Nasal polyps symptoms: What are the early signs of nasal polyps?

Overview: What do nasal polyps feel like?

Nasal polyps are small, teardrop-shaped, noncancerous growths in the nose and sinuses. They commonly occur in people with chronic rhinosinusitis (CRS), asthma, and aspirin sensitivity. About 4% or more of the population may have nasal polyps, but many don’t realize they have them because they have no symptoms. Other people may have noticeable symptoms such as a runny nose, stuffy nose, or sneezing but do not realize polyps are the cause, especially if they have allergies, hay fever, or frequent infections. Large polyps can cause more serious symptoms like pressure, pain, headaches, and nasal airway blockage. Some people may be unable to breathe through their noses because of the blockage. Symptoms can be severe enough to interfere with sleep and generally reduce the quality of a person’s daily life. Additionally, nasal polyps can make people more vulnerable to sinus infections, so chronic sinusitis may be a warning sign. People won’t know for sure until a doctor examines them. Because nasal polyps form in the nasal and sinus cavities, they usually can’t be seen without special instruments.

What are the early signs of nasal polyps?

The early signs of nasal polyps are often no signs at all. Many people will not know they have nasal polyps, especially if the polyps are small in size. In some people, the early signs may seem more like allergy or cold symptoms, such as:

• Stuffy nose

• Runny nose

• Sneezing

• Postnasal drip

Other nasal polyps symptoms

The most common symptoms of nasal polyps are:

• Nasal congestion

• Nasal obstruction

• Runny nose

• Postnasal drip

• Sneezing

• Facial pressure

• Facial pain

• Loss (or reduced sense) of smell

• Loss (or reduced sense) of taste

• Itching in the area around the eyes

• Chronic sinus infections

Nasal polyps vs. acute rhinosinusitis symptoms 

Nasal polyps often occur with chronic rhinosinusitis, a persistent inflammation of the nasal and sinus membranes. About 25% to 30% of people with chronic rhinosinusitis will develop nasal polyps. For both CRS and nasal polyps, symptoms are chronic. On the other hand, acute rhinosinusitis symptoms come on suddenly and eventually recede. The symptoms are very similar, but the onset and duration are different. The causes are also different. Nasal polyps are usually due to allergies or sensitivities. A viral or bacterial infection usually causes acute rhinosinusitis. 

RELATED: Sinus infection symptoms: what are the early signs of sinus infection?

Types of nasal polyps: How can I tell which one I have?

Healthcare professionals distinguish between two major types of nasal polyps. Ethmoidal polyps, which are more common, develop from the ethmoidal sinuses (between the nose and eyes). Antrochoanal polyps, which are less common, develop in the maxillary sinuses (above the teeth/below the nose and cheeks). However, the only way to tell the difference is to look at them through special instruments. The symptoms and treatments are largely identical.

When to see a doctor for nasal polyps symptoms

See a healthcare professional if any nasal polyp symptoms are experienced, particularly if breathing through the nose becomes difficult. Nasal polyps can be successfully treated, and complications like sleep disturbance, snoring, sleep apnea, loss of smell, and quality of life issues can be avoided. Nasal polyps don’t require emergency treatment unless breathing is difficult or there’s severe pain.

Clinicians diagnose nasal polyps through a medical history, a physical exam, and sometimes a CT scan of the sinuses. However, the centerpiece of diagnosis is an endoscopic exam of the nasal cavities and sinuses. In this procedure, the clinician inserts a small tube into the nose. At the end of the tube is a light and a camera or magnifier that allow the doctor to see the inside of the nose and the sinus cavities. If the polyps are too deep, a CT scan may be needed. If the doctor spots a growth that may be cancerous, a sample will be cut off for biopsy.

After diagnosing nasal polyps, the clinician will move on to the next step: figuring out the cause. This part of the diagnosis is important. Nasal polyps frequently come back after treatment unless the cause of the polyps is treated, too. In this stage, other tests may be necessary, such as blood tests, a skin-prick test (allergy test), a biopsy to identify a fungal infection, or a sweat test to diagnose cystic fibrosis. 

Complications of nasal polyps

Untreated nasal polyps can result in complications such as:

• Sleep disturbances

• Obstructive sleep apnea

• Fatigue due to poor sleep

• Sinus infections

• Permanent loss of smell

• Reduced quality of life

How to treat nasal polyps symptoms

Nasal polyps can be shrunk or removed with treatment. The first line of treatment is nasal corticosteroid sprays like Flonase Allergy Relief (fluticasone) or Rhinocort Allergy (budesonide). Sometimes, this is all that’s needed to shrink the polyps. Nasal steroids have minimal side effects, usually just stinging, dryness, and occasional nosebleeds. To be successful, however, nasal steroids also require regular saline irrigation to clean the nasal passages.

If the steroid sprays don’t succeed, the clinician may also prescribe an oral corticosteroid. Oral steroids are more powerful at shrinking polyps, but they can have more serious side effects. Biologic drugs such as Dupixent (dupilumab) may be used if steroids don’t work or polyps keep growing back. These drugs are injected every two to four weeks. 

If medications don’t work or there’s a significant blockage, surgery may be warranted. A specialist in ear, nose, and throat diseases called an otolaryngologist will remove the polyps using a procedure called endoscopic sinus surgery. It’s a minimally-invasive outpatient procedure performed with a nasal endoscope and tiny surgical tools. 

Nasal polyps often grow back unless the allergy, infection, or medical condition that causes them is treated. For allergies, that may mean avoiding allergens and using antihistamines and/or steroids to control inflammation. If nasal polyps are due to fungal infection, then treatment will include antifungal medications to clear the infection. Cystic fibrosis is a serious and lifelong illness that will require an entire team of healthcare professionals and a system of interrelated treatments. 

Living with nasal polyps

Even after successful treatment, nasal polyps often return. The best way to prevent recurrence is to prevent inflammation of the sinuses and nasal passages:

• Take all medications as instructed 

• Avoid allergens

• Avoid anything that irritates the nose or sinuses, like smoke, dust, or pollution—wearing a face mask can help

• Use saline irrigation, with distilled or (cooled) heat-sterilized water, regularly to clean out irritants, dust, debris, and other foreign objects

• Use an air purifier to clean allergens and irritants from the air

FAQs about nasal polyps symptoms

Can nasal polyps affect your eyes?

Nasal polyps form in the sinuses directly below the eyes. If they grow out of control, they can block the nasal passages and put pressure on the bone below the eyes, increasing the pressure within the eyes. More worrisome is the increased risk of sinus infections. If a sinus infection spreads upward to the area around the eye, it can cause swelling around the eyes or vision changes.

Do nasal polyps cause excessive mucus?

Runny noses and postnasal drip are common symptoms of nasal polyps. If the polyps are a long-term consequence of a fungal infection, the discharge can be thick and brown, like peanut butter.

Do nasal polyps cause smell?

When mucus and fluid can’t drain because nasal polyps block the way, the fluid can fill with bacteria. It's likely to have an unpleasant aroma. If it drips down the back of the throat, the breath won’t smell good, either. On the other hand, nasal polyps affect a person’s sense of smell. People have a reduced and sometimes distorted sense of smell as polyps grow. Things that generally don’t smell bad may start smelling wrong or simply bad.

What’s next? Additional resources for people with nasal polyps symptoms

Test and diagnostics

• Nasal endoscopy, Cleveland Clinic

• Nasal polyps, StatPearls

• Nasal polyps clinical update, Consultant360

Treatments

• Chronic rhinosinusitis, American Family Physician

• Nasal polyps, American Academy of Allergy Asthma & Immunology (AAAAI)

• Nasal polyps, Merck Manual

Scientific studies and clinical trials

• A review of nasal polyposis, Therapeutics and Clinical Risk Management

More information on related health conditions

• Asthma treatments and medications, SingleCare

• Allergy treatments and medications, SingleCare

• Cystic fibrosis treatments and medications, SingleCare

• Sinus infection treatments and medications, SingleCare