Nasal polyps - Treatment 

Treating nasal polyps 

Nasal polyps can be difficult to get rid of permanently, but steroid medication can often help shrink them, and surgery can be carried out to remove them if medication doesn't help.

Steroid sprays and drops

Your GP or specialist may initially prescribe nose drops or a nasal spray that contains steroid medicine (corticosteroids). These can reduce inflammation in your nose and help shrink your polyps.

Steroid nose drops may be recommended first because these generally work faster than sprays. However, they are usually only prescribed for around two weeks because they can cause side effects.

Common side effects include:

• irritation of the inside of the nose
• sore throat
• nosebleeds

If your symptoms improve while taking the drops, long-term treatment with a steroid nasal spray will usually be recommended to reduce the chances of the polyps returning quickly.

Speak to your GP or specialist if your symptoms don't improve while using a steroid spray or nose drops. You may require additional treatment with steroid tablets.

Steroid tablets

If you have large polyps, or you still have symptoms after using steroids drops or sprays, a short course of steroid tablets (oral corticosteroids) may be recommended in combination with nose drops.

A medication called prednisolone is usually used. It's likely you will be prescribed no more than 5 to 10 days' worth as using it for longer than this increases your risk of developing side effects such as:

• weakening of your bones (osteoporosis)
• high blood pressure
• diabetes
• weight gain

If your symptoms do not improve after taking steroid tablets, your doctor may suggest having surgery to remove your polyps. If they do get better, long-term treatment with a steroid nasal spray will usually be recommended.

Surgery

Surgery to remove nasal polyps may be recommended if steroid medication doesn't help or your polyps are particularly large.

The procedure to remove nasal polyps is called endoscopic sinus surgery. It's carried out under general anaesthetic, sometimes as a day procedure.

The surgeon will pass an endoscope (a tube with a video camera at one end) into your nostrils to allow them to see inside your nose and sinuses.

Surgical instruments, such as a micro-debrider (a tiny motorised revolving shaver) are passed up your nostrils and used to remove the polyps. This means it's not necessary to make any cuts to your face.

After surgery, you will be observed for a few hours. If a dressing has been used, it will be removed from your nose after this time. If there is no bleeding, you will be discharged and allowed home to continue your recovery.

You will usually be advised to rest for around two weeks after surgery. Your surgeon will be able to give you more detailed information and advice.

Common problems that occur after endoscopic sinus surgery include:

• crusting inside the nose, which will usually get better in a few weeks
• persistent nosebleeds, which may require further surgery
• an infection at the site of the surgery, which can usually be treated with antibiotics

Most people who have endoscopic sinus surgery will experience an improvement in their symptoms. However, it's common for polyps to grow back – usually within a few years – and treatment may need to be repeated regularly.

Long-term use of steroid nasal spray will usually be recommended after surgery to help stop polyps returning quickly.