If your GP has mentioned nasal polyps and you’ve been told the only options are steroid sprays for the rest of your life or surgery, you’re not alone. Thousands of people in the UK are looking for the best nasal spray for polyps that does not lock them into long-term medication, and the choices are confusing. This guide compares the main UK options (Avamys, Beconase, Flonase, Nasacort, Sterimar, and capsaicin-based sprays) so you can make a properly informed decision before your next prescription renewal.
What nasal polyps actually are
Nasal polyps are soft, painless growths on the lining of your nose or sinuses. They are not cancer. Most are caused by long-term inflammation, often linked to allergies, asthma, or recurrent sinus infections. Small polyps may not cause symptoms at all. Larger ones can lead to:
- A persistently blocked nose
- Reduced or lost sense of smell
- Postnasal drip and frequent sinus infections
- Snoring and disturbed sleep
Nasal sprays remain the first-line treatment in UK NHS guidance for symptomatic polyps, before surgery is considered. Which spray you use matters more than most people realise.
The standard UK option: steroid nasal sprays
Steroid (corticosteroid) nasal sprays reduce the inflammation that causes polyps to swell and grow. They are widely prescribed in the UK and available both on prescription and over the counter.
| Brand | Active ingredient | UK availability | Notes |
|---|---|---|---|
| Avamys | Fluticasone furoate | Prescription | Often first-line for polyps |
| Flonase / Flixonase | Fluticasone propionate | OTC + Prescription | Same drug class as Avamys |
| Beconase | Beclometasone dipropionate | OTC + Prescription | Older, well-established |
| Nasacort | Triamcinolone acetonide | OTC | Recently OTC in UK |
| Pirinase | Fluticasone propionate | OTC | Same as Flonase |
| Dymista | Fluticasone + azelastine | Prescription | Combination spray |
Steroid sprays work for many people. The trade-off is that they need consistent daily use, often for months or years, and the effect tends to fade once you stop. UK NHS data suggests that polyps return in roughly 30 to 60 percent of users within a year of stopping steroid sprays.
Reported side effects of long-term steroid spray use
- Nosebleeds and dryness
- Sore throat and altered taste
- Increased risk of infection
- In rare cases, raised eye pressure and reduced bone density (linked mainly to oral, not nasal, steroids; nasal absorption is much lower but not zero)
Most UK users tolerate steroid sprays well. A growing minority, however, look for an alternative that does not require indefinite daily use, especially if their polyps are small or moderate.
Why people look for alternatives
A search through UK nasal-polyps forums on Mumsnet and Patient.info shows three recurring themes:
- Concern about long-term steroid use, particularly in pregnancy or for children.
- Reduced effectiveness over time, sometimes called “spray fatigue”.
- A preference for non-prescription options that do not require GP visits.
This is where saline rinses, sea-water sprays, and capsaicin-based sprays enter the picture.
Natural alternatives: saline, sea water, and capsaicin
Saline and sea-water sprays (Sterimar)
Sterimar is a UK-popular nasal spray made from 100 percent natural sea water, free from steroids, drugs, and preservatives. It is suitable for daily use, including during pregnancy and for children from 3 years old. Sterimar gently flushes the nasal passages, which can ease congestion and reduce the build-up of mucus that aggravates polyps.
What it does well: gentle, safe, broadly recommended by pharmacists, no prescription needed.
What it does not do: actively shrink polyps. Saline rinsing is supportive, not a direct treatment for polyp growth.
Capsaicin-based nasal sprays
Capsaicin is the active compound in chilli peppers. In nasal applications it acts on TRPV1 receptors in the nasal lining, gradually desensitising over-reactive nerve endings. UK and European studies (including a 2014 Cochrane review on idiopathic and non-allergic rhinitis) have found that intranasal capsaicin can support nasal comfort in chronic non-allergic conditions, an indication that overlaps significantly with the inflammatory environment in which polyps form.
A capsaicin spray works differently from a steroid spray. It does not suppress immune activity. It targets the nerve hyper-reactivity that often accompanies chronic nasal inflammation. For people with small to moderate polyps who prefer not to use long-term steroids, this is one of the few non-prescription, non-saline routes available in the UK.
Capsinol Original Formula is a natural capsaicin nasal spray free from vasoconstrictors and steroids. Read how capsaicin works in the nose for the full mechanism.
Best nasal spray for polyps: a comparison
| Feature | Steroid sprays (Avamys, Beconase, Flonase) | Sterimar | Capsinol |
|---|---|---|---|
| Mechanism | Suppress inflammation | Wash and moisturise | Desensitise nerve receptors |
| Prescription needed | Often yes | No | No |
| Daily use long term | Required | Optional | Personal preference |
| Steroid content | Yes | No | No |
| Suitable in pregnancy | Check GP | Yes | Check GP |
| Children | Age-restricted | From 3 years | Adults; check formula |
| Effect on polyp size | Reduces inflammation, can shrink polyps | Supportive only | Supports nasal comfort |
| Common side effects | Dryness, nosebleeds, taste change | Minimal | Initial brief stinging |
| UK pharmacy availability | Boots, Lloyds | Boots, Lloyds | Online (capsinol.co.uk) |
Choosing the right approach
There is no single best nasal spray for every person with polyps. A reasonable framework:
- Large polyps with significant breathing problems: see your GP. Steroid sprays or surgery are usually appropriate.
- Moderate polyps, prefer to avoid long-term steroids: discuss a stepped approach with your GP. Saline rinsing plus a capsaicin-based spray can be a starting point.
- Small polyps or early symptoms: saline (Sterimar) and capsaicin sprays are reasonable first steps before escalating.
- Pregnancy or breastfeeding: always check with your GP before starting any nasal spray, including OTC options.
What our customers say
We hear regularly from UK customers who switched from years of steroid sprays to a natural capsaicin spray. Their experiences vary, and individual results are not predictable. Read first-hand accounts on our customer stories page.
Individual results may vary. Capsinol is not a medicine and is not intended to diagnose, treat, cure, or prevent any disease.
When to see a doctor
Always consult a GP or ENT specialist if you experience:
- Sudden, severe headache or facial pain
- Vision changes or eye pain
- A polyp on one side only (rare but worth checking)
- Bleeding that does not stop
- A polyp that does not respond to any spray within a few months
Polyps that do not respond to medical management may need a minor surgical procedure (FESS, functional endoscopic sinus surgery), which is routinely performed in NHS hospitals. The NHS guidance on nasal polyps outlines when surgery is appropriate and what to expect.
In short
The best nasal spray for polyps in the UK depends on polyp size, your tolerance of long-term steroid use, and personal preference. Steroid sprays (Avamys, Beconase, Flonase, Nasacort) remain the medical first line. Natural options (Sterimar, capsaicin-based sprays like Capsinol) are increasingly chosen by people who want to avoid daily steroid use without giving up effective symptom relief.
Compare all Capsinol formulas to see which suits your situation.
See also: Non-Allergic Rhinitis: When Antihistamines Don’t Work
See also: Rebound Congestion: Why Your Nasal Spray Is Making You Worse