Isotonic vs. Hypertonic: Which Saline Sinus Rinse Works Best for You?

We've recently had several customer inquiries about the difference between isotonic and hypertonic saline sinus rinses. Both saline solutions wash germs, allergens, and other pollutants out of the sinuses. However, some customers find that hypertonic solutions work better for them, while others experience uncomfortable burning or stinging sensations when they use hypertonic solutions.

Hypertonic Saline Sinus Rinses

Saline is simply salt water. "Iso" means "equal" and "hyper" means "high." Hypertonic saline has a higher concentration of salt. While some physicians recommend hypertonic solutions because a higher concentration of salt may draw fluid and mucus out more effectively, many patients experience a burning sensation when they use hypertonic solutions. It is strongly recommended that customers use hypertonic rinses only under the advice of their physician. If you experience painful burning or stinging when using a hypertonic saline wash, you should stop using it. If your sinus membranes are badly inflamed, then the simple sensation of touch could be enough to cause pain, and you should see a doctor if you haven't already.

SaltAire Sinus Relief is our best-selling hypertonic saline sinus wash. The saline solution is pre-mixed, and it comes in an easy-to-use, manually operated pump bottle, which gives you convenient fingertip control over the flow of the saline.

Isotonic Saline Sinus Rinses

Isotonic saline solutions have a lower concentration of salt. "Iso" means equal, and an isotonic solution should be perfectly balanced for your body.

If your nose is very dry, you may find that a hypertonic solution dries it out even more, while an isotonic solution should restore moisture. However, if your nose is very swollen, an isotonic solution may not be strong enough to draw out the mucus.

The NeilMed Sinus Rinse Kit and the Neilmed NasaFlo Neti Pot Kit come with packets of saline mix, and you just add water to create your own isotonic solution. The NasaFlo Neti Pot Kit relies on gravity to wash out the sinuses, and therefore you don't have to use force or pressure. Sinus rinsing should be gentle and soothing, not painful. If you wish to try a hypertonic solution with your NeilMed sinus rinse kit, you may create your own by using two Neilmed Mixture Packets instead of one.

The Breathe-Ease XL Nasal Wash System, developed leading MD specialist Murrary Grossan, also allows you to choose a hypertonic or isotonic concentration by adding more or less mix to the water. The Breathe-Ease XL Nasal Wash System comes with a convenient miniature spray bottle perfect for traveling.

Tips for Using Saline Sinus Rinses

Whether you're using a HydroPulse, a bottle, or a neti pot, water temperature is important. If the water is too hot or too cold, it could cause unpleasant sensations. The water should be pleasantly warm.

You should also rinse off your irrigator tip, bottle, or net poti with hot water and soap after each use to prevent bacterial growth.

To learn about other solutions to sinus problems, see our Sinus Problems Solution Guide.

Originally published in the March 2007 issue of Allergy Consumer Report.