i already do a netty routine and daily steroid spray leads to bleeding as it thins the tissues

The short version: your steroid spray is causing the bleeding, and the evidence supports switching to saline rinses alone, with an oral antihistamine as backup if needed.

The steroid spray is thinning your nasal tissues and causing epistaxis. A 2010 audit found that 11 of 119 patients on intranasal steroids reported nosebleeds [5]. That is about 9 in 100. The same audit found 79% of patients reported symptom improvement after three months, so the drug works for many, but not for you [5].

Saline irrigation is the obvious replacement. A 2024 pre-post study found it significantly improved total nasal symptom scores after one week [1]. A 2010 study in chronic rhinosinusitis patients found that adding saline to antiallergic treatment produced significantly greater improvement than antiallergic treatment alone [2]. Neither study reported nosebleeds as a side effect. A 2020 pediatric meta-analysis of four small trials found saline irrigation reduced antibiotic use and had good safety, though two of the four trials did report some nasal bleeding [3]. That bleeding was in children, not adults, and the rates were low.

If the saline rinse alone is not enough, an oral antihistamine can help. A 2025 five-group comparison found that desloratadine and olopatadine produced superior outcomes for sneezing, nasal itching, and rhinorrhea, with no significant difference in adverse events between groups [4]. Post-nasal drip was one of the symptom scores that improved significantly across all groups, with p-values from 0.005 to 0.023 [4]. These are oral pills, not sprays, so they will not thin your nasal tissues.

My call: stop the steroid spray, start daily isotonic saline rinses with sterile water, and add an oral antihistamine (desloratadine or olopatadine) if the drip persists. Confidence: moderate for saline rinses reducing symptoms; moderate for oral antihistamines helping post-nasal drip specifically.