Are Nasal Polyps Always a Sign of Allergies? What Else Could Be Causing Them?

If you’ve been diagnosed with nasal polyps, you might assume they’re caused by allergies. While allergies can contribute to their development, nasal polyps are not always allergy-related. These benign growths in the nasal passages can result from a variety of conditions, many of which involve chronic inflammation. Let’s explore the possible causes and when you should seek further evaluation.

What Are Nasal Polyps?

Nasal polyps are soft, painless, noncancerous growths that develop inside the sinuses and nasal passages. They can: ✔️ Block airflow, causing chronic congestion.
✔️ Lead to frequent sinus infections.
✔️ Reduce or completely eliminate your sense of smell.
✔️ Cause postnasal drip, facial pressure, and snoring.

Are Allergies Always to Blame?

No! While allergic rhinitis (hay fever) can contribute to nasal inflammation, many people with nasal polyps do not have allergies. If allergy treatment isn’t helping, another cause may be at play.

What Else Can Cause Nasal Polyps?

Several non-allergic conditions can lead to chronic nasal inflammation and polyp formation, including:

1. Chronic Sinusitis (with or without Allergies)

• Long-term sinus inflammation (lasting 12 weeks or more) increases the risk of polyp development.
• May be linked to bacterial or fungal infections.

2. Aspirin-Exacerbated Respiratory Disease (AERD/Samter’s Triad)

• A condition involving asthma, nasal polyps, and aspirin/NSAID sensitivity.
• Triggers severe nasal congestion and sinus inflammation after taking aspirin or ibuprofen.

3. Nonallergic Rhinitis

• Inflammation of the nasal passages without an allergic trigger.
• Often caused by irritants like pollution, strong odors, or temperature changes.

4. Cystic Fibrosis

• A genetic condition that leads to thick mucus buildup in the lungs and sinuses.
• Nearly 50% of people with cystic fibrosis develop nasal polyps.

5. Fungal Sinusitis

• Chronic sinus inflammation due to fungal overgrowth in the sinuses.
• More common in people with weakened immune systems.

6. Immune System Disorders

• Conditions like Churg-Strauss Syndrome (Eosinophilic Granulomatosis with Polyangiitis, EGPA) can cause polyps due to excess inflammation and eosinophilic activity.

How Are Nasal Polyps Diagnosed?

If you have persistent nasal congestion and breathing difficulties, your doctor may recommend:

• Nasal endoscopy – A small camera inserted into the nose to examine polyps.
• CT scan of the sinuses – Provides a detailed image of polyp size and location.
• Allergy testing – To determine if allergies are contributing to inflammation.
• Genetic testing (if cystic fibrosis is suspected in children or young adults).

Treatment Options for Nasal Polyps

✔️ Nasal steroid sprays (fluticasone, budesonide) to shrink polyps.
✔️ Oral steroids for severe inflammation (short-term use only).
✔️ Biologic medications (Dupixent) for polyp-related inflammation.
✔️ Sinus surgery (endoscopic polypectomy) for large or obstructive polyps.
✔️ Aspirin desensitization if AERD is the cause.
✔️ Saline rinses to flush irritants and improve sinus drainage.

FAQ: Nasal Polyps and Causes

Q: Can nasal polyps go away on their own?
A: Small polyps may shrink with medication, but larger ones often require medical treatment or surgery.

Q: Are nasal polyps cancerous?
A: No, nasal polyps are benign. However, persistent sinus symptoms should always be evaluated.

Q: If I don’t have allergies, how can I prevent nasal polyps?
A: Managing inflammation is key—use nasal steroids, rinse sinuses, and avoid irritants like smoke and pollution.

A Personal Story

One of my patients, Mike, assumed his severe nasal congestion was due to allergies, but allergy testing came back negative. A sinus CT scan revealed large nasal polyps caused by chronic sinusitis. After starting a nasal steroid spray and undergoing minimally invasive sinus surgery, his breathing and sense of smell improved significantly.  We prevent regrowth of the polyp by aggressively controlling his allergies with allergy shots and so far, he has done beautifully!

If you have persistent congestion or frequent sinus infections, nasal polyps could be the culprit—even if you don’t have allergies. A specialist can help identify the cause and find the right treatment plan for you!

What are you waiting for?  If you or your child need help controlling allergies or if you think you need testing or treatment or that you might be a good candidate for allergy shots, Dr. Wendt and her team staff at Relieve Allergy, Asthma & Hives would love to help. Call for testing or treatment today!

Call 480-500-1902 or request an appointment at https://relieveallergyaz.com/contact now!  Begin your allergy testing journey with Dr. Wendt at Relieve Allergy in Scottsdale, Arizona—It’s time to take care of yourself!

Learn more about Dr. Wendt and Relieve Allergy Asthma & Hives at www.relieveallergyaz.com or connect with us: https://www.facebook.com/RelieveAllergy/, https://www.linkedin.com/in/julie-wendt/, https://x.com/RelieveAllergy, https://www.instagram.com/relieve_allergy/ or https://www.youtube.com/@JulieWendt-qx7jm.

Did you know? Dr. Wendt wrote the book on allergies.  Buy it NOW!

Relieve Allergy Asthma & Hives is located near Kierland Commons, 21803 N. Scottsdale Road Ste. 200, and has convenient evening and morning hours to accommodate your schedule. Dr. Wendt is also available for telemedicine appointments as appropriate. Most insurance plans are accepted.

DISCLAIMER: This blog is not meant to substitute for medical care by an Allergist-Immunologist nor is it intended to provide medical advice or imply a Physician-Patient relationship with its readers or their family. It is intended to provide guidance, direction, and moral support from someone experienced in testing and treating allergies. This is also not meant to be a “do-it-yourself” manual or a “how to” overcome your allergies. Some of the issues mentioned, whether allergic or look-a-like, can be dangerous or if left unchecked, deadly. Please develop a relationship with a Physician you trust to help you with diagnosis, advice, questions, and treatment regarding your and your family’s medical conditions.