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What do we know about mouth and nose rinses, washes, sprays, or creams to prevent COVID-19?

This article was published on
April 21, 2021

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There is no scientific evidence to support using home or traditional therapies to prevent COVID-19 at this time. The World Health Organization (WHO) and other international health leaders say that caution is needed when considering “traditional remedies” as preventative measures or treatments for COVID-19, because they have not been widely studied and may cause harm in some cases. There are many traditional remedies and home remedies that have been promoted to prevent COVID-19 infection. People have suggested using mouth or nasal washes, sprays, and creams (or fats) could prevent the virus from entering the body or kill the virus in the nasal cavity (nose) and throat before it has a chance to spread. **Nasal (nose) washes:** There is no scientific evidence that suggests rinsing the inside of your nose will prevent COVID-19 infection. Additionally, for patients with COVID-19, researchers have raised a concern about using contaminated nasal rinse bottles (as well as surfaces and rinse fluids), suggesting they could be a source of exposure. **Nasal (nose) sprays:** Ongoing studies seek to learn more about how saline, iodine, special soaps, and other ingredients used as nasal washes and sprays may help improve virus symptoms and decrease the spread of COVID-19.  One Israeli study published in November 2020, and recently re-released with updates as a pre-print in January 2021, shows promising results for a nasal spray known as Taffix. Taffix is a nasal inhaler approved for sale and used for the prevention of respiratory viral infections in Israel and some other countries. The 2020/2021 study analyzed 243 members of a Jewish ultra-orthodox synagogue community during a high holiday, in which individuals were gathered and praying throughout the day. At the two-week follow-up mark of the event, the study investigators found that the individuals who used Taffix had a reduction in odds of COVID-19 infection by 78%, compared to those who did not use Taffix. Eighteen members out of the total 243 were infected with COVID-19, 16 in the no-Taffix group and 2 in the Taffix group, both of whom did not adhere to the recommended use. Studies are ongoing to test over the counter and other types of nasal sprays for protection against COVID-19, with some showing early promise in lab and animal studies. **Mouthwash, rinses, and gargle solutions:** Like nasal washes and sprays, there is no scientific evidence that suggests using mouthwashes, rinses, and gargles will prevent COVID-19 infection. Ongoing studies seek to learn about how special antiseptic mouthwashes may help prevent COVID-19 (see the Experimental Therapies section below). So far, many studies have explored these treatments in laboratory cells, and data on humans is limited. **Alcohol, chlorine, or disinfectant spray:** Alcohol, chlorine (e.g. bleach solutions), or disinfectant sprays should never be sprayed or applied to your nose, mouth, or eyes, and doing so may cause serious harm. Drinking alcohol will not prevent or treat COVID-19. **Fats or oils:** This includes coconut oil, ghee, sesame oil, shea butter, petroleum jelly, and others. There is no scientific evidence that nasal treatments or mouth rinses with different fats will prevent, treat, or cure COVID-19. While many types of fats or oils (like coconut oil, sesame oil, and others) have been shown to kill or stop bad bacteria in cell-based laboratory studies, most of these studies have focused on how these ingredients may be used to prevent bacterial growth on food to improve food safety. Studies have not looked at the effect of fats on prevention of viral or bacterial infections in humans when applied in the nose or used as a mouth rinse. There is no scientific evidence that supports the theory that using these oils would improve health or prevent illness. In addition, though rare, it is possible that inhaling fats from the inside of the nose can cause lung problems. **Steam inhalation:** Though inhaling steam may help to thin mucous or relieve congestion (stuffy nose), there is no scientific evidence to suggest that inhaling steam will prevent or treat COVID-19. Contact with steaming hot water can cause burns, and inhaling steam can burn the inside of your nose. **Experimental therapies:** There are ongoing studies using nasal sprays (and rinses) and special mouthwashes to prevent COVID-19, such as the Taffix study discussed above. Much of the current scientific evidence is based on animal or laboratory cell studies. For humans, efficacy and safety studies are ongoing, and most treatments are not recommended for the public at this time. Currently, studies seek to understand if nasal rinses (using saltwater, special soaps, and other ingredients) may help to improve symptoms and decrease the viral load in patients with COVID-19 (with the thought that decreasing the viral load could decrease how much an infected person may spread the virus). Researchers are also studying whether gargling or rinsing with special solutions (e.g. povidone-iodine) may help prevent healthcare workers from contracting COVID-19. A pre-print study or a nasal spray medication (INNA-051) has shown good results in preventing COVID-19 in ferrets, but human studies have not yet begun. Human study results for Taffix nasal spray and its pre-existing approval for prevention of respiratory viral infections makes it feasible for human use in protection against COVID-19; however, it is not a replacement for mask use and physical distancing. To prevent COVID-19 infection, health authorities continue to recommend avoiding crowds, practicing social distancing measures (at least 6 feet/2 meters apart), frequent and careful handwashing, wearing face masks (wearing a cloth mask over a surgical mask is recommended by the U.S. Centers for Disease Control and Prevention), staying home when possible (especially if you are sick), clean high-touch surfaces often, and avoid touching your nose, eyes, and mouth.

There is no scientific evidence to support using home or traditional therapies to prevent COVID-19 at this time. The World Health Organization (WHO) and other international health leaders say that caution is needed when considering “traditional remedies” as preventative measures or treatments for COVID-19, because they have not been widely studied and may cause harm in some cases. There are many traditional remedies and home remedies that have been promoted to prevent COVID-19 infection. People have suggested using mouth or nasal washes, sprays, and creams (or fats) could prevent the virus from entering the body or kill the virus in the nasal cavity (nose) and throat before it has a chance to spread. **Nasal (nose) washes:** There is no scientific evidence that suggests rinsing the inside of your nose will prevent COVID-19 infection. Additionally, for patients with COVID-19, researchers have raised a concern about using contaminated nasal rinse bottles (as well as surfaces and rinse fluids), suggesting they could be a source of exposure. **Nasal (nose) sprays:** Ongoing studies seek to learn more about how saline, iodine, special soaps, and other ingredients used as nasal washes and sprays may help improve virus symptoms and decrease the spread of COVID-19.  One Israeli study published in November 2020, and recently re-released with updates as a pre-print in January 2021, shows promising results for a nasal spray known as Taffix. Taffix is a nasal inhaler approved for sale and used for the prevention of respiratory viral infections in Israel and some other countries. The 2020/2021 study analyzed 243 members of a Jewish ultra-orthodox synagogue community during a high holiday, in which individuals were gathered and praying throughout the day. At the two-week follow-up mark of the event, the study investigators found that the individuals who used Taffix had a reduction in odds of COVID-19 infection by 78%, compared to those who did not use Taffix. Eighteen members out of the total 243 were infected with COVID-19, 16 in the no-Taffix group and 2 in the Taffix group, both of whom did not adhere to the recommended use. Studies are ongoing to test over the counter and other types of nasal sprays for protection against COVID-19, with some showing early promise in lab and animal studies. **Mouthwash, rinses, and gargle solutions:** Like nasal washes and sprays, there is no scientific evidence that suggests using mouthwashes, rinses, and gargles will prevent COVID-19 infection. Ongoing studies seek to learn about how special antiseptic mouthwashes may help prevent COVID-19 (see the Experimental Therapies section below). So far, many studies have explored these treatments in laboratory cells, and data on humans is limited. **Alcohol, chlorine, or disinfectant spray:** Alcohol, chlorine (e.g. bleach solutions), or disinfectant sprays should never be sprayed or applied to your nose, mouth, or eyes, and doing so may cause serious harm. Drinking alcohol will not prevent or treat COVID-19. **Fats or oils:** This includes coconut oil, ghee, sesame oil, shea butter, petroleum jelly, and others. There is no scientific evidence that nasal treatments or mouth rinses with different fats will prevent, treat, or cure COVID-19. While many types of fats or oils (like coconut oil, sesame oil, and others) have been shown to kill or stop bad bacteria in cell-based laboratory studies, most of these studies have focused on how these ingredients may be used to prevent bacterial growth on food to improve food safety. Studies have not looked at the effect of fats on prevention of viral or bacterial infections in humans when applied in the nose or used as a mouth rinse. There is no scientific evidence that supports the theory that using these oils would improve health or prevent illness. In addition, though rare, it is possible that inhaling fats from the inside of the nose can cause lung problems. **Steam inhalation:** Though inhaling steam may help to thin mucous or relieve congestion (stuffy nose), there is no scientific evidence to suggest that inhaling steam will prevent or treat COVID-19. Contact with steaming hot water can cause burns, and inhaling steam can burn the inside of your nose. **Experimental therapies:** There are ongoing studies using nasal sprays (and rinses) and special mouthwashes to prevent COVID-19, such as the Taffix study discussed above. Much of the current scientific evidence is based on animal or laboratory cell studies. For humans, efficacy and safety studies are ongoing, and most treatments are not recommended for the public at this time. Currently, studies seek to understand if nasal rinses (using saltwater, special soaps, and other ingredients) may help to improve symptoms and decrease the viral load in patients with COVID-19 (with the thought that decreasing the viral load could decrease how much an infected person may spread the virus). Researchers are also studying whether gargling or rinsing with special solutions (e.g. povidone-iodine) may help prevent healthcare workers from contracting COVID-19. A pre-print study or a nasal spray medication (INNA-051) has shown good results in preventing COVID-19 in ferrets, but human studies have not yet begun. Human study results for Taffix nasal spray and its pre-existing approval for prevention of respiratory viral infections makes it feasible for human use in protection against COVID-19; however, it is not a replacement for mask use and physical distancing. To prevent COVID-19 infection, health authorities continue to recommend avoiding crowds, practicing social distancing measures (at least 6 feet/2 meters apart), frequent and careful handwashing, wearing face masks (wearing a cloth mask over a surgical mask is recommended by the U.S. Centers for Disease Control and Prevention), staying home when possible (especially if you are sick), clean high-touch surfaces often, and avoid touching your nose, eyes, and mouth.

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What our experts say

There is no scientific evidence to support using home or traditional therapies to prevent or cure COVID-19 at this time. The World Health Organization (WHO) and other international health leaders say that caution is needed when considering “traditional remedies” as preventative measures or treatments for COVID-19, because they have not been widely studied and may cause harm in some cases.

There are many traditional remedies and home remedies that have been promoted to prevent COVID-19 infection. People have suggested using mouth or nasal washes, sprays, and creams (or fats) could prevent the virus from entering the body or kill the virus in the nasal cavity (nose) and throat before it has a chance to spread.

Nasal (nose) washes: There is no research that suggests rinsing the inside of your nose with any liquid or solution will prevent or cure COVID-19 infection. This includes lemon juice, for which there is no research to show that it protects against or treats COVID-19; while lemon juice contains Vitamin C that is essential for your health, this is only for when a person drinks it, and even then, that immune system boost is not shown to protect against or cure COVID-19. Engaging in such self-medication like putting lemon drops in the nose that lacks research of any benefits and that lacks research of any potential harms is cautioned against because of potential risks to health. Additionally, for patients with COVID-19, researchers have raised a concern about the use of contaminated nasal rinse bottles (as well as surfaces and rinse fluids), suggesting they could be a source of exposure.

Nasal (nose) sprays: Ongoing studies seek to learn more about how saline, iodine, special soaps, and other ingredients used as nasal washes and sprays may help improve virus symptoms and decrease the spread of COVID-19. 

One Israeli study published in November 2020, and recently re-released with updates as a pre-print in January 2021, shows promising results for a nasal spray known as Taffix. Taffix is a nasal inhaler approved for sale and used for the prevention of respiratory viral infections in Israel and some other countries. The 2020/2021 study analyzed 243 members of a Jewish ultra-orthodox synagogue community during a high holiday, in which individuals were gathered and praying throughout the day.

At the two-week follow-up mark of the event, the study investigators found that the individuals who used Taffix had a reduction in odds of COVID-19 infection by 78%, compared to those who did not use Taffix. Eighteen members out of the total 243 were infected with COVID-19, 16 in the no-Taffix group and 2 in the Taffix group, both of whom did not adhere to the recommended use.

Studies are ongoing to test over the counter and other types of nasal sprays for protection against COVID-19, with some showing early promise in lab and animal studies.

Mouthwash, rinses, and gargle solutions: Like nasal washes and sprays, there is no scientific evidence that suggests using mouthwashes, rinses, and gargling solutions will prevent COVID-19 infection. However, one study suggested that gargling with saltwater may be effective at reducing the symptoms and severity of COVID-19. A Scottish randomized control trial found that hypertonic saline nasal irrigation and gargling (HSNIG) reduced the duration of coronavirus upper respiratory tract infection (URTI) by an average of two and a half days. As a result, it may offer a potentially safe, effective and scalable intervention for those with COVID-19 to supplement additional care. These results build off of a randomized control trial conducted in Japan demonstrating the beneficial impact of salt water gargling in preventing upper respiratory infections. It’s necessary to note that evidence has not demonstrated any instance of saline nasal irrigation and/or gargling at preventing COVID-19, and that gargling is not by any means a recommended standalone cure or treatment. In addition, this area is highly under-researched and needs additional evidence to understand the impact of salt water gargling on COVID-19. Ongoing studies seek to learn about how special antiseptic mouthwashes may help prevent COVID-19 (see the Experimental Therapies section below). So far, many studies have explored these treatments in laboratory cells, and data on humans is limited.

Alcohol, chlorine, or disinfectant spray: Alcohol, chlorine (e.g. bleach solutions), or disinfectant sprays should never be sprayed or applied to your nose, mouth, or eyes, and doing so may cause serious harm. Drinking alcohol will not prevent or treat COVID-19.

Fats or oils: This includes coconut oil, ghee, sesame oil, shea butter, petroleum jelly, and others. There is no scientific evidence that nasal treatments or mouth rinses with different fats will prevent, treat, or cure COVID-19. While many types of fats or oils (like coconut oil, sesame oil, and others) have been shown to kill or stop bad bacteria in cell-based laboratory studies, most of these studies have focused on how these ingredients may be used to prevent bacterial growth on food to improve food safety. Studies have not looked at the effect of fats on prevention of viral or bacterial infections in humans when applied in the nose or used as a mouth rinse. There is no scientific evidence that supports the theory that using these oils would improve health or prevent illness. In addition, though rare, it is possible that inhaling fats from the inside of the nose can cause lung problems.

Steam inhalation: Though inhaling steam may help to thin mucous or relieve congestion (stuffy nose), there is no scientific evidence to suggest that inhaling steam will prevent or treat COVID-19. Contact with steaming hot water can cause burns, and inhaling steam can burn the inside of your nose.

Experimental therapies: There are ongoing studies using nasal sprays (and rinses) and special mouthwashes to prevent COVID-19, such as the Taffix study discussed above. Much of the current scientific evidence is based on animal or laboratory cell studies. For humans, efficacy and safety studies are ongoing, and most treatments are not recommended for the public at this time. Currently, studies seek to understand if nasal rinses (using saltwater, special soaps, and other ingredients) may help to improve symptoms and decrease the viral load in patients with COVID-19 (with the thought that decreasing the viral load could decrease how much an infected person may spread the virus). Researchers are also studying whether gargling or rinsing with special solutions (e.g. povidone-iodine) may help prevent healthcare workers from contracting COVID-19. A pre-print study or a nasal spray medication (INNA-051) has shown good results in preventing COVID-19 in ferrets, but human studies have not yet begun. Human study results for Taffix nasal spray and its pre-existing approval for prevention of respiratory viral infections makes it feasible for human use in protection against COVID-19; however, it is not a replacement for mask use and physical distancing.

To prevent COVID-19 infection, health authorities continue to recommend avoiding crowds, practicing social distancing measures (at least 6 feet/2 meters apart), frequent and careful handwashing, wearing face masks (wearing a cloth mask over a surgical mask is recommended by the U.S. Centers for Disease Control and Prevention), staying home when possible (especially if you are sick), clean high-touch surfaces often, and avoid touching your nose, eyes, and mouth.

Context and background

COVID-19 is known to spread through the air, via close personal contact, and by coming into contact with "high-touch" surfaces then touching one's eyes, nose, or mouth. Research has shown that the infection primarily begins in the mucosa of the nose and throat so preventing the virus from entering or taking hold in our nose or throat has been of great interest in the scientific community.

Nasal washes, creams (or fats), and sprays and mouthwashes and gargle solutions have been promoted as possible ways to prevent COVID-19, but there is no scientific evidence that these therapies are effective and studies are ongoing.

For example, in parts of Africa, shea butter is commonly applied to the inside of the nose to help with congestion (or a stuffy nose). Ghee (clarified butter), coconut, and sesame oil applied to the inside of the nose or oral rinses with sesame oil have been promoted as part of Ayurveda- a form of traditional medicine with roots in ancient India. While some people have experienced benefits in using traditional medicine as a complementary part of their medical care, doctors and scientists have also voiced safety and efficacy concerns about certain practices. At present, there is no scientific evidence that nasal treatments or oral rinses will prevent, treat, or cure COVID-19.

Resources

  1. COVID-19 virtual press conference, April 2020, (WHO)
  2. Petroleum jelly: Safe for a dry nose? (Mayo Clinic)
  3. Can Drinking Lemon Juice Kill Coronavirus? (Cleveland Clinic)
  4. Lemon juice does not cure COVID-19 (The National Academies of Sciences, Engineering, Medicine)
  5. Interim analysis of an open-label randomized controlled trial evaluating nasal irrigations in non-hospitalized patients with coronavirus disease 2019 (International Forum of Allergy & Rhinology)
  6. Povidone-Iodine Use in Sinonasal and Oral Cavities: A Review of Safety in the COVID-19 Era (Ear, Nose & Throat Journal)
  7. Rapid In‐Vitro Inactivation of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) Using Povidone‐Iodine Oral Antiseptic Rinse (J Prosthodont)
  8. Clinical Trial Looks at Antiseptic Nasal Spray and Gargle to Prevent COVID-19 Infections (Univ Kentucky Research)
  9. Low pH Hypromellose (Taffix™) nasal powder spray reduced SARS-CoV-2 infection rate post mass-gathering event at a highly endemic community: An observational prospective open label user survey (Research Square)
  10. In Vitro Analysis of the Anti-viral Potential of nasal spray constituents against SARS-CoV-2 (BioRxiv)
  11. Covid-busting Nasal Spray Begins UK Trials January 11th (AP)
  12. Maximizing Fit for Cloth and Medical Procedure Masks to Improve Performance and Reduce SARS-CoV-2 Transmission and Exposure, 2021 (U.S. CDC)
  13. Hypertonic saline nasal irrigation and gargling should be considered as a treatment option for COVID-19 (Journal of Global Health)Prevention of Upper Respiratory Tract Infections by Gargling: A Randomized Trial (American Journal of Preventive Medicine)
  14. Debunking COVID-19 (coronavirus) myths (Mayo Clinic)
  15. Prophylactic intranasal administration of a TLR2 agonist reduces upper respiratory tract viral shedding in a SARS-CoV-2 challenge ferret model (bioRxiv)
  16. Treatments that target the coronavirus in the nose might help prevent COVID-19 (Science News)
  17. Benefits and Safety of Nasal Saline Irrigations in a Pandemic—Washing COVID-19 Away (JAMA Otolaryngol Head Neck Surg)
  18. Nasal disinfection for the prevention and control of COVID-19: A scoping review on potential chemo-preventive agents (International Journal of Hygiene and Environmental Health)
  19. Ayurveda’s immunity boosting measures for self care during COVID 19 crisis (Indian Government's Press Information Bureau)

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