Aw.
The spray caused a septal perforation…
The spray caused a septal perforation due to its vasoconstrictor that the company falsely advertises as safe for daily use
Response from AllermiFeb 5, 2026
We are so sorry to hear of your recent diagnosis of a nasal septal perforation. Nasal septal perforation due to nasal spray use is exceedingly rare and almost always results from long-term nasal trauma or improper spray technique—especially when combined with other risk factors, such as a history of intranasal drug use, severe untreated chronic inflammation, prior nasal trauma or surgery, or improper spray technique. Septal perforation due to Allermi use in patients without significant predisposing risk factors, using our formulation, delivery method and proper recommended technique is highly improbable. Septal perforation was an occasional side effect noted with very early corticosteroid nasal sprays, primarily from the 1980s, that were considerably more caustic to the nasal lining, were formulated in an irritating and over-drying alcohol-based solvent and alcohol-based preservative solution, and were delivered to the nasal passages in high-velocity aerosolized form from dispensers that could easily and readily direct their aerosol jet to the septum, which is comprised of cartilage. These nasal sprays are no longer available. In contrast, Allermi uses an alcohol-free, aqueous formulation in a bottle that delivers a gentle, broad spray-mist. Our active ingredients are carefully titrated and micro-dosed to prevent irritative side-effects to the nasal lining (including oxymetazoline, which is an intranasal decongestant that we strictly use in micro-dosages). When used correctly (not angled towards the septum) and as prescribed (not overused), the chance of developing a nasal septal perforation with any of the ingredients in Allermi is extremely unlikely. As with any nasal spray, proper spray technique is crucial. The bottle should be shaken well before use, then, in the nose-to-toes position, the nozzle should be inserted as deeply as comfortable and pointed straight back into the nostril, towards the eye—not angled inward toward the septum. All of these steps help avoid contact with the nasal septum and ensure the medication is delivered safely and effectively. The method of directing the nozzle away from the septum is the clinically-accepted method of preventing irritation to the septum with nasal spray use. If you have been diagnosed with a nasal septal perforation or if one is suspected, we ask our patients discontinue use and be evaluated by an ENT specialist. Since nasal sprays can irritate a pre-existing septal perforation, we require ENT clearance to use Allermi in any patient with a pre-existing nasal septal perforation.



