Are nasal steroids safe?

Nasal steroids have emerged as an integral part of rhinitis management. Most studies have shown no evidence of significant hypothalamic-pituitary-adrenal axis suppression from nasal steroid use, at least based on dynamic testing. Bone mineral density loss, glaucoma, and cataract formation are risks associated with systemic steroids, but reports with nasal steroid use are few. Growth retardation has been seen with some nasal steroids, but not others, based on stadiometric growth studies. Further studies are certainly needed to resolve this issue. Nasal steroids, in general, have an excellent safety record.