From the Guidelines
For nasal irritation and a superficial wound on the medial internal nare due to URI congestion and rhinorrhea, I recommend applying a thin layer of petroleum jelly (Vaseline) or antibiotic ointment like Bacitracin or Polysporin to the affected area 2-3 times daily for 5-7 days. Use a cotton swab for application to avoid introducing bacteria from your fingers. Saline nasal sprays can help reduce congestion and keep the nasal passages moist; use 1-2 sprays in each nostril 3-4 times daily, as supported by studies such as 1 that show the benefits of topical saline in treating symptoms of chronic rhinorrhea and rhinosinusitis. Avoid picking or rubbing the nose, which can worsen the wound. A humidifier in your bedroom can provide additional moisture to prevent further irritation. If using tissues, choose ones with lotion to minimize friction. These measures work by creating a protective barrier over the wound while maintaining moisture, which promotes healing. The saline spray helps thin mucus and reduce congestion that contributes to irritation, as noted in guidelines for managing viral rhinosinusitis 1. If the wound doesn't improve within a week, shows signs of infection (increased redness, swelling, pain, or discharge), or if you develop fever, seek medical attention as you may need prescription antibiotics, following the principles outlined for high-value care in managing acute respiratory tract infections 1.
Some key considerations in managing such cases include:
- Distinguishing between viral and bacterial causes of rhinosinusitis, as the treatment approaches differ significantly 1.
- The use of symptomatic relief measures such as analgesics, topical intranasal steroids, and nasal saline irrigation for both viral rhinosinusitis and acute bacterial rhinosinusitis 1.
- The importance of watchful waiting and the judicious use of antibiotics to avoid unnecessary prescribing and potential harm 1.
Overall, the management of nasal irritation and superficial wounds due to URI congestion and rhinorrhea should focus on symptomatic relief, prevention of infection, and promotion of healing, with a careful approach to the use of antibiotics based on the most recent and highest quality evidence 1.
From the Research
Nasal Irritation and Congestion Treatment
- Nasal congestion associated with upper respiratory tract infection (URTI) can be treated with pseudoephedrine, which has been shown to be safe and effective in reducing nasal airway resistance (NAR) and subjective scores of nasal congestion 2.
- A combination of paracetamol and pseudoephedrine has been found to be superior to either medication alone or placebo in treating nasal congestion and pain-related symptoms in URTI 3.
- Aspirin combined with pseudoephedrine has also been shown to be effective in relieving pain symptoms and nasal congestion in patients with URTI 4.
Wound Healing of the Nasal Mucosa
- The healing of nasal mucosa wounds is a complex process involving clot formation, inflammatory reaction, immune response, and tissue remodeling and maturation 5.
- Current treatment options for enhancing wound healing following sinus surgery include intravenous antibiotics or steroids, nasal sprays, and nasal packing, but strong evidence of their efficacy is lacking 6.
- Alternative therapies such as herbal medicine and regenerative medicine therapies like stem cells and their byproducts are being explored for nasal mucosa wound healing, but more research is needed to recommend them as part of the treatment modality 6.