Nasal polyps are soft, painless growths that can develop inside the nasal passages. Signs may include a congested or runny nose, postnasal drip, or feeling like your nasal passage is blocked or swollen.

Have you ever felt like you have a cold that doesn’t go away?

Nasal congestion that doesn’t seem to stop, even with over-the-counter cold or allergy medication, may be due to nasal polyps.

Nasal polyps are benign (noncancerous) growths of your nose’s lining tissues or mucosa.

Nasal polyps grow in inflamed tissue of the nasal mucosa. The mucosa is a mucus-making layer that helps protect the inside of your nose and sinuses and humidifies the air you breathe.

During an infection or allergy-induced irritation, the nasal mucosa becomes swollen and red, and it may produce fluid that drips out. With prolonged irritation, the mucosa may form a polyp, which is a round growth (like a small cyst, but not fluid-filled ) that can block nasal passages.

Although some people can develop polyps with no previous nasal problems, there’s often a trigger for developing polyps. These triggers include:

Some people may have a hereditary tendency to develop polyps. This may be due to how their genes cause their mucosa to react to inflammation.

Nasal polyps are soft, painless growths inside the nasal passages. They often occur in the area where the upper sinuses drain into your nose (where your eyes, nose, and cheekbones meet).

You may not even know that you have polyps because they lack nerve sensation, but if they’re larger and closer to your nostril, you may be able to feel them with your finger.

Polyps can grow large enough to block your nasal passages, resulting in chronic congestion. Symptoms can include:

  • a sensation that your nose is blocked
  • runny nose
  • postnasal drip, which is when excess mucus runs down the back of your throat
  • nasal stuffiness
  • nasal congestion
  • reduced sense of smell
  • breathing through your mouth
  • a feeling of pressure in your forehead or face
  • sleep apnea
  • snoring

Pain or headaches may also occur if there’s a sinus infection besides the polyp.

A nasal polyp will likely be visible if your doctor looks up into your nasal passages with a lighted instrument called an otoscope or nasoscope.

If the polyp is deeper in your sinuses, your doctor may need to perform a nasal endoscopy. This procedure usually involves your doctor guiding a thin scope with a light and camera at the end into your nasal passages.

A CT or MRI scan may be necessary to determine the exact size and location of the polyp. Polyps appear as opaque spots on these scans. Scans can also reveal whether the polyp deformed the bone in the area.

Nasal polyps are benign (noncancerous), but tests can rule out other cancerous growths, similar-looking noncancerous conditions like inverted papilloma, or structural deformities.

Allergy tests can help doctors determine the source of persistent nasal inflammation. These tests involve making tiny skin pricks in your skin and depositing the liquid form of various allergens. Your doctor will then see if your immune system reacts to any of the allergens.

If a very young child has nasal polyps, tests for genetic diseases, such as cystic fibrosis, may be necessary.

Medications

Medications that reduce inflammation may help reduce the polyp’s size and relieve congestion symptoms.

Spraying nasal steroids into the nose can reduce your runny nose and the sensation of blockage by shrinking the polyp. However, if you stop taking them, symptoms may quickly return. Examples of nasal steroids that may be used include:

  • fluticasone (Flonase, Veramyst)
  • budesonide (Rhinocort)
  • mometasone (Nasonex)

If nasal sprays don’t work, a steroid-based nasal irrigation or an oral or injectable steroid may be an option. However, these aren’t a long-term solution due to their serious side effects, including fluid retention, increased blood pressure, and elevated eye pressure.

Another treatment can involve monoclonal antibody drugs, which have been shown to be effective in treating chronic nasal sinusitis with polyps. The drugs currently approved by the Food and Drug Administration (FDA) for this purpose are:

Antihistamines or antibiotics may also treat allergies or sinus infections caused by inflammation in the nose.

Surgery

If your symptoms aren’t improving, surgery can completely remove the polyps. This is usually done with an endoscope, but the type of surgery depends on the polyp size.

For smaller polyps, a doctor may perform a polypectomy. For larger polyps, your doctor can perform an endoscopic sinus surgery (ESS). In both cases, it involves guiding the endoscope into your nostrils and removing the polyps. Your doctor may also enlarge the openings to your sinus cavities. This is usually an outpatient procedure.

Nasal sprays and saline washes can prevent polyps from returning after surgery. Reducing the inflammation of the nasal passages with nasal sprays, anti-allergy medications, and saline washes can also help prevent nasal polyps from developing.

In some cases, your doctor may also place a drug-eluting stent during the procedure. This stent releases steroids internally and helps prevent post-surgical inflammation.

Since an underlying health problem often causes nasal polyps, the complications depend on the cause.

Other than cause-related complications, nasal polyps may also make breathing difficult through the nose, which can affect sleep quality.

These growths can sometimes block sinus drainage and cause mucus cysts. They can also pressure the eye area and cause bulging or double vision problems. While rare, nasal polyps can also cause you to lose some or all of your sense of smell (anosmia).

Surgery can result in nosebleeds in treating nasal polyps, and continued treatment with nasal steroid sprays or oral corticosteroids may lower your resistance to sinus infections, though the research on this is largely based on self-reported data.

In addition, the ethmoid sinuses are located near the eye socket. Any accidental damage to the bone during surgery risks impacting structures around the eye and the eye itself.

Additionally, the roof of the ethmoid sinuses is at the base of the skull. Any injury to this area could lead to a brain fluid leak and a subsequent infection.

The specific outlook depends on the underlying cause, and nasal polyps can also reoccur after treatment.

Research suggests that people with allergic fungal rhinosinusitis have a higher recurrence rate than people with asthma or AERD. However, compared to people with chronic rhinosinusitis, those with AERD may experience more severe polyps and more recurrence.

Other factors that may affect outlook include being of younger age, bone inflammation, and inflammatory markers such as higher eosinophils or neutrophils.

What happens if nasal polyps go untreated?

Most symptoms improve significantly with medical or surgical treatment. However, nasal polyps are unlikely to disappear on their own without treatment.