I have nasal polyps. Do allergies cause polyp recurrence?

Question

Hello doctor,

I am 37 and was recently told I have nasal polyps after a CT scan showed blockage in both sinuses. I have been using a steroid nasal spray for two months, but I still have congestion and loss of smell.

So, my concerns are:

How long does it usually take for sprays to show full effect?
Would surgery be needed if the polyps do not shrink with medicines?
Additionally, can allergies or asthma cause the polyps to recur more quickly, even after surgery?
My blood eosinophil count was slightly high (650 cells/µL). Does this mean the condition is more severe or linked to an underlying inflammatory problem?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Thanks for reaching out. You are dealing with chronic rhinosinusitis with nasal polyps, which is an inflammation-driven condition.

Sprays help, but I want to set the right expectation up front: nasal steroid sprays rarely make established polyps disappear completely. Their main job is to shrink them, calm the lining, open the sinus drainage a bit, and help prevent new growths.

Most people need eight to 12 weeks (sometimes up to three to four months) of strict daily use for the full effect.

The method of using the spray also matters. Firstly, do a saline rinse, lean slightly forward, aim the nozzle outward toward the ear, and sniff gently so the medicine coats the sides rather than shooting straight back.

If congestion and smell loss remain significant after a true three to four month trial with correct technique, the next steps are to intensify medical therapy or consider endoscopic sinus surgery (FESS).

Surgery becomes reasonable if symptoms stay moderate to severe despite optimized medicines. It is very effective for relief, but not a “forever cure” because the underlying inflammation can make polyps return.

That is why long-term nasal steroids and saline rinses continue even after surgery.

Your eosinophil count suggests allergic inflammation, which is common in polyp disease and often links with allergies and asthma. This pattern tends to respond to steroids but has a higher chance of coming back, especially if allergies or asthma are under-treated.

Allergy testing and tightening asthma control can meaningfully reduce recurrence. If standard therapy (sprays, rinses, short oral steroids, even surgery) is not enough, biologic injections that target the inflammation at its source can help.

I hope you find this helpful.

Thank you.