Nasal Polyps

What are nasal polyps?

Nasal polyps are painless and benign (noncancerous) growths. They form in the mucosa (thin, soft tissue) that lines your nasal and sinus passages. They usually appear on both sides of your nose. Nasal polyps can get irritated and swollen, making it hard for you to breathe through your nose.

Small polyps are teardrop-shaped. But as they grow larger, they often resemble peeled grapes that are pink, yellow or gray.

Nasal polyps affect up to 40% of the general population. Anyone can get them. But they’re twice as common in people assigned male at birth (AMAB). Many people get them in their 30s or 40s. But the overall risk increases with age.

Nasal polyposis is another name for nasal polyps.

Nasal polyp symptoms

Small polyps in your nose might not cause symptoms at all. But if they start to grow, you could develop:

• Nasal congestion (stuffy nose).
• Rhinorrhea (runny nose).
• Headaches.
• Loss of taste and smell.
• Nosebleeds.
• Postnasal drip.
• Sinus pressure.
• Snoring.

When polyps grow large enough, they can block your nasal passages and sinuses, leading to:

• Frequent asthma attacks (in people with asthma).
• Repeated sinus infections (sinusitis).
• Sleep apnea or other sleep disorders.
• Difficulty breathing, even in people who don’t have asthma.

Nasal polyp causes

Healthcare providers know that inflammation causes nasal polyps. But they don’t know why some people go on to develop polyps because of inflammation while others don’t.

Chronic sinusitis — from allergies, infection or asthma — seems to be the most common reason polyps appear. Chronic sinusitis refers to nasal and sinus inflammation that’s lasted three months or longer. But several risk factors could contribute to the development of nasal polyps.

Risk factors

A risk factor is something that increases your chance of getting a certain condition. Nasal polyp risk factors include existing health conditions like:

• Asthma.
• Allergic rhinitis (hay fever).
• Chronic sinus infections.
• Cystic fibrosis.
• Hypersensitivity to certain NSAIDs (nonsteroidal anti-inflammatory drugs).

Genetics may also play a role in the development of nasal polyps. For instance, certain gene mutations (changes) may impact how your nasal tissues react to inflammation.

Complications of nasal polyps

Ongoing sinus infections associated with nasal polyps can result in rare but serious complications like:

• Bone infection (osteomyelitis) and bone loss.
• Abscesses (pockets of infection) that can spread to your eye sockets and brain.
• Meningitis (infection of the tissues around your brain and spinal cord).

How doctors diagnose nasal polyps

To diagnose nasal polyps, a healthcare provider will start with a physical examination. During this appointment, they may:

• Look inside your nose with a scope (a thin, tubelike instrument with a camera and light).
• Review your medical history (with a focus on allergies, asthma or sinus infections).
• Ask about your symptoms and how long you’ve had them.

Tests used to diagnose nasal polyps

If your healthcare provider needs more information, they may order one of these imaging tests to help them determine the size and location of each polyp:

• CT (computed tomography) scan.
• MRI (magnetic resonance imaging).

Your provider may also recommend allergy testing. This can help them identify allergens that lead to nasal inflammation and polyps.

How are nasal polyps treated?

Nasal polyp treatment depends on the severity of your condition. Medication and surgery are the two main approaches.

Even with surgical removal, nasal polyps may grow back over time. Your healthcare provider will talk to you about the likelihood of recurrence (return) and how you can manage it.

Medication

Medication usually doesn’t get rid of nasal polyps, but it can ease symptoms. Common treatments include:

• Steroid nasal sprays to shrink polyps and improve symptoms.
• Oral steroids (pills you swallow) like prednisone.
• Biologic medications, such as dupilumab injections. (Dupilumab contains monoclonal antibodies that stimulate your immune system and may shrink nasal polyps.)

Your healthcare provider also may prescribe antibiotics if you have an infection.

Surgery for nasal polyps

If medication doesn’t work — or if you have large polyps — you may need sinus surgery to remove them. Your provider may use nasal endoscopy to do one of these minimally invasive procedures:

• Polypectomy. A healthcare provider uses tiny instruments — like surgical scissors or snares — to grab onto and remove the polyps inside your nose. (A surgical snare is like a lasso that wraps around a polyp.)
• Balloon sinuplasty. A surgeon threads a small balloon through your nostril and into your sinus cavity. They slowly inflate the balloon to unblock your nasal passages. In some cases, they’ll remove nasal polyps at the same time.
• Functional endoscopic sinus surgery (FESS). A surgeon uses small instruments to remove polyps, diseased tissue, damaged bone and anything else that obstructs your nasal passages.

All these procedures are minimally invasive. That means your surgeon does everything through your nostrils. So, you won’t have visible incisions or sutures.

Can nasal polyps be prevented?

It’s not always possible to prevent nasal polyps. But here are a few things you can do to reduce your risk:

• Take all medications exactly as directed.
• Avoid breathing airborne allergens or irritants that can lead to nose and sinus inflammation.
• Use a humidifier in your home to help moisten your breathing passages.
• Use a saline nasal rinse or spray to flush out allergens or other irritants.
• Practice good hygiene.

What can I expect if I have nasal polyps?

Treatment can help you get rid of nasal polyps and make it easier for you to breathe through your nose. But unfortunately, polyps can come back after treatment. Some people need to stay on steroid medications or have repeat surgery to manage them.

People with loss of taste (ageusia) and loss of smell (anosmia) may not see a total improvement of symptoms after treatment. Ask your healthcare provider what you should expect in your case.

When should I see my healthcare provider?

Schedule an appointment with your healthcare provider if you have nasal polyp symptoms that last longer than 10 days.

Additionally, let your provider know if you notice a single growth on one side of your nose. This could be a nasal or paranasal tumor rather than a polyp.

What questions should I ask my doctor?

Consider asking your healthcare provider:

• How can I lessen the symptoms?
• Do I need medications, surgery or both?
• Should I restrict my activities?
• Do I need to see a specialist?
• Should I go to the emergency room for any symptoms?

Will nasal polyps go away on their own?

In some cases, nasal polyps can shrink on their own over time. But they rarely go away. People who have severe symptoms will likely need treatment.

Can you see nasal polyps by looking up your nose?

You usually can’t see nasal polyps by looking up your own nose. But if they grow large enough, a provider might be able to see them if they look up your nose with a nasoscope (lighted tool).

Can nasal polyps get dislodged?

Trauma or blowing your nose really hard can cause nasal polyps to swell or become dislodged. Nasal steroid sprays may help reduce inflammation and help the polyps return to their original position.

How can I remove nasal polyps at home?

You should never — under any circumstances — try to remove nasal polyps yourself. Doing so can lead to injury, excessive bleeding and infection.

A note from Cleveland Clinic

Nasal polyps can make your nose feel stuffy all the time. Left untreated, they can interfere with your breathing and ultimately lead to bone and tissue damage. If you develop nasal polyp symptoms, tell your healthcare provider right away. They can find a treatment option that works for your situation.