for what to do.
How do I keep the bottle clean?
- After each use, wash the bottle, cap and tube with warm water and a little dish soap, rinse well, and let them air-dry completely (or dry the inside with a paper towel).
- Follow the instructions that came with your device, and replace the bottle every 3 months or sooner if it cracks or discolors.
Can I make my own saline?
Packets are the simplest option, but you can save money by mixing your own:
- Mix 1 teaspoon of non-iodized salt (pickling or canning salt) and ½ teaspoon of baking soda into 2 cups (16 ounces, about 480 mL) of safe water (distilled, sterile, boiled or filtered). That fills an 8-ounce bottle twice.
- Use it fresh, or keep it covered in a clean container and throw it out after 24 hours.
When should I call?
Call our office if
- Your symptoms get worse, or do not improve after several weeks of rinsing
- You have frequent nosebleeds, ear pain, or real discomfort when you rinse
- You have a fever, severe facial pain, or thick colored drainage that is not improving
After nasal or sinus surgery
Call us for bleeding that does not stop or that worries you. Call 911 or go to the ER for severe bleeding that cannot be controlled, or bleeding with lightheadedness or fainting.
Austin 512-339-4040 · Lakeway 512-682-4798 · Marble Falls 830-992-2830
Questions patients ask
Yes. For ongoing sinus or allergy symptoms, rinsing once or twice a day is typical, and it is safe to keep rinsing daily for the long term. Use distilled, sterile, boiled or filtered water, never water straight from the faucet, and keep your bottle clean. If rinsing causes nosebleeds, ear pain or real discomfort, stop and call us.
Not straight from the faucet. Tap water is safe to drink, but it is not sterile, and the CDC advises against using it to rinse your nose. Use distilled or sterile water, tap water boiled for 1 minute (3 minutes above 6,500 feet) and cooled to lukewarm, or water run through a filter labeled NSF 53 or NSF 58 or with an absolute pore size of 1 micron or smaller.
Either works. What matters most is the amount of fluid: a device that holds about 8 ounces (240 mL) rinses the nose more thoroughly than a small saline spray. A squeeze bottle uses gentle pressure and a neti pot uses gravity, so use whichever you find easier to do every day.
Rinse first, then use your spray. The rinse clears out mucus so the medicated spray reaches a clean lining instead of being washed away.
A little stinging or burning is normal, especially the first few times. Make sure the packet is fully dissolved and the water is lukewarm, not hot or cold. If rinsing is painful or causes ear pain, stop and call us.
For chronic sinus problems, the benefit builds over time. Rinse daily and give it at least 4 to 8 weeks of regular use before judging how well it works.
This guide is for educational purposes only and does not replace an in-person evaluation. If your provider gave you different instructions, follow theirs.
Video, full guide and sources: capitalent.com/nasal-saline-irrigation.html
Sources
- Pynnonen MA, Mukerji SS, Kim HM, Adams ME, Terrell JE. Nasal saline for chronic sinonasal symptoms: a randomized controlled trial. Archives of Otolaryngology–Head & Neck Surgery. 2007;133(11):1115-1120. doi:10.1001/archotol.133.11.1115. PMID: 18025315
- Chong LY, Head K, Hopkins C, et al. Saline irrigation for chronic rhinosinusitis. Cochrane Database of Systematic Reviews. 2016;(4):CD011995. doi:10.1002/14651858.CD011995.pub2. PMID: 27115216
- Head K, Snidvongs K, Glew S, et al. Saline irrigation for allergic rhinitis. Cochrane Database of Systematic Reviews. 2018;(6):CD012597. doi:10.1002/14651858.CD012597.pub2. PMID: 29932206
- Centers for Disease Control and Prevention. How to Safely Rinse Sinuses. cdc.gov