The Atlantic Having caught a cold every month since my kid started day care, I’ve devoted a lot of time recently to the indignity of unclogging my nose. I’m blowing, always. I have also struck up an intimate acquaintance with neti pots and a great variety of decongestants. (Ask for the stuff that actually works, squirreled away behind the counter.) And on sleepless nights, I’ve spent hours turning side to side, trying to clear one nostril and then the other.
Nasal congestion, I’ve learned in all this, is far weirder than I ever thought. For starters, the nose is actually two noses, which work in an alternating cycle that is somehow connected to our armpits.
The argument that humans have two noses was first put to me by Ronald Eccles, a nose expert who ran the Common Cold Centre at Cardiff University, in Wales, until his retirement a few years ago. This sounds absurd, I know, but consider what your nose—or noses—looks like on the inside: Each nostril opens into its own nasal cavity, which does not connect with the other directly. They are two separate organs, as separate as your two eyes or your two ears.
And far from being a passive tube, the nose’s hidden inner anatomy is constantly changing. It’s lined with venous erectile tissue that has a “similar structure to the erectile tissue in the penis,” Eccles said, and can become engorged with blood. Infection or allergies amplify the swelling, so much so that the nasal passages become completely blocked. This swelling, not mucus, is the primary cause of a stuffy nose, which is why expelling snot never quite fixes congestion entirely. “You can blow your nose until the cows come home and you’re not blowing that swollen tissue out,” says Timothy Smith, an otolaryngologist at the Oregon Health & Science University’s Sinus Center. Gently blowing your nose works fine for any mucus that may be adding to the stuffiness, he told me. But decongestants such as Sudafed and Afrin work by causing blood vessels in the nose to shrink, opening the nasal passages for temporary relief.