[Rhinitis medicamentosa: an increasing therapeutical problem]

The most common upper respiratory illness is rhinitis. The majority of ENT specialists and general practitioners prescribe topical decongestants as first line therapy in rhinitis, independently of causes and kind of rhinitis. Long term use of topical vasoconstrictors for the nose may result in rhinitis medicamentosa, the rebound swelling of the nasal mucosa. The swelling probably is due to vasodilatation, but it may be also due to interstitial oedema. The prolonged use of decongestants may destroy the nasal cilia and mitochondria of epithelial cells, disturbing their function. Rhinitis medicamentosa from topical vasoconstrictor abuse results in nasal obstruction which can be life-threatening in neonates. Rhinitis medicamentosa is a increasing therapeutical problem that is best managed by prevention.