Local corticosteroids, why are they not used more / properly ?

It has been almost 50 years since Niels Mygind published the first paper on the use of nasal corticosteroids. Twenty years ago, Weiner et al. showed in their systematic review that nasal corticosteroids are more effective than oral antihistamines in patients with allergic rhinitis. Over 3000 papers later, all showing the efficacy and superiority of local corticosteroids over most other treatment options available in rhinitis and chronic rhinosinusitis (CRS); we still have not been able to convince the public and our colleagues that most patients with rhinitis/rhinosinusitis would significantly benefit from the use of a local corticosteroid.