Does Wildfire Smoke Cause Sinus Issues? - The New York Times

Q: I've noticed I get a runny nose when there's wildfire smoke in the air. Should I be concerned?

It's well understood that wildfire smoke can wreak havoc on the body — taxing the lungs and heart, stinging the eyes and prompting headaches.

But nasal passages are particularly susceptible, said Dr. Mark Dykewicz, an allergist and immunologist at Saint Louis University School of Medicine.

Even brief exposures to wildfire smoke can irritate your nose, leading to sneezing, congestion and the sniffles, he said. Smoke can also trigger additional nasal issues, including flare-ups of allergy symptoms and increased vulnerability to sinus infections. Here's what to know.

Why your sinuses suffer

Children, older adults and people with asthma, weakened immune systems or other underlying chronic conditions are particularly vulnerable to developing health issues from wildfire smoke, said Laura Corlin, an assistant professor of public health and community medicine at Tufts University School of Medicine.

Some people in these groups may find it harder to fend off harmful pollutants, she said.

If you have a seasonal or environmental allergy — such as to pollen, dust, pet dander or mold — you may also be more likely to develop nasal symptoms when smoke is in the air, Dr. Dykewicz said. In such cases, your nasal lining is already inflamed as it defends against those allergens, he said, so it may produce an outsize response when it comes into contact with particulate matter in smoke.

Even if you're not in a high-risk group, wildfire smoke can still inflame and irritate the tissue in your nose, Dr. Corlin said. This can cause congestion and tender cheeks, she said, making it feel as if you have a sinus infection. Though "from the purest medical standpoint," Dr. Dykewicz said, that does not necessarily mean "that it's truly sinusitis."

Wildfire smoke exposure can also weaken your immune system as it strains to protect itself against the air pollution, which in turn can make you more susceptible to illnesses in general — such as the flu, Covid-19 or an actual sinus infection, Dr. Corlin said.

When you breathe in smoke, it passes through the mucus membranes in your nose, which are lined with hairlike structures called cilia; these are the first line of defense against dirt, dust and other particles.

Some scientists think that wildfire smoke can damage those cilia, making it more difficult to clear mucus from the nose, said Dr. Raj Fadadu, a researcher at the University of California, San Francisco School of Medicine who has studied the health effects of wildfire smoke. This may provide a habitable environment for bacteria to grow, he said, which could potentially lead to sinus infections.

How to handle sinus struggles

If wildfire smoke is present and you're experiencing symptoms in your nose or anywhere else in your body, stay inside, Dr. Corlin said. If you must go outside, wear a well-fitting mask like an N95. Rest and hydration can also improve your symptoms, and can help fight off a potential infection, Dr. Corlin added.

Nasal sprays can provide short-term relief from sneezing and congestion, Dr. Dykewicz said. But if you use sprays containing decongestants like oxymetazoline (Afrin) or phenylephrine (Neo-Synephrine), don't use them for longer than three to five days. Any more than that may trigger what doctors call rebound congestion, which can further irritate and swell your nasal passages, making a stuffy or runny nose worse.

Nasal irrigation, such as with a neti pot, may also help alleviate symptoms, Dr. Dykewicz said, but if you do try a neti pot, be sure to use sterile or distilled water, or water that has been boiled for at least one minute and then cooled.

If your symptoms last longer than 10 days, consider consulting a doctor, Dr. Fadadu said, as you may have a sinus or other type of infection that might benefit from antibiotics.

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