Medically known as rhinosinusitis, a sinus infection occurs when your nasal cavities become infected, swollen, and inflamed.
Sinusitis is usually caused by a virus and often persists even after other upper respiratory symptoms are gone. In some cases, bacteria, or rarely fungus, may cause a sinus infection. Other conditions such as allergies, nasal polyps, and tooth infections can also contribute to sinus pain and symptoms..
Acute sinusitis only lasts for a short time, defined by the American Academy of Otolaryngology as less than four weeks. An acute infection is usually part of a cold or other respiratory illness. Chronic sinus infections last for more than twelve weeks or continue to recur. Specialists agree that the main criteria for sinusitis include facial pain, infected nasal discharge, and congestion.
Many sinus infection symptoms are common to both acute and chronic forms. Seeing your doctor is the best way to learn if you have an infection, to find the cause, and to get treatment.
Pain is a common symptom of sinusitis. You have several different sinuses above and below your eyes as well as behind your nose. Any of these can hurt when you have a sinus infection.
Inflammation and swelling cause your sinuses to ache with a dull pressure. You may feel pain in your forehead, on either side of your nose, in your upper jaws and teeth, or between your eyes. This may lead to a headache.
When you have a sinus infection, you may need to blow your nose often because of nasal discharge, which can be cloudy, green, or yellow. This discharge comes from your infected sinuses and drains into your nasal passages.
The discharge may also bypass your nose and drain down the back of your throat. You may feel a tickle, an itch, or even a sore throat. This is called postnasal drip and it may cause you to cough at night when you’re lying down to sleep, and in the morning after getting up. It may also cause your voice to sound hoarse.
Your inflamed sinuses may also restrict how well you can breathe through your nose. The infection causes swelling in your sinuses and nasal passages. Because of the nasal congestion, you probably won’t be able to smell or taste as well as normal. Your voice may sound “stuffy.”
The relentless pressure and swelling in your sinuses can give you symptoms of a headache. Sinus pain can also give you earaches, dental pain, and pain in your jaws and cheeks.
Sinus headaches are often at their worst in the morning because fluids have been collecting all night long. Your headache can also get worse when the barometric pressure of your environment changes suddenly.
As the discharge from your sinuses drains down the back of your throat, it can cause irritation, especially over a long period of time. This can lead to a persistent and annoying cough, which can be worse when lying down to sleep or first thing in the morning after getting up from bed. It can also make sleeping difficult. Sleeping upright or with your head elevated can help reduce the frequency and intensity of your coughing.
Postnasal drip can leave you with a raw and aching throat. Although it may start as an annoying tickle, it can get worse. If your infection lasts for a few weeks or more, the mucus can irritate and inflame your throat as it drips, resulting in a painful sore throat and hoarse voice.
When to see your doctor
Make an appointment with your doctor if you have a fever, nasal discharge, congestion, or facial pain that lasts longer than ten days or keeps coming back.
A fever is not a typical symptom of either chronic or acute sinusitis, but it is possible. You could have an underlying condition that is causing your chronic infections, in which case you may need special treatment.
Using a nasal decongestant spray, such as oxymetazoline, can help relieve sinus infection symptoms short-term. But you should limit your use to no more than three days. Longer use can cause a rebound effect in nasal congestion. When using nasal spray to treat a sinus infection, keep in mind that prolonged use can make your symptoms worse.
Sometimes a steroid nasal spray, such as fluticasone, triamcinolone or mometasone, can help with nasal congestion symptoms without the risk of rebound symptoms from prolonged use. Currently, fluticasone and triamcinolone nasal sprays are available over-the-counter
Decongestants are typically not recommended for people with high blood pressure, prostate issues, glaucoma, or sleep difficulties. Talk to your doctor before taking any of these medicines to make sure that they are the best choice for your specific medical condition.
Recent studies have shown the usefulness of nasal irrigation in both acute and chronic sinusitis, as well as allergic rhinitis and seasonal allergies.
According to the CDC, there is a small risk of infection when using tap water as part of a nasal rinse system. If using tap water, it is recommended that you boil the water and allow it to cool, or use a water filtration system. Other options include buying distilled water or using over-the-counter premixed solutions. Nasal solutions can be made at home by mixing 1 cup of prepared warm water with 1/2 teaspoon of table salt and 1/2 teaspoon of baking soda and spraying it into your nose using a nasal sprayer, or by pouring it in your nose with a Neti pot or sinus rinsing system. This saline and baking soda mixture can help clear your sinuses of discharge, relieve dryness, and flush allergens.
In Europe, herbal medications are commonly used for sinusitis. The product GeloMytrol, which is an oral capsule of essential oils and Sinupret, an oral mixture of elderflower, cowslip, sorrel, verbena, and gentian root have both been shown in studies to be effective in treating both acute and chronic sinusitis. It is not recommended to mix these herbs yourself. Using too little or too much of each herb can have unintended side effects, such as allergic reactions or diarrhea.
Antibiotics, like amoxicillin, are only used to treat acute sinusitis that has failed other treatments such as nasal steroid sprays, pain medications and sinus rinse/irrigation. Talk to your doctor before attempting to take antibiotics for sinusitis. Side effects, such as a rash, diarrhea, or stomach issues, can result from taking antibiotics for sinusitis. The overuse and inappropriate use of antibiotics also leads to superbugs, which are bacteria that cause serious infections and cannot be easily treated.
Avoiding things that irritate your nose and sinuses can help decrease sinusitis. Cigarette smoke can make you especially prone to sinusitis. Smoking damages the natural protective elements of your nose, mouth, throat and respiratory system. Ask your doctor if you need help quitting or if interested in quitting. It can be an important step in preventing episodes of both acute and chronic sinusitis.
Wash your hands frequently, especially during cold and flu season, to keep your sinuses from becoming irritated or infected by viruses or bacteria on your hands.
Talk to your doctor to see if allergies are causing your sinusitis. If you’re allergic to something that causes persistent sinus symptoms, you will likely need to treat your allergies. You may need to seek an allergy specialist allergic immunotherapy shots or similar treatments. Keeping your allergies under control can help prevent repeated episodes of sinusitis.
It’s common for children to have allergies and to be prone to infections in the nose and ears. Colds happen frequently and it is estimated that up to 10 percent of them will lead to acute sinusitis.
Your child may have a sinus infection if they have the following symptoms:
- a cold that lasts over 7 days with fever
- swelling around eyes
- thick, colored drainage from the nose
- post-nasal drip, which can cause bad breath, coughing, nausea, or vomiting
See your child’s doctor to determine the best course of treatment for your child. Nasal sprays, saline sprays, and pain relief are all effective treatments for acute sinusitis.
Do not give over-the-counter cough or cold medicines or decongestants to your child if they’re under 2 years old.
About 90 percent of children will fully recovery from a sinus infection without antibiotics. Antibiotics are used for severe cases of sinusitis or in children who have other complications because of sinusitis. If your child doesn’t respond to treatment or develops chronic sinusitis, your doctor might recommend that they see an otolaryngologist, who specializes in ear, nose, and throat (ENT) issues. An ENT specialist can take a culture of nose drainage to better understand the cause of an infection. The ENT specialist can also examine the sinuses more closely and look for any problem in the structure of the nasal passages that could lead to chronic sinus problems.
Outlook and recovery
Acute sinusitis usually goes away within one to two weeks with proper care and medication. Chronic sinusitis is more severe and may require seeing a specialist or having long-term treatment to address the cause of the constant infections. Chronic sinusitis can last for three or more months. Good hygiene, keeping your sinuses moist and clear, and treating symptoms immediately can help shorten the course of the infection.
Many treatments and procedures exist for both acute and chronic cases. Even if you experience multiple acute episodes or chronic sinusitis, seeing a doctor or specialist can greatly improve your outlook after these infections.