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Are Neti Pots Safe To Use?

A woman uses a neti pot. She is sitting down and the water coming out her nose is falling into a small metal tin.

Neti pots have been around for a long time, and their popularity has risen in recent years. While it’s great that people find relief in a simple nasal rinse, there are dangers to consider when using a neti pot. Amoebas in tap water, which are generally safe to drink, are not safe for the nose. The Centers for Disease Control and Prevention (CDC) is issuing statements to prevent amoeba infections that could rise in tandem with popular sinus rinses.

What Is a Neti Pot or Sinus Rinse?

Neti pots are small containers with spouts that people use to clean debris from their noses. Along with nasal bulbs, teapots, squeeze bottles, syringes, and automatic neti pots, they all fall under the broad category of nasal irrigation devices. The most popular neti pot choice is the squeeze bottle. 

Sinus rinsing is part of some religious practices, like ablution in Islam, yoga, and Ayurveda. The term “neti” comes from the Sanskrit term “not so” and indicates one part of a longer cleansing technique in Hatha Yoga.

The concept is the same with each type of device: water flows into one nostril and out the other, bringing any mucus, allergens, or other debris with it. Many people find that neti pots bring quick, effective relief for nasal allergies without waiting for an antihistamine to kick in. They’re also helpful in clearing out sinus congestion when battling a cold.

Neti Pot Risks, Dangers, and Prevention

Because of the neti pot’s rise in popularity, there’s potential for a simultaneous surge in their improper usage. The CDC has released statements like this one in anticipation of possible problems.

The Biggest Danger Is Water

The primary safety hazard with neti pots is water. The most important thing to know is that some water supplies contain a small amount of organisms like protozoa, bacteria, and amoebas. Stomach acid kills them, so drinking tap water is typically safe if the organism levels remain low. The problems begin when they pass through your nose.

An amoeba by the name Naegleria fowleri, or the “brain-eating amoeba,” infects the body through the nose. While cases of Naegleria are rare, they are typically fatal. You risk infection when unsafe water enters your sinuses, like in a nasal wash. Other amoeba species, like Acanthamoeba, can infect the body through a sinus rinse. 

Naegleria thrives in warm freshwater lakes, rivers, and hot springs. Home water sources are generally safe but can also be affected. It’s one reason people use chlorine in swimming pools.

Therefore, do not put water directly from the tap into your nose without taking proper measures.

Thankfully, there’s an easy way to minimize your risk: using water that’s distilled, sterile, filtered, or previously boiled. 

You can purchase sterile and distilled water at the store; a label will mark it as such.

When filtering water, find a filter with an absolute pore size of 1 micron or less. This is the largest size the holes in a filter can be when trying to sieve out any dangerous amoebas.

If going the route of boiling, there are a few essential steps to follow:

  • Bring the water to a rolling boil. Once there, let it boil for at least 1 minute.
    • Are you at an altitude above 6,500 feet? Then boil for 3 minutes.
  • Let the water cool until it’s lukewarm.
  • Be sure to use any boiled water within 24 hours of boiling. Otherwise, reboil it.
  • Store the water in a clean, airtight container.

Additionally, the CDC has outlined a method for using bleach to disinfect water that will specifically be used in nasal rinsing.

Don’t use cold water in a neti pot, especially after a sinus surgery. This could lead to paranasal sinus exostoses or bony growths in your nasal passage. It can also give you the same sensation as a “brain freeze.”

Cleanliness

It’s important to be sure anything you’re sticking near or around a body opening is clean. Before using a neti pot, wash your hands and your nasal irrigation device of choice with warm soap and water, rinse, and thoroughly dry the device as well.

While neti pots don’t necessarily expire, follow the manufacturer’s instructions for replacement. It’s typically best practice to replace a neti pot every three months. 

Saline Solution

The water used in neti pots has a little bit of salt and baking soda added to it. This is because pure freshwater irritates the nose (have you ever gotten water up your nose in a shower?). Plain water creates a burning sensation and may dry out the sinuses more. Using water that is not properly salinated can cause more irritation. 

Benefits of Neti Pots and General Guidelines

When used properly, neti pots may provide immediate relief to people struggling with allergies and fighting off congestion. Neti pots are typically safe as long as you take the proper measures to keep germs in the water supply out of your nostrils.

Neti pots may help relieve sinus pressure caused by a cold or the flu. They may rinse out allergens causing nasal irritation and even relieve dry nasal passages caused by indoor air circulation. After speaking with a healthcare provider, parents may help children as young as two years old with their nasal allergies by using a neti pot to ease symptoms. 

How To Use a Neti Pot: General Guidelines

No matter which nasal irrigation device you choose, here are some general guidelines. However, be sure to follow the manufacturer’s instructions.

  • Fill the bottle with safe water and add the proper salt solution (if one is provided)
  • Tilt your head with one nostril facing the sink, and one angled slightly up
  • Place the tip of the neti pot at the raised nostril
  • Squeeze or pour while letting gravity pull the water through one nostril and out the other 
    • It helps to breathe through your mouth and relax
  • Do not try to force water through your nose, especially if it’s severely blocked, as this can lead to nasal damage

It’s important to note that there are a few steps in this process that, if you’re not careful, could result in nasal irritation or a serious infection.

Questions? Call the Missouri Poison Center

It seems counterintuitive that water that is safe to drink is potentially unsafe for your nose, hence the call to spread awareness. If you or someone you know has questions about neti pots, Naegleria fowleri, or sinus rinsing in general, call the Missouri Poison Center. One of our specialists will be happy to answer any questions you may have 24/7.

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