How to Use a Neti Pot or Nasal Rinse Correctly

What does nasal irrigation actually do?

A nasal rinse delivers a stream of saline (salt water) through one nostril and out the other, mechanically clearing:

• Thick or sticky mucus
• Allergens such as pollen, dust, and mold spores
• Viral particles during and after a cold
• Inflammatory debris in sinusitis

Beyond physical clearing, saline supports the cilia — the tiny hair-like structures that move mucus toward drainage — by maintaining moisture and appropriate salt concentration at the mucosa.

The AAO-HNS sinusitis guideline identifies nasal saline irrigation as a first-line recommendation for sinusitis management and a recommended adjunct for both acute and chronic cases 1Ref 1Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Kumar KA, Kramper M, et al. (2015).Clinical Practice Guideline (Update): Adult Sinusitis.Nasal saline irrigation as first-line recommendation for sinusitis; high-volume irrigation (≥200 mL) carries the strongest evidence; recommended frequency for acute and chronic sinusitis. High-volume irrigation (200 mL or more per session) has the most evidence for sinusitis.

Step-by-step: how to use a neti pot or squeeze bottle

What you need: - A neti pot, squeeze bottle, or pulsed irrigator - Distilled, sterile, or previously boiled and cooled water (see water safety below) 2Ref 2Centers for Disease Control and Prevention (2024).How to Safely Rinse Your Sinuses — Naegleria fowleri Prevention.CDC warning against untreated tap water in nasal irrigation; documents rare fatal Naegleria fowleri and Acanthamoeba infections linked to tap-water neti pot use; recommends distilled water, sterile water, boiled-and-cooled tap water (1 min at sea level, 3 min above 6,500 ft), or NSF 53/58-filtered water - Saline packets (premixed) or plain non-iodized salt (typically 1/4 to 1/2 teaspoon per 8 oz of water, or per manufacturer's directions)

Steps: 1. Prepare the saline solution. Use the provided packets or mix salt into the appropriate water. The solution should be lukewarm — not cold, which is uncomfortable; not hot, which can cause burns. 2. Stand over a sink. Lean forward and tilt your head to one side so one nostril is higher than the other. 3. Insert the spout gently into the upper nostril. Do not press it tightly — allow air to circulate. 4. Breathe through your mouth throughout the rinse. 5. Pour or squeeze the saline in. Gravity and gentle pressure carry the solution through the nasal passage and out the lower nostril (or possibly the mouth initially). This is normal. 6. Let the solution drain fully. Gently blow your nose once before switching sides. 7. Repeat on the other side. 8. Clean the device immediately after use: rinse with distilled water, air dry completely, and store in a clean place 2Ref 2Centers for Disease Control and Prevention (2024).How to Safely Rinse Your Sinuses — Naegleria fowleri Prevention.CDC warning against untreated tap water in nasal irrigation; documents rare fatal Naegleria fowleri and Acanthamoeba infections linked to tap-water neti pot use; recommends distilled water, sterile water, boiled-and-cooled tap water (1 min at sea level, 3 min above 6,500 ft), or NSF 53/58-filtered water.

If you feel stinging: the saline may be too concentrated or not properly dissolved. Follow the mixing ratio exactly. Isotonic saline (approximately 0.9% salt) matches body fluid concentration and should not sting.

Water safety: why tap water can be dangerous

Tap water in many areas contains low levels of microorganisms that are safe to drink (stomach acid kills them) but can be dangerous when introduced directly into the nasal passages. The CDC has documented rare but serious infections — including Naegleria fowleri (a rare but potentially fatal amoeba) and Acanthamoeba — linked to using untreated tap water in nasal irrigation devices 2Ref 2Centers for Disease Control and Prevention (2024).How to Safely Rinse Your Sinuses — Naegleria fowleri Prevention.CDC warning against untreated tap water in nasal irrigation; documents rare fatal Naegleria fowleri and Acanthamoeba infections linked to tap-water neti pot use; recommends distilled water, sterile water, boiled-and-cooled tap water (1 min at sea level, 3 min above 6,500 ft), or NSF 53/58-filtered water.

Safe water options (CDC-recommended) 2Ref 2Centers for Disease Control and Prevention (2024).How to Safely Rinse Your Sinuses — Naegleria fowleri Prevention.CDC warning against untreated tap water in nasal irrigation; documents rare fatal Naegleria fowleri and Acanthamoeba infections linked to tap-water neti pot use; recommends distilled water, sterile water, boiled-and-cooled tap water (1 min at sea level, 3 min above 6,500 ft), or NSF 53/58-filtered water: - Distilled water (most common; available at grocery stores) - Sterile water (labeled for medical use) - Tap water that has been boiled for at least 1 minute (3 minutes at elevations above 6,500 feet) and then cooled to lukewarm before use - Tap water filtered through a filter rated NSF 53 or NSF 58 (absolute pore size of 1 micron or smaller)

Once water is treated appropriately, nasal irrigation is very safe.

How often should you rinse?

Frequency depends on your condition and symptoms 1Ref 1Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Kumar KA, Kramper M, et al. (2015).Clinical Practice Guideline (Update): Adult Sinusitis.Nasal saline irrigation as first-line recommendation for sinusitis; high-volume irrigation (≥200 mL) carries the strongest evidence; recommended frequency for acute and chronic sinusitis:

• Acute sinusitis: twice daily rinsing is commonly recommended during the active infection
• Chronic sinusitis or allergic rhinitis: once daily (often in the morning) helps manage ongoing congestion and inflammation
• Maintenance for frequent sufferers: some people rinse once daily year-round; others rinse only during allergy season or when they feel a cold coming on

The most important factor is consistency — irregular use is less effective than a steady routine.

When nasal irrigation is not appropriate

Nasal irrigation is safe for most adults, but avoid it if:

• You have a blocked nostril from a deviated septum or nasal polyps that prevents flow — the solution will not pass through properly and pressure can build uncomfortably
• Your sinuses feel completely blocked and pressure is severe — in this case, see a clinician before irrigating
• You have active ear infections or known ear pressure problems — saline can reach the eustachian tube opening and worsen middle-ear symptoms in some people

Also avoid using isotonic saline without your clinician's approval if you have had recent sinus surgery — your surgeon will specify when and how to restart irrigation after a procedure.