Nasal polyps are soft, painless, non-cancerous growths that develop in the lining of the sinuses or nasal passages. They usually occur in both nostrils and can range in size from tiny to quite large. Nasal polyps are common, affecting around 1-4% of the population. While benign, they can cause bothersome symptoms like nasal congestion, reduced sense of smell, facial pain and more. One of the most frequently asked questions about nasal polyps is what color they are.
What Causes Nasal Polyps?
The exact cause of nasal polyps is not fully understood. However, they are associated with chronic inflammation in the sinuses and nasal passages. This inflammation is often linked to asthma, recurring sinus infections, allergies and sensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen.
Some theories suggest that nasal polyps may form as a result of trapped mucus and fluids in the blocked sinus drainage pathways. The trapped fluids cause swelling and irritation of the nasal membranes, leading to further obstruction and polyp growth. Genetics and environmental factors like airborne allergens and pollution may also play a role.
Typical Appearance of Nasal Polyps
Nasal polyps are soft, painless, noncancerous growths. They have a teardrop shape and a smooth surface. Polyps range in size, from a few millimeters to several centimeters. Small polyps may not cause symptoms, while larger ones can block the nasal passages and sinuses, leading to breathing problems.
Polyps originate from the lining of the nose or sinuses. They are attached to the nasal membranes by a thin stalk. The color of nasal polyps can vary somewhat based on their maturity. However, they are most often pale yellow, grey or pinkish in color. The surface is translucent with a jelly-like consistency.
Why Are Nasal Polyps Often Yellowish?
The typical yellowish hue of nasal polyps is related to their inflammatory origin. When chronic inflammation occurs in the nasal passages, it causes fluid accumulation and a buildup of immune cells. These fluids often contain proteins and enzymes that are released by the body during an inflammatory response.
One of these enzymes is myeloperoxidase, which is found in certain white blood cells. Myeloperoxidase catalyzes several reactions that generate reactive molecules to help fight infection. However, as a byproduct, it also leads to the formation of tyrosine metabolites that give nasal polyps a yellowish discoloration.
Therefore, the yellowish color of nasal polyps provides a visual clue to the underlying inflammatory process occurring in the nasal membranes. It distinguishes them from other types of nasal masses like mucous retention cysts that are more pearly white in color.
Other Colors of Nasal Polyps
While yellowish is the most common color, nasal polyps can sometimes exhibit other hues:
Pink or Red
A pink or reddish color may be seen in newly formed nasal polyps that are still actively growing and filling with fluid. The reddish tint results from the increased blood supply and blood vessels forming as part of the inflammatory process.
Pale Grey
Advanced or longstanding polyps often appear more pale grey. The greyish color occurs as polyps age and lose their vascularity and blood supply.
White
Rarely, some polyps may be pearly white. This can occur if the polyp lacks the typical protein content and enzymatic processes that produce the yellowish pigments. White polyps may also suggest a different diagnosis like an antrochoanal polyp or retention cyst.
Dark Red or Purplish
A dark reddish-purple color raises concerns for potential bleeding or vascular abnormalities in the polyp. This unusual coloring warrants further evaluation by a specialist.
How Are Nasal Polyps Diagnosed?
Nasal polyps are typically diagnosed based on a medical history and physical examination. The physician will inquire about symptoms and use specialized instruments to visualize the nasal passages.
Diagnostic tests may include:
- Nasal endoscopy – A thin tube with a light and camera (endoscope) is inserted into the nose to examine the nasal passages and sinuses.
- Imaging tests – CT scans or MRI scans provide detailed images of sinus anatomy and nasal polyps.
- Allergy testing – This helps identify potential allergic triggers contributing to nasal polyp formation.
Identifying the number, size, shape, color and location of polyps aids in diagnosis and surgical planning. The pale yellowish color is characteristic of inflammatory nasal polyps and helps distinguish them from other nasal masses.
Do Nasal Polyps Change Color?
The color of nasal polyps may change somewhat over time. Initially, newly formed polyps tend to be pink or red. As they grow larger and persist for longer periods, they often become more yellowish or greyish.
Bleeding into the polyp can also alter its color temporarily. Following nasal surgery or trauma, reddish blood clots may be visible on the surface prior to healing. Similarly, inflammation from an infection can make polyps appear reddened until the infection resolves with antibiotic treatment.
In rare cases, some nasal polyps may change color significantly and become dark or bluish. This unusual coloring requires prompt evaluation to rule out rare, dangerous conditions like nasal melanoma or inverted papilloma.
Treatment for Nasal Polyps
Treatment for nasal polyps aims to shrink the growths, improve breathing and prevent recurrence. Options include:
Nasal Steroid Sprays
Corticosteroid nasal sprays are the mainstay of medical treatment for nasal polyps. The steroids help reduce inflammation and shrink polyps over the course of several weeks to months. However, polyps often return once steroid spray is stopped.
Oral Steroids
A short course of oral corticosteroids (e.g. prednisone) may be prescribed to rapidly shrink large polyps and open up obstructed breathing. However, oral steroids carry greater side effects with long-term use.
Surgery
Endoscopic sinus surgery is frequently performed for symptomatic polyps. The surgery removes polyps and clears obstructed sinus drainage pathways. Functional endoscopic sinus surgery (FESS) is generally an outpatient procedure with low complication rates.
Despite treatment, nasal polyps tend to recur in most patients. Lifelong medication, observation and additional surgeries may be needed to manage symptoms. Preventing underlying inflammatory triggers can help reduce recurrence.
When to See a Doctor
Consult an ear, nose and throat (ENT) physician or allergist if you experience any of the following:
- Chronic nasal congestion or stuffiness
- Reduced sense of smell
- Postnasal drip
- Visible growths or blockage in the nasal passages
- Facial pressure or pain
- Recurrent sinus infections
- Bleeding from the nose
- Symptoms that persist despite medication treatment
Prompt evaluation is recommended if you notice any unusual growths, bleeding, or dark discoloration of nasal tissues. Rarely, a bluish colored nasal mass may indicate a dangerous condition requiring urgent biopsy.
Conclusion
Nasal polyps typically appear as pale yellow or greyish growths originating from the nasal membranes. This yellowish hue results from enzyme byproducts linked to chronic inflammation in the sinuses. The color helps distinguish benign inflammatory polyps from other nasal masses. Reddish polyps may signal recent bleeding or infection, while black or blue masses are rare but require prompt evaluation. To relieve symptoms from nasal polyps, treatment options include nasal steroid sprays, surgery and managing underlying triggers like allergies. Consultation with an ENT specialist is advised for evaluation and management of problematic nasal polyps.