Sinusitis can resemble a cold but may cause additional symptoms, including facial pressure or sinus headache. Symptoms and treatment may differ depending on whether the cause is bacterial or viral.
A sinus infection, medically known as sinusitis or rhinosinusitis, occurs when your nasal cavities become infected, swollen, and inflamed. Fluid buildup in the sinuses can cause germs to grow, leading to a sinus infection.
Sinusitis is usually caused by a virus and often lasts 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.
There are four types of sinus infections. These classifications depend on the length and frequency of the infection:
- Acute sinusitis. This type of sinus infection lasts only for a short time, defined by the American Academy of Otolaryngology as less than 4 weeks. This short-term infection is usually part of a cold or other respiratory illness. It may also be caused by a bacterial infection (acute bacterial sinusitis).
- Subacute sinusitis. A subacute sinus infection lasts between
4 and 12 weeks.
- Recurrent acute sinusitis. An acute sinus infection is considered recurrent if the infection returns four or more times within a year, with each infection lasting 7 days or more.
- Chronic sinusitis. Chronic sinus infections last for more than 12 weeks or continue to recur.
Many sinus infection symptoms are common in both acute and chronic forms. Seeing a doctor is the best way to learn if you have an infection, find the cause, and get treatment.
Sinusitis symptoms often resemble those of a cold. The main criteria for viral sinusitis include:
- facial pain or pressure
- infected nasal discharge
- nasal congestion
For cases of acute bacterial sinus infections, these symptoms last at least 10 days without improving, or they worsen within 10 days after seeming to improve. In this case, it’s important to talk with a doctor, such as a general practitioner or an ear, nose, and throat doctor (ENT), to get a diagnosis and treatment plan.
Learn more about the symptoms of a sinus infection below.
Pain or pressure in your sinuses
Facial 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 air-filled cavities can hurt when you have a sinus infection.
Inflammation and swelling can cause your sinuses to ache with dull pressure. This is because inflammation may alter the typical path of mucus from the nose to the back of the throat.
You may feel pain in:
- your forehead
- on either side of your nose
- in your upper jaws and teeth
- between your eyes
This may lead to a headache. Headaches caused by sinus infections can occur where the sinuses are or in other places.
Tenderness in the face
Your face may also be tender to the touch due to the built-up pressure. This tends to occur at the bridge of the nose or under the eyes, and may also occur on the forehead and cheeks.
Runny nose and postnasal drip
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 and can lead to a “blocked“ feeling.
Because of the nasal congestion, you probably won’t be able to smell or taste as well as normal. Your voice may also sound “stuffy.”
Persistent pressure and swelling in your sinuses can give you symptoms of a headache. Sinus pain can also cause earaches and pain in your teeth, 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 around you changes suddenly, or when you change the position of your head.
Throat irritation and cough
As 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.
Sore throat and hoarse voice
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, mucus can irritate and inflame your throat as it drips, resulting in a painful sore throat and hoarse voice. Frequent coughing and throat clearing can make a hoarse voice worse.
While not common, fever may also occur with sinusitis, as it does with many types of infections.
A fever due to this type of infection typically falls in the low grade range, meaning 100.4 to 103°F (38 to 39.4°C). Having a fever is a signal that the body is fighting off a virus or a bacterial or fungal infection.
Bad breath (halitosis)
The mucus that’s produced by your infected sinuses can smell bad and drip down the throat into the mouth. Drinking a lot of water along with frequent mouth rinsing, sinus rinses, or brushing your tongue may help reduce this symptom.
Using a nasal decongestant spray, such as oxymetazoline, can help relieve sinus infection symptoms in the short term. But you should limit your use to no more than 3 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 (Flonase), 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.
Other over-the-counter medications that contain antihistamines and decongestants can help with sinus infections, particularly if you also experience allergies. Popular medications of this kind include:
- cetirizine (Zyrtec)
- fexofenadine (Allegra)
- loratadine (Claritin)
Decongestants are typically not recommended for people with:
Talk with a doctor before taking any of these medications to make sure they are the best choice for your specific situation.
Nasal irrigation involves flushing out your nostrils with sterile water or a nasal solution. A
If using tap water, doctors recommend 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.
Using unfiltered tap water instead of sterile water could lead to a type of fatal infection, according to the
Nasal solutions also can be made at home by mixing 1 cup of prepared sterile warm water with a 1/2 teaspoon of table salt and 1/2 teaspoon of baking soda.
Spray the mixture into your nose using a nasal sprayer, or pour it into your nose with a Neti pot or other sinus rinsing system.
Talk with a doctor before making your own nasal spray. If mixed incorrectly, it’s possible the solution could irritate your nose.
This saline and baking soda mixture can help clear your sinuses of discharge, relieve dryness, and flush allergens.
In Europe, herbal medicines are commonly used for sinusitis.
Certain herbal treatments have been shown in
Additional research is needed to study these herbal mixtures compared with other methods for treatment. If you’re considering herbal remedies, be sure to talk with a doctor about which treatment options are right for you.
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, treat acute sinusitis caused by a bacterial infection that has not resolved with other treatments such as nasal steroid sprays, pain medications, and sinus rinses or irrigation.
Before prescribing antibiotics, a doctor may practice “watchful waiting,“ which involves monitoring a sinus infection to determine its cause before prescribing antibiotics. Antibiotics can only treat bacterial sinus infections.
A doctor may prescribe antibiotics for a bacterial sinus infection that has lasted 10 days or more without symptoms improving, or if symptoms seem to improve but then get worse within 10 days.
Talk with a doctor before attempting to take antibiotics for sinusitis.
Side effects can result from taking antibiotics for sinusitis, including:
- stomach issues
The overuse and inappropriate use of antibiotics also lead to
Other remedies for symptom relief
Staying hydrated can help thin mucus to ease congestion.
Drinking hot liquids such as tea and broth may help relieve your symptoms. Breathing in moist air may also help relieve the discomfort that comes with nasal congestion. Try breathing in steam from the shower, a bowl of hot water, or a mug of tea.
If your voice is hoarse, rest it by avoiding yelling, whispering, and singing.
Placing a warm compress over the inflamed area can help reduce pressure and provide relief.
Avoiding things that irritate your nose and sinuses can help decrease your chances of developing sinusitis. Cigarette smoke can make you especially prone to this type of infection. Smoking
If you smoke, consider quitting. Ask a doctor if you need help or are interested in quitting. Quitting may help prevent future episodes of both acute and chronic sinusitis.
Wash your hands frequently, especially during cold and flu seasons, to keep your sinuses from becoming irritated or infected by viruses or bacteria on your hands.
Using a humidifier during the cooler, dryer months may also help prevent sinus infections.
Talk with a 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 to relieve your sinus infection.
You may need to seek an allergy specialist to determine the cause of the allergy. The specialist may suggest:
- avoiding the allergen
- taking oral medications such as antihistamines
- doing allergic immunotherapy
Keeping your allergies under control can help prevent repeated episodes of sinusitis.
It’s also possible that another condition is causing your symptoms. For instance, gastroesophageal reflux disease (GERD) may cause sinus infections. In kids and adolescents, enlarged adenoids may also be a contributing factor. The first step should be getting a diagnosis from a general practitioner, pediatrician, or ENT.
Sinus infections often start to improve on their own after about 10 days. If your symptoms last longer without improving or if they worsen, a doctor may need to treat the underlying cause of the infection.
If a sinus infection affects a sinus cavity close to the brain, it can spread to the brain if left untreated. Though rare, an infection can also pass into the eye socket and cause vision changes or blindness. These types of infections are more common in kids.
While uncommon, a serious fungal sinus infection left untreated may pass into the bones.
Make an appointment with a doctor if you have severe symptoms, or if the following symptoms last longer than 10 days or keep coming back:
- nasal discharge
- facial pain
Because the cause of your sinus infection can affect your treatment options, it’s important to see a doctor for a diagnosis. The Healthline FindCare tool can provide options in your area if you’re looking for a doctor.
If you believe you have chronic or recurring sinusitis, consider asking for a referral to an otolaryngologist, also known as an ear, nose, and throat (ENT) specialist. You may need imaging and other tests to determine the cause of your symptoms.
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.
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.
Conditions causing your chronic infections may include:
- nasal polyps
- deviated septum
- other medical conditions
A doctor can try to figure out the cause of your sinus infection and offer options for treatment.
See a doctor immediately if you experience any symptoms of a more serious infection, such as:
- a fever over 103°F (39.4°C)
- stiff neck
- changes in vision
- other related symptoms that are concerning or severe
It’s common for children to have allergies and to be prone to infections in the nose and ears.
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
- postnasal 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.
Most children will fully recover 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 ENT doctor.
Acute sinusitis usually goes away within 1 to 2 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 recurring infections.
An episode of chronic sinusitis can last longer than
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.