Specialist article: Nose
Dry noseCauses and what really helps
Your nose burns, feels tight and is full of crusts, even though you hardly have a cold? Here you will learn why mouth breathing, long-term use of nasal spray and dry air dry out the nasal mucosa, what brings relief and why a moist nose needs a pattern of breathing, swallowing and head balance.
Does this sound familiar?
Your nose is dry, and the spray only helps briefly?
What applies to you?
Tap whatever applies to you.
If several points apply, it is worth looking at the cause. Moistening brings relief but does little to change the cause. In our view, the cause usually lies in how much air flows through the nose. This breathing pattern can be trained.
The three most common causesPutting nasal spray in contextThe key points at a glance
- A dry nose is not a disease in its own right but a sign that the nasal mucosa cannot maintain its film of moisture. Typical signs are burning, crusts and slight nosebleeds.
- Common causes are mouth breathing, long-term use of decongestant nasal sprays and dry air. Saline solution and care bring relief; prescribed medicines such as corticosteroid spray should not be stopped on your own.
- The nasal mucous membrane needs the airflow of nasal breathing, and in our view nasal breathing is a pattern of breathing, swallowing and head balance. The training starts where a dry nose usually develops and creates the conditions for the mucous membrane to have air flowing through it and be humidified again.
Video
Dry nose: causes and what really helps
Das Video lädt erst nach dem Klick. Dann werden Daten an YouTube (Google) übertragen.
Symptoms
Dry nose: what lies behind it
Many people know a dry nose from the heating season. For some, however, it lasts all year round, and then there is more behind it than a dry winter.
There is no uniform definition of a dry nose. A review from the ENT clinic in Karlsruhe describes the range from a purely subjective feeling of dryness to visible crusts on the nasal mucosa1. Specialists speak of rhinitis sicca, literally dry inflammation of the nasal mucosa. The front section of the nose, where the inhaled air first strikes, is affected most often.
Feeling of dryness
The inside of the nose feels rough and parched, often together with itching or burning.
Crusts and scabs
Although little mucus forms, the nose feels blocked. Dried secretions stick to the mucosa.
Slight nosebleeds
The thin, dry mucosa tears more easily, for example when blowing your nose or loosening the crusts.
Blocked nose
The feeling of not getting enough air, even though there is no cold.
Impaired sense of smell
Odorants reach the olfactory mucosa less easily when the mucus film is missing.
As long as the cause continues, you are caring for a mucosa that dries out again day after day.The same review names eliminating triggering factors as the first element of treatment. Moistening, loosening crusts and care are added to this1.
Nasal mucosa
What the nasal mucosa does day after day
The nose is not a pipe that air simply passes through. It is a functional organ that prepares the air before it reaches the lungs.
The nasal mucosa is covered by a thin film of mucus. It is produced by goblet cells and small glands in the mucosa. Fine ciliated hairs, the cilia, sit on the surface. They beat in coordinated waves and push the mucus film, together with dust and germs, towards the throat, where it is swallowed unnoticed.
This cleaning route is called mucociliary clearance. It only works as long as the film is moist enough. If it dries out, the cilia slow down, the mucus becomes thick, and the film turns into crusts.
wore fine sensors in their noses in Ulm. The humidity and temperature of the inhaled air rose sharply already in the front section of the nose2
When you breathe in, the nose releases moisture; when you breathe out, it recovers part of it. You can read more about the nose as a filter and laboratory in the article on allergies and nasal breathing.
A moist nose is not a state. It is the result of constant work.Mucus production, ciliary beating and humidification run without interruption. For this they need a stimulus: the airflow of nasal breathing.
Distinction
Dry nose or dry mouth? Two mucous membranes
The two often occur together, and both frequently have the same starting point. Nevertheless, they are two different complaints.
Dry nose
- Affects the nasal mucosa with its mucus film
- Burning, crusts, slight nosebleeds
- Important triggers: long-term use of nasal spray, dry air, too little airflow through the nose
- Relief with saline solution and nasal care
Dry mouth
- Affects the oral mucosa and saliva
- Sticky tongue, thirst at night, chapped lips
- Important triggers: medication, salivary gland disorders, an open mouth at night
- Relief with water, saliva substitutes, lip care
The common bridge is mouth breathing. Breathing through the mouth dries out the mouth and deprives the nose of the airflow it needs.
This article is about the nose. If you mainly wake up with a dry mouth and a sticky tongue, the article on dry mouth covers the causes, from medication to Sjögren’s syndrome, and what happens in the mouth at night. It is often worth looking at both sides together, because an open mouth at night affects both mucous membranes.
Causes
Dry nose causes: three common routes
A dry nose rarely comes out of nowhere. We encounter three routes particularly often, and they reinforce each other.
Mouth breathing
If the air flows through the mouth during the day or at night, the nose lacks airflow. In our view, the mucosa thereby loses the stimulus that keeps humidification and cleaning going.
Long-term use of decongestant nasal spray
In the short term it opens the nose. Used over weeks, the nose can block up increasingly quickly without spray, and the mucosa suffers3.
Dry air
Heated air in winter, air conditioning and cabin air on aeroplanes draw water from the mucosa. Mucus transport slows down7.
Further triggers are operations on the turbinates, against whose uncritical removal the Karlsruhe review warns1. Added to this are dust, smoking, some medications and radiotherapy in the head area.
A crooked nasal septum is part of the anatomical norm and, in our view, usually does not explain a dry nose. An operation can improve patency, but it does not change the learned breathing pattern. Anyone who has breathed through the mouth for years does not automatically breathe through the nose after a straightening. That is why we consider it the wrong route to operate on the septum for a dry nose before nasal breathing itself has been looked at and trained. More on this in the article on the deviated nasal septum.
Have a dry nose examined by a doctor if it bleeds frequently, if only one side is affected, if a foul smell develops or if your sense of smell gets worse. These signs can point to findings that need their own treatment.
Mouth breathing
Mouth breathing: when the nose is not used
In the video, Dr. Berndsen describes an observation that recurs in many affected people: even as children, they could not breathe well through their nose.
There was often a reason back then, such as frequent infections or an enlarged adenoid. The reason passed, the pattern remained. Consciously, nasal breathing does work. But at the first exertion, in conversation or during sleep, the mouth takes over again.
With nasal breathing, the air passes over the nasal turbinates, is warmed, moistened and cleaned, and only then reaches the throat. The lips are closed, the tongue rests against the palate, and the mouth is sealed.
If the mouth is open, the air takes the shorter route. The nose then remains almost without airflow for hours, especially at night, when nobody pays attention to it.
In our view, the nasal mucosa behaves like tissue everywhere else in the body. What is integrated into a function is used and stays capable. What is not used declines. If the airflow is missing, the stimulus for humidification, ciliary beating and blood flow is missing. We do not know of a direct study on mouth breathing and dry nose, which is why we present this as our model.
In our understanding, constant mouth breathing is not harmless. The air bypasses the filtering, humidification and warming of the nose and reaches the throat and lower airways dry and uncleaned, while the nasal mucous membrane loses its stimulus without airflow. In our view, mouth breathing is therefore usually not an incidental finding, but a link at the start of the chain at the end of which a dry, crusted nose can stand.
The nose is used little
It often begins in childhood.
The airflow is missing
Humidification and cleaning run on a low flame.
The mucosa dries out and swells
Crusts form, the nose feels blocked.
The mouth steps in
The air takes the easier route, and the nose is used even less.
The spray is added
For many people, this starts a second cycle.
Nasal spray
Nasal spray: what it can do and when it tips over
Not all nasal sprays are the same. For a dry nose, it matters which type you use and for how long.
Decongestant sprays
Xylometazoline or oxymetazoline narrow the blood vessels of the mucosa, and the nose opens within minutes. Intended for a few days; the package leaflet states the maximum duration.
Corticosteroid sprays
They dampen inflammation and are often prescribed by doctors for longer periods for allergies or chronic inflammation.
Saline and care sprays
Saline solution, seawater or additives such as hyaluronic acid and dexpanthenol moisten without narrowing the blood vessels.
Anyone who uses decongestant spray for weeks knows the pattern. The effect lasts for a shorter time, afterwards the nose is more blocked than before, and the next spray follows sooner. Specialists speak of rebound and, with continued use, of rhinitis medicamentosa, colloquially known as nasal spray dependence.
In a Swedish study, 30 healthy people used oxymetazoline, the preservative benzalkonium chloride or a placebo for four weeks. With oxymetazoline, the nose felt more blocked at the end and reacted markedly more sensitively. The preservative alone made the mucosa swell3.
of oxymetazoline were enough in healthy people for the nose to feel more blocked and react more sensitively than with placebo3
from people with long-term use of decongestant drops showed damaged epithelium and lost ciliated cells under the electron microscope4
The evidence is not consistent. In 2013, a French expert panel found contradictory results and considered the effects of the spray difficult to separate from those of the underlying inflammation5. For everyday life, this changes little. Decongestant spray belongs in short phases, not in long-term use, and if you need it for longer, your nose needs a different solution.
Never stop nasal sprays prescribed by a doctor, especially corticosteroid spray, on your own. If you want to get off decongestant spray, get support. A proven approach is to stop the spray and bridge the transition period with a corticosteroid spray6. After that, the underlying cause should be treated. Training nasal breathing can be combined with this.
Indoor climate
Dry air: heating, air conditioning, aeroplanes
Cold outdoor air contains little water. When it is heated indoors, the relative humidity drops, and the nose has to release more moisture.
That is why symptoms increase in winter, with air conditioning and on flights.
A simple test shows how quickly this affects cleaning. A tiny crumb of sweetener is placed at the front of the lower nasal turbinate, and the time until it can be tasted in the throat is measured. That is how long the mucus film takes for the journey.
was the average time the sweetener needed with normal room air, measured in 11 healthy non-smokers7
was the time after the same people had breathed dry air through the nose for 30 minutes7
The authors explain this by the mucosa losing water. The mucus becomes thicker, and the cilia make less progress7. Dry air, however, affects everyone. Why do some people react with crusts and others hardly at all? In our view, one deciding factor is whether the mucosa is kept in practice through regular nasal breathing and has reserves.
When is your nose driest?
Relief
What helps with a dry nose: moistening and care
Care relieves the acute symptoms of the nose. A study from German ENT practices shows how far it goes.
240 people with a dry nose used one of three sprays for four weeks: hyaluronic acid, hyaluronic acid with dexpanthenol or simple isotonic saline solution. In all three groups, the symptoms decreased markedly, including with the simple saline solution8. A limitation is that a manufacturer funded the study and there was no group without spray.
Relieving the symptoms
- Saline or seawater spray without preservatives
- Nasal rinse with saline solution to loosen crusts
- Nourishing nasal ointment for the front section of the nose
- Raise the humidity in the bedroom, air the room regularly
Addressing the cause
- Stop decongestant spray in an orderly way together with your doctor’s practice
- Reduce dry air and dust at the workplace
- Make nasal breathing the norm during the day and at night
- Train breathing, swallowing and head balance as a pattern
The two are not mutually exclusive. Care makes the transition period more pleasant; nasal breathing gives the mucosa back its task.
Dr. Berndsen sums it up in the video. Saline spray and nasal rinses moisten temporarily, do no harm and do many people good because the crusts finally come out. The decisive question comes afterwards: do you actually breathe through the now clear nose, or does habit switch back to the mouth?
The triad
Nasal breathing is a pattern
A nose that only has air flowing through it now and then stays dry. For it to be used constantly, three basic functions have to work together.
Breathing
The air flows calmly through the nose, during the day and in sleep. This gives the mucosa its stimulus.
Swallowing
After every swallow, the tongue settles against the palate and the lips rest gently together. The mouth is sealed, and the air stays in the nose. The starting point is the tongue reference position.
Head balance
When the head is balanced over the body, the mouth closes more easily. If the head moves forward, in our view the mouth opens more easily.
These three functions are connected. You swallow many hundreds to a thousand times a day, and with each of these swallows the mouth is sealed anew, or not. Upright head balance makes lip closure easier, and the sealed mouth directs the air through the nose.
In the video, Dr. Berndsen describes the vicious circle. If the nose does not work, the habit cannot change, and if the habit does not change, the nose does not get going.
A rinsed-clear nose is an opportunity. It is used only through habit.Nasal breathing is a stored sequence. Good intentions are not enough for this, but repetition is.
We call this coupling of the basic functions the triadic functional circuit. In our view, it stands at the beginning of many causal chains that can extend from a dry nose to snoring and frequent sinus infections.
Training
Training nasal breathing: putting the nose back to use
If you follow this logic, a dry nose can be addressed most deeply where, in our view, it usually develops: with nasal breathing as a pattern. Care sprays and humidifiers provide relief; the training aims to put the nose back into use by day and by night. It thus creates the conditions for the mucous membrane to have air flowing through it again, to be humidified and cleaned, and for the complaints to be able to improve.
The FaceFormer lies in the oral vestibule, behind the lips and in front of the teeth. In the basic exercise, you squeeze the lip wedge together with your lips, bite briefly with your back teeth and swallow. The negative pressure draws the tongue to the palate, and the air takes the route through the nose.
From about week 6, the breathing exercise is added. You breathe in through the nose for around six seconds, swallow during the pause and breathe out for six seconds. The hand on your abdomen shows whether the breathing goes calmly into the abdomen.
- From day 1
Basic exercise
Three times a day for a few minutes with the FaceFormer ZERO. The free app guides you.
- After a few weeks
Night and pull exercise
At night you wear the ZERO as soon as the basic exercise is established. This way you also breathe through your nose during sleep.
- After a few weeks
Switching to the ONE
During the day you train with the FaceFormer ONE. It is the same size as the ZERO, just made of a firmer material.
- From around week 6
Breathing exercise
Calm nasal breathing with breathing pauses that you extend step by step.
- Over months
Pattern and mucosa
The exercise manual expects six to twelve months until the new sequences run without thinking.
A pattern that has become ingrained over many years does not change overnight, and there is no quick solution for it. A mucous membrane that has been without airflow for a long time also needs time until it works again. You have to keep at it, and it can be worth it.
If the mucosa reacts with irritation at first, take a short break and continue with fewer repetitions. If the nose is completely blocked, have this checked before training. There is no study with the FaceFormer on dry nose. You can find what has been investigated and what has not under Studies and science. A separate plan applies to children; more under FaceFormer for children.
Everyday life
Dry nose: what you can do yourself
Lips closed, nose open
The lips rest gently together, the tip of the tongue at its reference point behind the upper front teeth. This way the air takes the route through the nose by itself.
Saline solution instead of long-term spray
You can use saline or seawater spray without preservatives as often as it does you good. Decongestant spray remains for short phases.
Loosen crusts gently
Soften crusts with saline solution instead of pulling them off. This way the mucosa tears less often.
Keep an eye on the indoor climate
Do not overheat the bedroom, air it briefly and thoroughly, humidify if the air is very dry and keep the humidifier clean.
Pay attention to your mouth at night
If you wake up with a dry nose and a dry mouth, you probably breathe through your mouth at night. Taping your mouth shut is not a solution; you can read why in the article on mouth taping.
Do not stop prescribed treatment on your own
If you use corticosteroid spray or other medicines on medical advice, discuss changes with your doctor’s practice. The training can be combined with them.
Questions
Frequently asked
What helps quickly with a dry nose?
For the moment, saline or seawater spray, a nasal rinse and a nourishing nasal ointment help. They moisten the mucosa and loosen crusts. In a study with 240 affected people, symptoms also decreased markedly with simple saline solution. The effect lasts a few hours. For the nose to stay moist by itself, it needs the airflow of nasal breathing.
Why is my nose so dry in the morning?
In our view, it is usually due to an open mouth at night. The air then flows through the mouth, and the nose receives hardly any airflow for hours. Often the mouth is also dry in the morning. Dry heated air in the bedroom can make this worse.
Can nasal spray dry out the nose?
Decongestant nasal spray can strain the mucosa with continuous use. In studies, the nose felt more blocked after four weeks, and tissue samples from long-term users lacked ciliated cells. The evidence is not consistent, but the advice is clear: decongestant spray only for a few days. Saline sprays without preservatives do not dry out the nose.
How do I get off decongestant nasal spray?
Ideally with medical support. A proven approach is to stop the spray and bridge the transition period with a corticosteroid spray prescribed by your doctor’s practice. Saline solution makes the first few days easier. At the same time, it is worth training nasal breathing so that the nose is actually used afterwards.
Should I stop my corticosteroid nasal spray?
No, not on your own. Corticosteroid sprays work differently from decongestant sprays and are often deliberately prescribed for longer. If you notice a dry nose, talk to your doctor’s practice about it. Training nasal breathing can be combined with the treatment.
What is the difference between a dry nose and a dry mouth?
With a dry nose, the nasal mucosa lacks its film of moisture; with a dry mouth, saliva is lacking. The two often occur together because mouth breathing dries out the mouth and deprives the nose of airflow. More about the mouth in the article on dry mouth.
When should I have a dry nose checked?
If the nose bleeds frequently, only one side is affected, a foul smell develops or your sense of smell gets worse. Persistent dryness after nasal surgery also belongs in an ENT practice.
How long does it take for the nasal mucosa to recover?
That varies a great deal. A breathing pattern that has become ingrained over years does not change overnight. The exercise manual expects six to twelve months until the new patterns run without thinking.
More articles from the knowledge section
Where to go next
Sources
- Hildenbrand T, Weber RK, Brehmer D (2011). Rhinitis sicca, dry nose and atrophic rhinitis: a review of the literature. European Archives of Oto-Rhino-Laryngology 268(1):17-26. PMID 20878413. Source
- Keck T, Leiacker R, Heinrich A, Kühnemann S, Rettinger G (2000). Humidity and temperature profile in the nasal cavity. Rhinology 38(4):167-171. PMID 11190750. Source
- Graf P, Hallén H (1996). Effect on the nasal mucosa of long-term treatment with oxymetazoline, benzalkonium chloride, and placebo nasal sprays. The Laryngoscope 106(5 Pt 1):605-609. PMID 8628089. Source
- Knipping S, Holzhausen HJ, Riederer A, Bloching M (2006). Ultrastrukturelle Veränderungen der Nasenschleimhaut bei Rhinitis medicamentosa (Ultrastructural changes in human nasal mucosa in rhinitis medicamentosa). HNO 54(10):742-748. PMID 16477462. Source
- Mortuaire G, de Gabory L, François M, Massé G, Bloch F, Brion N, Jankowski R, Serrano E (2013). Rebound congestion and rhinitis medicamentosa: nasal decongestants in clinical practice. Critical review of the literature by a medical panel. European Annals of Otorhinolaryngology, Head and Neck Diseases 130(3):137-144. PMID 23375990. Source
- Graf P (1997). Rhinitis medicamentosa: aspects of pathophysiology and treatment. Allergy 52(40 Suppl):28-34. PMID 9353558. Source
- Salah B, Dinh Xuan AT, Fouilladieu JL, Lockhart A, Regnard J (1988). Nasal mucociliary transport in healthy subjects is slower when breathing dry air. European Respiratory Journal 1(9):852-855. PMID 3229484. Source
- Thieme U, Müller K, Bergmann C, Bock B, Wurzer-Materna N, Shahab T, Zeman F, Eberhardt Y, Huppertz G, Koller M, Meiser P (2020). Randomised trial on performance, safety and clinical benefit of hyaluronic acid, hyaluronic acid plus dexpanthenol and isotonic saline nasal sprays in patients suffering from dry nose symptoms. Auris Nasus Larynx 47(3):425-434. PMID 32067777. Source
Get started
Ready for the training?
The free FaceFormer app guides you through the basic exercises, counts along and reminds you of your sessions. If you wish, a practice from the practitioner directory can support you.
FaceFormer ZERO + ONE
Both material hardnesses for getting started, day and night. The set for adults.
FaceFormer ZERO
The softer FaceFormer for getting started, for children and for the night.
FaceFormer ZERO Children’s Set
ZERO with hygiene box, plush bag and success book with stamp.
FaceFormer training aims to restore the physiological setting of the basic functions of breathing, swallowing and head balance, with lip closure and the tongue reference position, thereby creating the conditions under which symptoms can improve. It does not replace a medical assessment. You can find practitioners near you in the practitioner directory.
