Nasal irrigations aid in removing stagnant mucus, inflammatory products, fungus, bacteria, crusts, and other products that might be irritating the sinus lining (mucosa).

High volume positive pressure irrigation has been shown to be the most effective way to deliver solution to the sinus mucosa. Simple nasal sprays only reach the mucosa (lining) of the nasal cavity. Nebulizers, inhalations, pressurized sprays, and other forms of delivery are less effective.

Betamethasone cream is the potent topical anti-inflammatory steroid betamethasone. It helps to reduce inflammation by directly acting on the mucosa. You must make sure to use the cream, not the ointment.


  • NeilMed Sinus Rinse bottle (or similar)
  • Betamethasone Cream (0.05%)


  1. Prepare a basic saline solution as the base. Empty a salt sachet into the bottle and fill with water. Clean tap water is OK. Filtered water, bottled water or previously boiled water can be used immediately after surgery or when there is a concern regarding contamination. Alternatively a saline solution can be made by adding 1/4-1/2 teaspoon of rock or sea salt to the bottle.
  2. Add a 2 cm strip of Betamethasone cream to the bottle (about a quarter dollar length). With your finger on the nozzle, shake the bottle to mix.


With your head over the sink, place the black bottle tip firm against the nostril and squeeze the bottle firmly, this should empty about half the bottle. Solution should flow out the other nostril. Repeat on the other nostril.

*Only 5% of the solution will remain in sinuses and the amount of solution that you are finally exposed to is limited.

  1. Barham HP, Harvey RJ. Distribution of Topical Therapies in CRSwNP. International Forum of Allergy and Rhinology. 2016.
  2. Barham HP, Harvey RJ. Distribution of Topical Therapies in CRSsNP. International Forum of Allergy and Rhinology. 2016.
  3. Barham HP, et.al. Frontal sinus surgery and sinus distribution of nasal irrigation. International Forum of Allergy and Rhinology. 2016.
  4. Harvey RJ, et.al. Fluid residuals and drug exposure in nasal irrigation. Otolaryngol Head Neck Surg. Dec 2009;141(6):757-761.

Relevant Publications

Nasal saline irrigation: Therapeutic or homeopathic