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Most of us associate sinus issues with the winter months and flu season, but that’s not always the case.

It’s possible to have a sinus infection any time of year, including during the summer months. Hot, humid summer weather, a sinus infection, and a mask on top is a recipe for an uncomfortable situation.

But could your mask actually be causing or worsening your summer sinus situation? Let’s take a closer look at the connection between masks and your sinuses.

Sinus infections, or rhinosinusitis, occur when the lining in the sinuses and nasal cavity become inflamed.

The majority of sinus infections occur during the winter months, but certain factors during summer can also lead to sinus infections — or at least symptoms that people might mistake for a sinus infection.

Sujan Gogu, an osteopathic physician board certified in family medicine, sports medicine, and pain medicine, says sinus infections can happen from a number of summer-related sources, including:

“In most parts of the [United States], pollen increases during the summer. With climate change, this has had a huge impact as our summers have changed,” he adds.

A 2018 review noted that sinus issues can be triggered by changes in:

  • weather
  • allergies
  • environmental irritants, like pollen

A 2020 review noted that 12 out of 17 locations on multiple continents showed an increase in pollen load over time, and that this increase was significantly associated with an increase in maximum temperatures.

The review also noted that the American Academy of Allergy Asthma & Immunology (AAAAI) has linked climate change to an increase in the intensity and duration of pollen season.

For some people, breathing pollen-laden air can cause:

  • sneezing
  • itchy nose
  • watery eyes
  • nasal congestion

All of this can bring about sinus issues.

A person can have either acute sinusitis (symptoms last less than 4 weeks), chronic sinusitis (symptoms last greater than 12 weeks), or subacute (symptoms last somewhere in the middle).

Symptoms of acute sinusitis include:

People may mistake symptoms for a sinus infection when they’re something else, according to Dana Crosby, MD, the director of rhinology, endoscopic skull base surgery, and otolaryngic allergy​ at the Southern Illinois University School of Medicine.

Viral URIs are often confused with sinus infections and inappropriately treated with antibiotics. Adenitis in kids can also look like a sinus infection.

It’s important to note that allergies don’t necessarily indicate a sinus infection unless the mucosal lining of the sinuses becomes inflamed.

“Right now, it’s also important to try to differentiate the symptoms of COVID-19 from a sinus infection,” Crosby adds.

Wearing your mask during the summer months may make it feel more difficult to breathe. But does that actually mean that masks are causing sinus issues?

Anecdotally, Gogu notes, “I have seen an uptick [of sinus infections] in the Rio Grande Valley of Texas.” However, he believes this is due to the summer heat, humidity, and rain, rather than masks.

“More and more parts of the country will start to have people having trouble with sinuses as the planet warms up,” Gogu says.

On the other hand, Crosby hasn’t noticed an increase in summer sinus issues in her region.

“In general, potentially due to mask wearing or social distancing, I have seen fewer issues with sinusitis, regardless of the season,” she says.

There hasn’t been much research yet on the trends of sinus infections and masking due to the relative newness of widespread masking. Anecdotally, some medical professionals have seen more viral URIs in kids due to loosening mask mandates.

A 2021 study found that there was a reduction in ear, nose, and throat-related visits to emergency departments during the pandemic. This could indicate fewer sinus infections, but it could also be related to people avoiding crowds and hospital settings due to COVID-19.

Perhaps the most applicable study done on this subject examined if masks made symptoms worse for patients who had rhinosinusitis balloon sinuplasty, a medical treatment for chronic sinus infections, during the COVID-19 pandemic.

The study found that there was no difference in symptoms between pre-pandemic patients and those who wore masks throughout the pandemic.

The authors stated that patient reports of worsening sinus symptoms with mask usage is likely to be perceived discomfort rather than a physical exacerbation.

In other words, the discomfort of the mask itself often gets confused with sinus discomfort when the two aren’t related.

The bottom line

Reports of sinus symptoms getting worse with mask usage are likely due to perceived discomfort. Research shows that sinus issues aren’t worsened by masks.

Masks can filter irritants or allergens, which may play a role in preventing sinus issues.

Crosby believes that masks, in part, may protect allergy-prone people from some aeroallergens they would otherwise be exposed to, thereby preventing sinus infections.

A 2020 study supported this theory. It found that face masks — both N95 and surgical — reduced allergic rhinitis symptoms among nurses during the pandemic.

Allergic rhinitis is not the same as sinusitis. However, it can lead to sinusitis in some cases.

Social distancing and masking can also reduce the spread of viral URIs, which is another trigger for sinus infections.

“Keep in mind that there’s no evidence that wearing a mask makes you [sicker]. While it might be an inconvenience, most people with true sinus symptoms note that their quality of life has improved with mask wearing,” Crosby says.

She notes that many of her patients have reported they will likely wear masks more in the future for better symptomatic control.

Overall, it’s unlikely for masking to cause sinus infections or make sinus infections worse. In fact, masking may help prevent sinus infections for some people.

Still, many people still report discomfort with masks. Luckily, there are a few ways to cope with this.

The bottom line

Most people with sinus symptoms note that their quality of life improves with mask-wearing.

If your nose is clogged, and you have facial pressure, breathing can feel difficult.

While Crosby doesn’t believe that sinus issues are worsened by mask wearing, she does note that “some people may perceive it’s more difficult to breathe with a mask [during] the summer months due to the increase in temperatures and humidity.”

Despite this common perception, Crosby says that mask-wearing, even in summer heat, “is very safe.”

If your mask is getting you down, try these tips:

  • Take frequent mask breaks if possible.
  • Only wear the same mask for a couple of hours.
  • Frequently wash reusable masks.
  • Bring a plastic bag of “clean” and “dirty” masks when you go out, so you always have a fresh one on hand.
  • Choose masks made of non-irritating fabrics, like cotton.
  • Avoid wearing makeup under your mask.

Crosby recommends that, if your mask feels too uncomfortable in the heat, you should find a place outside in the shade where you can take a mask break and catch your breath safely.

If you have a history of sinusitis, this discomfort might increase the longer you wear your mask. This is due to an increase in heat and humidity over time. If it’s possible, try to avoid situations where you have to wear a mask for hours, or take frequent mask breaks.

Additionally, wearing the same mask over and over for prolonged periods isn’t recommended.

“It collects bacteria, and bacteria proliferate, causing risk for sinusitis,” Gogu says.

Gogu also recommends being aware of your mask’s fabric. Certain fabrics may be more irritating. Many people find that a surgical mask is most comfortable.

Wearing makeup under your mask is also not advised.

“You can inadvertently be taking your mask off and on, not knowing some of those particles could be irritating your nasal mucosa every time,” Gogu says.

Both Crosby and Gogu agree, however, that wearing a mask is completely safe and may even help your sinus issues in the long run.

It can be challenging to differentiate between symptoms of sinus infections, allergies, URIs, and COVID-19.

If you experience loss of smell and other COVID-19 symptoms, it’s important to discuss it with your primary care doctor.

COVID-19 symptoms include:

If you suspect you might have COVID-19, immediately quarantine and get tested.

If your symptoms persist past 12 weeks, you may benefit from seeing an ear, nose, and throat doctor.

Masks are unlikely to worsen or cause sinus infections. In fact, masks can protect against triggers of sinus infections, like airborne allergens and viruses.

Climate change can contribute to increased pollen and warmer temperatures. According to some experts, it may actually be a bigger factor in causing sinus issues this summer.

If you’re uncomfortable wearing a mask, there are a few ways to cope, like choosing a soft, breathable fabric and taking frequent mask breaks.

Ultimately, masks are an essential tool during the COVID-19 pandemic, and they’re completely safe — even for people with a history of sinus infections.

Sarah Bence is an occupational therapist (OTR/L) and freelance writer, primarily focusing on health, wellness, and travel topics. Her writing can be seen in Business Insider, Insider, Lonely Planet, Fodor’s Travel, and others. She also writes about gluten-free, celiac-safe travel at EndlessDistances.com.