What is the main side effect associated with the use of intranasal steroids?

Intranasal steroids are commonly used to treat conditions such as allergic rhinitis and chronic sinusitis. One of the more prevalent side effects associated with their use is epistaxis, or nosebleeds. This occurs because the local application of steroid medication can lead to the thinning of the nasal mucosa and disruption of the nasal blood vessels, making them more susceptible to bleeding.

While dry throat, headaches, and chest pain can be side effects of other medications or conditions, they are not primarily associated with intranasal steroids. Dry throat may result from other types of medication or environmental factors, headaches can be caused by various other reasons, and chest pain is not relevant to the typical side effect profile of intranasal steroids. Thus, epistaxis stands out as the most recognized and clinically significant side effect when using intranasal steroid preparations.