To evaluate the effectiveness of a hypertonic essential oil (EO)-based nasal spray on perennial allergic rhinitis symptoms.

A total of 43 patients from academic hospitals in France and Belgium were recruited. Participants were >18 years of age, diagnosed with allergic rhinitis, and had a >1-year history of perennial allergic rhinitis and positive skin test for at least 1 perennial allergen.

This was a multicentric, prospective open-label, nonrandomized study. All patients used Puressential Respiratory-Decongestant Nasal Spray, which is a combination of hypertonic seawater and organic rosemary floral water with 4 EOs (ravintsara, geranium, eucalyptus radiata, and niaouli). Subjects were asked to use 2 sprays in each nostril morning and evening for 4 weeks. Participants continued to take their usual allergy medications but were not allowed to add any new medications. Rhinitis control was assessed by using a self-completed questionnaire, the Allergic Rhinitis Control Test. Daily questions pertaining to discomfort and side effects were also completed. Nasal Inspiratory Peak Flow, which is a direct measure of nasal obstruction, was measured at baseline and at 4 weeks.

Statistically significant improvement was documented in both the Allergic Rhinitis Control Test (ARCT) and Nasal Inspiratory Peak Flow. According to ARCT scores, 70% of subjects reported controlled rhinitis symptoms at the end of the study, compared with 14% at the start of the study. No moderate or severe adverse events were reported.

The use of Puressential Respiratory-Decongestant Nasal Spray, when used as an add-on to baseline rhinitis management for 4 weeks, was associated with an improvement in subjective nasal symptom scores and improvement in objective measurement of nasal obstruction.

EOs have been previously demonstrated to have antiinflammatory effects. With this study, the researcher yields promising results for a natural way to significantly improve symptoms of perennial allergic rhinitis. Although the data are impressive, the study is limited by the fact that there was no placebo group. In addition, although a significant response in a brief time period is encouraging, 4 weeks is not long enough to demonstrate long-term tolerance of intranasal EOs. It remains to be determined if side effects, such as irritation of the nasal mucosa, will occur with long-term use.