Sinusitis

Sinusitis is an infection that causes sinus tissue in the nose to swell. It affects about 11% of people in the U.S. each year, causing sinus pressure and congestion.

A sinus infection tends to go away after a week or so. Home remedies and over-the-counter medicines can help relieve symptoms.

If sinusitis symptoms persist or keep coming back, you may need antibiotics or further testing.

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On this page

• What Is Sinusitis?
• What Are the Symptoms of Sinusitis?
• How Do You Diagnose Sinusitis?
• How Do You Treat Sinusitis?

What Is Sinusitis?

Doctors define sinusitis as an infection in the sinuses.

The sinuses are hollow areas behind the nose and below the eyes. They have mucus to trap germs and a lining of small hairs to help drain the mucus.

What causes sinusitis?

Most often, a viral infection causes sinusitis. For instance, a common cold can progress to a sinus infection if the virus infects the sinus membranes.

More rarely, bacteria can cause sinusitis. This can happen after a virus because the added mucus of the immune system response can promote bacterial growth. Or it can occur when mucus builds up for another reason, like allergies.

People with weaker immune systems may get sinusitis from a fungal infection.

Sinusitis differs from a common cold (rhinitis), though the symptoms can be alike.

The common cold causes mucus in the nose and sinuses — the immune system's response to the virus. But sinusitis causes swelling of the sinus lining and more mucus.

What Are The Signs and Symptoms of Sinusitis?

Sinus infection symptoms include:

• Congestion or a stuffed-up nose.
• Decreased sense of smell.
• Thick and opaque nasal discharge.
• Pressure or pain near the bridge of the nose, the forehead, or under the eyes. (Some call this a sinus headache.)

You may also have other symptoms from the virus causing your sinusitis, such as:

• A fever.
• Cough.
• Fatigue.

When should I see a doctor about sinus problems?

You should see a doctor if you have:

• A fever that lasts longer than 3 days.
• Severe facial pain or severe headache.
• Sinus infection symptoms that don't go away after 10 days.
• Symptoms of a sinus infection that get better but then come back or worsen again.

These symptoms may mean you have bacterial sinusitis and need antibiotics, or that you have a complication from sinusitis.

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Sinusitis Types, Risks, and Complications

What are the types of sinusitis?

There are two main types of sinusitis: acute and chronic.

Acute sinusitis

Acute sinusitis can last up to 4 weeks but often goes away within 10 days. Most cases of acute sinusitis don't need treatment.

Subacute sinusitis lasts beyond 1 month, with more mild symptoms, compared to the initial symptoms. Subacute sinusitis may resolve, or it may become chronic.

Chronic/recurrent sinusitis

• Chronic sinus infections are when symptoms last more than 12 weeks.
• Recurrent sinusitis means you get four sinus infections per year that last less than 4 weeks each.

People who have chronic/recurrent sinusitis should see a doctor to find out the cause and get treatment.

Are sinus infections contagious?

Common cold viruses cause most sinus infections. These viruses spread through viral particles in the air — coughing, talking, or sneezing — or through touching.

Many people who catch a cold don't get a sinus infection. They only get cold symptoms.

What are sinusitis risk factors and complications?

Certain risk factors can make people more likely to get sinus infections:

• Your age. Children are more prone to sinus infections than adults.
• Not getting enough sleep.
• Having allergies or asthma.

Chronic sinus infections are more common in people with:

• Cilia dysfunction, where the hairs in the sinuses don't properly clear out the mucus.
• Nasal polyps, or benign cysts in the sinuses.
• Cystic fibrosis, a genetic issue.
• Weaker immune systems, due to a health problem or medicine side effect.

Complications of sinusitis

Acute sinus infections rarely cause issues.

Complications are more likely to occur with chronic/recurrent sinusitis but are still rare.

These include:

• A cyst that can block the sinuses and put pressure on the optic nerve of the eye. This can affect vision and may require surgery.
• Permanent decreased sense of smell if the swelling damages nerves in the sinuses.
• Spreading to the skin, eye, fluid surrounding the brain and spinal cord, outer layer of the brain, or the bones. (These are very rare.)

How can I reduce my risks of sinusitis?

To reduce your risk of a sinus infection, you can:

• Avoid close contact with people who have a respiratory infection, like a cold or flu.
• See your doctor for treatment if you have allergies or asthma.
• Use a humidifier if your home is dry to reduce mucus buildup in the sinuses.
• Wash your hands to avoid the spread of germs.

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How Do You Diagnose Sinusitis?

The doctor will ask about your symptoms, when they started, and whether you've had sinus infections in the recent past.

If your sinus infection didn't get better or came back after 10 days, it's likely bacterial. In most cases, your doctor will prescribe antibiotics without doing tests.

If you have chronic or recurrent sinusitis, your doctor may test you for allergies or asthma.

These may include:

• Blood tests, which can also find signs of other rare health issues that may cause sinusitis
• Allergy skin test.
• Lung function tests.

If your doctor thinks there might be a complication from a sinus infection, they may also order a CT scan.

Imaging tests look for a cyst in the sinuses or swelling around the eyes or brain.

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How Do You Treat Sinusitis?

In most cases, you don't need prescription medicine to treat a sinus infection. That's because most cases of viral sinusitis clear on their own within 3 to 10 days.

You can help relieve symptoms with these at-home sinus infection treatments:

• Drink plenty of fluids and get rest to support your immune system.
• Flush the sinuses with a saline (salt water) nasal spray.
• Put a warm cloth on your nose and forehead to decrease congestion.
• Take an OTC pain reliever for sinus pain or pressure, if needed.
• Try an oral decongestant or nasal spray for congestion. Be sure to read the label on proper use. Many decongestants cause congestion if you use them for more than 3 days.
• Use a humidifier to help break up mucus.
• Use a corticosteroid nasal spray to reduce swelling in the sinuses. You don't need a prescription.

If you have sinusitis that lasts more than 10 days, see your doctor. This means you likely have a bacterial infection and need antibiotics.

If you have chronic or recurrent sinusitis, your sinusitis treatments will depend on the cause.

For instance, your doctor may:

• Need to treat your allergies.
• Change any medicines that weaken your immune system.
• Prescribe nasal spray, which can work better than those sold over the counter.

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By UPMC Editorial Staff. Last reviewed on 2024-05-14 by Donna Geraci, CRNP.