A steroid nasal spray for hay fever and a potent cream for skin — and the spray only works if aimed correctly.
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Mometasone furoate is a corticosteroid used in two quite different ways, and the confusion between them is worth clearing up first.
Very little of the nasal spray is absorbed into the bloodstream, which is what makes it safe for long-term daily use through a hay fever season.
The cream is a different proposition. Elocon sits in the potent category — several steps above hydrocortisone — and is used in short courses on specific areas rather than freely.
Start two weeks before your hay fever season and use it every single day. Steroid nasal sprays are preventive and take days to reach full effect. Used only when symptoms are bad, they will seem not to work — which is the commonest reason people abandon them.
Systemic effects are minimal at normal doses, which is the point of a topical nasal steroid.
Neither is used in pregnancy without advice, though the nasal spray is generally considered low risk where treatment is needed.
Ritonavir and some antifungals such as ketoconazole and itraconazole can raise steroid levels by slowing their breakdown, which occasionally matters with prolonged use.
No routine monitoring is needed for a nasal spray at standard doses, even long term.
For the cream, what needs watching is duration and site. A potent topical steroid used continuously for months, or applied to thin skin, is where the lasting problems come from — and those changes do not reverse.
In children using both a steroid nasal spray and an inhaled steroid for asthma, growth is worth monitoring, since the doses add up.
Yes for both, and this is a good example of where a consultation adds more than the prescription does.
The commonest reason a steroid nasal spray “does not work” is technique and timing, not the drug. Aiming at the septum instead of away from it, sniffing hard, starting too late, and using it only on bad days between them account for most failures. Twenty minutes is enough to fix all four.
Some steroid nasal sprays are available over the counter, and for straightforward seasonal hay fever a pharmacy is cheaper. We would say so.
Eczema and psoriasis assess well from good photographs. What matters is choosing an appropriate potency for the site, setting a clear duration, and making sure emollients are being used properly — which they usually are not.
What we will not do is issue a potent steroid as an open repeat. Where eczema needs continuous potent treatment, it needs a dermatology opinion rather than a standing prescription.
This page is information, not an offer to supply.
Mometasone is off patent and generic versions are inexpensive in both forms. On a private prescription the cost is broadly comparable to the England NHS prescription charge. NHS prescriptions are free in Wales.
Hay fever that is not responding despite a spray — usually a technique problem worth twenty minutes — or eczema needing something more potent than hydrocortisone with a proper plan attached.
Continue daily through your season, then stop. There is no withdrawal and no need to taper. Stopping and restarting according to how you feel is the least effective way to use it.
If it is not working, check these before changing drug: are you aiming outwards? Are you using it every day? Did you start early enough? Have you given it two full weeks?
Step down rather than stopping abruptly after a long course — reduce frequency, then move to a milder steroid, then to emollients alone. Abrupt withdrawal after prolonged potent use can cause a rebound flare.
Almost always one of four things: aiming at the middle of the nose instead of outwards, sniffing hard, starting too late, or using it only on bad days.
Steroid nasal sprays are preventive and take up to two weeks. Used daily and started early, they are the single most effective hay fever treatment — more so than antihistamines.
Because the spray is hitting the septum. Use the opposite hand to the nostril and aim towards the ear on that side. This one change resolves most nosebleeds from nasal sprays.
Yes — the nasal spray is designed for exactly that, and very little is absorbed. Daily use through a whole season is correct use, not overuse.
Yes. Elocon is a potent steroid, several steps above hydrocortisone. That is why it is used in short courses, on specific areas, and not on the face or in skin folds without advice.
Not without being told to. Facial skin is thin and shows steroid damage soonest, and steroid-induced rosacea is difficult to unpick afterwards.
Used correctly — thin layer, short course, right site — the risk is low. The problems come from potent steroids used continuously for months, or on thin skin.
Fear of steroids causes its own harm, because undertreated eczema is itchy, infected and miserable. The answer is using enough for long enough, then stopping.
Yes, and that combination is standard for hay fever that is not controlled by one alone. Add antihistamine eye drops for eye symptoms.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
September 5, 2026
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