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Sinus Infection (Sinusitis)

   Sinus infection (sinusitis) definition and facts

   What are the sinuses? How many do we have?

   18 signs and symptoms of sinus infection or sinusitis

   What is a sinus infection or sinusitis?

   What causes sinus infections or sinusitis?

   What are the types of sinusitis and sinus infections?

   How is sinus infection or sinusitis diagnosed?

   What kinds of doctors treat sinusitis and sinus infections?

   Are antibiotics necessary to treat sinus infections and sinusitis?

   What decongestants and nasal sprays soothe or cure sinus infections or sinusitis?

   What home remedies help soothe sinus infection or sinusitis symptoms?

   What are complications of sinus infection or sinusitis?

   Can sinus infection or sinusitis be prevented?

A woman in pain with a sinus headache.

Sinus infection (sinusitis) definition and facts

   Sinusitis or sinus infection is inflammation of the air cavities within the passages of the nose.

   Sinusitis can be caused by infection, allergies, and chemical or particulate irritation of the sinuses.

   Most people do not spread sinus infections to other people.

   Sinusitis may be classified as acute sinus infection, subacute sinus infection, chronic sinus infection, infected sinusitis, and noninfectious sinusitis.

   Sinusitis signs and symptoms include

       sinus headache,

       facial tenderness,

       pressure or pain in the sinuses, in the ears and teeth,


       cloudy discolored nasal or postnasal drainage,

       feeling of nasal stuffiness,

       sore throat,

       cough, and

       occasionally facial swelling.

   Symptoms of a bacterial sinus infection include

       facial pain,

       pus-like nasal discharge, and

       symptoms that persist for longer than a week and that are not responding to over-the-counter (OTC) nasal medications.

   Sinus infection is generally diagnosed based on the patient history and physical examination.

   Bacterial sinusitis is usually treated with antibiotics. Early treatment of allergic sinusitis may prevent secondary bacterial sinus infections.

   Home remedies for sinusitis and sinus infections include over-the-counter (OTC) medications such as acetaminophen (Tylenol and others), decongestants, and mucolytics. Nasal irrigation can be accomplished with a Neti-pot or rinse kit (nasal bidet).

   Rare fungal infections of the sinuses (for example, zygomycosis) are medical emergencies.

   Complications of a sinus infection that may develop are meningitis, brain abscess, osteomyelitis, and orbital cellulitis.

   There are no fungal vaccines available to prevent fungal sinus infections.

Quick GuideSinus Infection (Sinusitis) Symptoms & Treatment

Sinus Infection (Sinusitis) Symptoms & Treatment

Nasal allergy attack

Is Sinus Infection Contagious?

How Will I Know if I Have a Sinus Infection?

The majority of doctors think that most people do not transmit sinus infections except in rare instances, and conclude that sinus infections are not contagious.

Sinus infections usually begin with the symptoms of a cold (for example, a runny nose, occasional cough and/or mild fever), and then develop into pain and pressure in the sinus cavities. About 7 to 10 days after initial cold-like symptoms other symptoms develop that suggest you may have a sinus infection. Sinus infection symptoms include

   a yellowish-greenish nasal discharge that may have an odor,

   bad breath,

   puffiness around the eyes,


   pressure in the sinuses, and


Learn more about sinus infection contagious »

Illustration of sinuses.

What are the sinuses? How many do we have?

A sinus is a hollow, air-filled cavity. For the purposes of this article, a sinus will refer to those hollow cavities that are in the skull and connected to the nasal airway by a narrow hole in the bone (ostium). Normally all sinuses are open to the nasal airway through an ostium. Humans have four pair of these cavities each referred to as the:

   frontal sinus (in forehead),

   maxillary sinus (behind cheeks),

   ethmoid sinuses (between the eyes), and

   sphenoid sinus (deep behind the ethmoids).

The four pair of sinuses are often described as a unit and termed the "paranasal sinuses." The cells of the inner lining of each sinus are mucus-secreting cells, epithelial cells and some cells that are part of the immune system (macrophages, lymphocytes, and eosinophils).

Functions of the sinuses include humidifying and warming inspired air, insulation of surrounding structures (eyes, nerves), increasing voice resonance, and as buffers against facial trauma. The sinuses decrease the weight of the skull. If the inflammation hinders the clearance of mucous or blocks the natural ostium, the inflammation may progress into a bacterial infection.

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A doctor examining a patient with a sinus infection.

18 signs and symptoms of sinus infection or sinusitis

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There are many signs and symptoms of sinusitis and sinus infections. The following is a summary of predominant ones (18 total) that may occur. Most patients have several signs and symptoms at the same time. Others may have some symptoms that are intermittent; most do not have all symptoms at once. The signs and symptoms of a sinus infection or sinusitis include the following:

   Headache due to pressure in partially or completely blocked sinuses. The pain may increase when the person bends down.

   Facial tenderness and/or swelling when facial areas over sinus areas are touched.

   Pressure or pain due to mucus pressing on sinus tissue or inflammation of sinuses.

   Fever due to inflammation of sinus tissues and infection.

   A cloudy, discolored nasal drainage is often seen in bacterial sinus infections.

   Congestion is a feeling of nasal stuffiness, and occurs with both infectious and non-infectious sinusitis.

   Post nasal drip is mucus overproduction from sinusitis that flows to the throat and irritates throat tissue.

   Sore throat is inflammation of throat tissue by post nasal drip.

   Cough is a response to post nasal drip and body's attempt to clear out throat tissue irritants.

   Tooth pain caused by pressure on surrounding nerves and tissues

   Ear pain caused by pressure on surrounding nerves and tissues

   Eye pain caused by pressure on surrounding nerves and tissues

   Fatigue due to fever, immune response and/or coughing

   Bad breath usually is due to bacterial infections

   Itching/sneezing - In noninfectious sinusitis, other associated allergy symptoms of itching eyes and sneezing may be common, but may include some of the symptoms listed above for infectious sinusitis.

   Nasal drainage usually is clear or whitish-colored in people with noninfectious sinusitis.

   Ulceration can occur with rare fulminant fungal infections with sharply defined edges and a black, necrotic center in the nasal area. Some fungal infections cause dark, black-appearing exudates. This requires immediate medical evaluation.

   Multiple chronic (over 1-3 months) symptoms usually are a sign of subacute or chronic sinusitis

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A 3D illustration of sinusitis.

What is a sinus infection or sinusitis?

Inflammation of the air cavities within the passages of the nose (paranasal sinuses) is referred to as sinusitis. Sinusitis can be caused by infection (sinus infection), but also can be caused by allergy and chemical irritation of the sinuses. A sinus infection (infectious sinusitis) occurs when a virus, bacterium, or a fungus grows within a sinus.

Sinusitis is one of the more common conditions that can afflict people throughout their lives. Sinusitis commonly occurs when environmental pollens irritate the nasal passages, such as with hay fever. Sinusitis can also result from irritants, such as chemicals or the use and/or abuse of over-the-counter (OTC) nasal sprays, and illegal substances that may be snorted or inhaled through the nose. About 30 million adults have "sinusitis." Colds differ from sinusitis and are only caused by viruses and last about 7 - 10 days while sinusitis may have many different causes (infectious and non-infectious), and usually last longer with more pronounced and variable symptoms.

Illustration of cilia and mucus in the nasal cavity.

What causes sinus infections or sinusitis?

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Sinus infections or sinusitis may be caused by anything that interferes with airflow into the sinuses and the drainage of mucus out of the sinuses. The sinus openings (ostea) may be blocked by swelling of the tissue lining and adjacent nasal passage tissue, for example with

   common colds,

   allergies, and

   tissue irritants such as OTC nasal sprays, cocaine, and cigarette smoke.

Other causes of sinus infections or sinusitis

Tumors or growths also can block the sinuses if they are near the sinus openings.

Dehydration, disease, drying medications, and lack of sufficient humidity can cause sinusitis or sinus infection.The drainage of mucous from the sinuses can also be impaired by thickening of the mucous secretions, by decrease in hydration (water content) of the mucous brought on by disease (for example, cystic fibrosis), drying medications (antihistamines), and lack of sufficient humidity in the air. The epithelial cells have small hair-like fibers, called cilia, which move back and forth to help the mucus move out of the sinuses. These small cilia may be damaged by many irritants, especially smoke. This can prevent them from assisting the mucus in draining from the sinuses, and thus results in sinus infections or sinusitis.

Stagnated mucus provides an environment for bacteria, viruses and in some circumstances, (for example, AIDS or immunodepressed persons) fungus, to grow within the sinus cavities. In addition, the microbes themselves can initiate and exacerbate sinus blockage. The most commonly infected sinuses are the maxillary and ethmoid sinuses.

Rarely, immunodepressed or victims of multiple traumas in disasters such as tsunamis, hurricanes, earthquakes, or tornadoes may breathe in fungi from the soil or water. Eventually, in a few days to over a week, the fungi can grow and cut off blood supply to almost any type of tissue, especially in the nose and eyes. These infections, although rare, are serious and can be deadly and require immediate medical and surgical care. Although the fungal infection may resemble common bacterial sinusitis initially, it is a disease termed zygomycosis or mucormycosis.

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False color brain MRI showing mucosal thickening in both maxillary sinuses.

What are the types of sinusitis and sinus infections?

Sinusitis may be classified in several ways, based on its duration (acute, subacute, or chronic) and the type of inflammation (either infectious or noninfectious). The term rhinosinusitis is also used to imply that both the nose and sinuses are involved.

   Acute sinus infection (also termed acute sinusitis caused by infection or acute bacterial rhinosinusitis) is usually defined as being of less than 30 day duration.

   Subacute sinus infection as being over 1 month but less than 3 months.

   Chronic sinus infection as being greater than a 3 month duration. Chronic sinusitis may be further sub-classified into chronic sinusitis with or without nasal polyps, or allergic fungal sinusitis.

   Recurrent sinusitis is when a person has several attacks per year

There is no medical consensus on the above time periods.

   Infected sinusitis usually is caused by uncomplicated virus infection. Less frequently, bacterial growth causes sinus infection and fungal sinus infection is very infrequent. Subacute and chronic forms of sinus infection usually are the result of incomplete treatment of an acute sinus infection.

   Noninfectious sinusitis is caused by irritants and allergic conditions and follows the same general time line for acute, subacute and chronic as infectious sinusitis.

An ENT doctor using a rhinoscope to examine the nose of a patient.

How is sinus infection or sinusitis diagnosed?

Sinus infection is most often diagnosed based on the history and examination of a doctor. Because plain X-ray studies of the sinuses may be misleading and procedures such as CT and MRI scans, which are much more sensitive in their ability to diagnose sinus infection, are so expensive and not available in most doctors' offices, most sinus infections are initially diagnosed and treated based on clinical findings on examination. These physical findings may include:

   redness and swelling of the nasal passages,

   purulent (pus like) drainage from the nasal passages (the symptom most likely to clinically diagnose a sinus infection),

   tenderness to percussion (tapping) over the cheeks or forehead region of the sinuses, and

   swelling about the eyes and cheeks.

Occasionally, nasal secretions are examined for secreted cells that may help differentiate between infectious and allergic sinusitis. Infectious sinusitis may show specialized cells of infection (polymorphonuclear cells) while allergic sinusitis may show specialized white blood cells of allergy (eosinophils). Physicians prescribe antibiotics if bacterial infection is suspected. Antibiotics are not effective against viral infections; many physicians then treat the symptoms.

If sinus infection fails to respond to the initial treatment prescribed, then more in-depth studies such as CT or MRI scans may be performed. Ultrasound has been used to diagnose sinus infections in pregnant women, but is not as accurate as CT or MRI. Rhinoscopy or endoscopy, a procedure for directly looking in the back of the nasal passages with a small flexible fiber optic tube, may be used to directly look at the sinus openings and check for blockage of these openings by either swelling or growths.

It may sometimes be necessary to perform a needle aspiration (needle puncture) of a sinus to get infected material to culture to determine what microbe is actually causing the sinus infection. Cultures of the nasal passages are rarely helpful in determining what bacteria or fungus is causing a sinus infection since the nasal passages are often normally colonized by non-infecting bacteria. The needle puncture procedure is usually done by an otolaryngologist when treatments have failed to alleviate the disease. The procedure requires local anesthesia to minimize any discomfort; some patients require general anesthesia. The sinus is aspirated, the contents sent for culture and staining, and the sinus may be flushed with a saline solution. This is technically the most accurate way to diagnose infectious sinusitis.

In addition, both rigid and flexible endoscopy has been used to obtain diagnostic material from sinuses. These procedures are usually done by an otolaryngologist under topical and local anesthesia. Occasionally, there may be a need to sedate the patient. Some investigators suggest that endoscopy specimens are comparable to those obtained by needle puncture.

Fungal infections are usually diagnosed by such biopsy procedures and tissue removed by a surgeon, or by fungal culture and microscopic identification by a microbiologist or pathologist trained to identify fungi. Allergic fungal sinusitis (emphasis on allergic) is an inflammatory response to fungal elements in the sinus cavity and is suspected based on certain CT imaging characteristics as well as the history and physical exam.

What kinds of doctors treat sinusitis and sinus infections?

Many sinus infections can be treated by your primary care physician or an Internal Medicine doctor. However, it is not unusual to consult an ENT (Eye, Ears, Nose and Throat) specialist, Infectious disease specialist, Allergist or Immunologist. With some complex sinus infections, a surgeon who specializes in sinus surgery may be necessary to consult.

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Decongestant medications and a tissue box.

Are antibiotics necessary to treat sinus infections and sinusitis?

   Readers Comments 36

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For sinusitis caused by virus infection, no antibiotic treatment is required. Frequently recommended treatments include pain and fever medications (such as acetaminophen [Tylenol]), decongestants and mucolytics (medication that dissolve or breakdown mucous, for example, guaifenesin.

Bacterial infection of the sinuses is suspected when facial pain, nasal discharge resembling pus, and symptoms persist for longer than a week and are not responding to OTC nasal medications. Acute sinus infection from bacteria is usually treated with antibiotic therapy aimed at treating the most common bacteria known to cause sinus infection, since it is unusual to be able to get a reliable culture without aspirating the sinuses.

The five most common bacteria causing sinus infections are Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and Streptococcus pyogenes. The antibiotics that are effective treatment for sinus infection must be able to kill these bacterial types. Although amoxicillin (Amoxil) is an acceptable first antibiotic for an uncomplicated acute sinus infection, many physicians choose amoxicillin-clavulanate (Augmentin) as the first-line drug for treatment of a suspected bacterial sinus infection because it is usually effective against most of the species and strains of bacteria that cause the disease.

In the penicillin allergic individual, cefaclor (Ceclor), loracarbef (Lorabid), clarithromycin (Biaxin), azithromycin (Zithkromax), sulfamethoxazole (Gantanol), trimethoprim (Bactrim, Septra) ciprofloxin (Cipro), and other antibiotics may be used as first choices. If a patient is not improving after five days of treatment with amoxicillin, the patient may be switched to one of the above drugs or amoxicillin-clavulanate (Augmentin). Generally, an effective antibiotic needs to be continued for a minimum of 10-14 days. However, it is not unusual to need to treat sinus infection for 14-21 days. Some antibiotics are now thought to also reduce inflammation, independent of the anitbacterial activity.

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A woman using nasal spray.

What decongestants and nasal sprays soothe or cure sinus infections or sinusitis?

Taking decongestants (pseudoephedrine) and mucolytics (guaifenesin) orally may be helpful in assisting drainage of sinus infection.

The treatment of chronic forms of sinus infection requires longer courses of medications, such as Augmentin, and may require a sinus drainage procedure. This drainage typically requires a surgical operation to open the blocked sinus under general anesthesia.In general, antihistamines should be avoided unless it is felt that the sinusitis sinus infection is due to allergy, such as from pollens, dander, or other environmental causes.

It is likely that the use of a topical nasal steroid spray will help reduce swelling in the allergic individual without the drying that is caused by using antihistamines although both are occasionally used.Oral steroids may be prescribed to reduce acute inflammation and to help with chronic inflammation in cases with or without polyps and in allergic fungal sinusitis.

In many people, allergic sinusitis develops first, and later, bacterial infection occurs. For these individuals, early treatment of allergic sinusitis may prevent development of secondary bacterial sinusitis.

In rare instances or in natural disasters, fungal infections (termed zygomycosis or mucormycosis) may develop in debilitated people. Death rates of 50%-85% have been reported for patients with these sinus infections. Treatment relies on early diagnosis followed by immediate surgical debridement, antifungal drugs, (mainly Amphotericin B) and stabilizing any underlying health problem such as diabetes.

Quick GuideSinus Infection (Sinusitis) Symptoms & Treatment

Sinus Infection (Sinusitis) Symptoms & Treatment

A woman using a sinus rinse kit.

What home remedies help soothe sinus infection or sinusitis symptoms?

   Readers Comments 7

   Share Your Story

Sinus infections caused by viruses can use home (over-the-counter, OTC) treatments such as pain and fever medications (acetaminophen [Tylenol]), decongestants, and mucolytics. In addition, some health-care professionals suggest nasal irrigation or a sinus rinse solution to help relieve symptoms of sinus infections, even chronic sinusitis symptoms. This irrigation is accomplished with a "Neti-Pot" or a sinus rinse kit (sometimes termed a nasal bidet). The last reference of this article shows a video of a sinus rinse procedure. In 2012, the FDA issued a warning about the use of Neti-Pots. The FDA cautions people not to use untreated tap water for rinsing, as contaminated tap water rinses lead to two deaths.

Bacterial and fungal sinus infections usually require antibiotic or antifungal therapy so home treatments without them are often not successful. However, some authors suggest home treatments may reduce symptoms after medical therapy has begun; some health-care professionals recommend nasal irrigation after sinus surgery.

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A doctor explaining complications of sinus infections using a model of a human head.

What are complications of sinus infection or sinusitis?

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While serious complications do not occur frequently, it is possible for sinus infection to cause a direct extension of infection into the brain through a sinus wall, creating a life-threatening emergency (for example, meningitis or brain abscess). In addition, other adjacent structures can become infected and develop problems, such as osteomyelitis of bones in the skull and infection around the eye (orbital cellulitis). Rarely, these infections (mainly bacterial and fungal organisms) may cause death. The most susceptible individuals to complications are patients with suppressed immune systems, diabetes, and relatively rarely from multiple trauma injuries that may occur in natural disasters.

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A girl blowing her nose at a doctor's office.

Can sinus infection or sinusitis be prevented?

Currently, there are no vaccines designed specifically against infectious sinusitis or sinus infections. However, there are vaccines against viruses (influenza) and bacteria (pneumococci) that may cause some infectious sinusitis. Vaccination against pathogens known to cause infectious sinusitis may indirectly reduce or prevent the chance of getting the disease but there are no specific studies to support this assumption.There are no fungal vaccines against sinusitis.

If a person is prone to recurrent bouts of "yearly sinus infection" it may be important to consider allergy testing to see if this is the underlying cause of the recurring problem. Treatment of the allergy may prevent secondary bacterial sinus infections. In addition, sinus infections may be due to other problems such as nasal polyps, tumors or diseases that obstruct normal mucus flow. Treatment of these underlying causes may prevent recurrent sinus infections.

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   Sinus Infection (Sinusitis) Center

Medically Reviewed on 8/18/2017


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Complete List

Top Sinusitis Related Articles

   Adenoids and Tonsils

   Tonsillitis is a contagious infection with symptoms of bad breath, snoring, congestion, headache, hoarseness, laryngitis, and coughing up blood.

   Tonsillitis can be caused acute infection of the tonsils, and several types of bacteria or viruses (for example, strep throat or mononucleosis). There are two types of tonsillitis, acute and chronic. Acute tonsillitis lasts from one to two weeks while chronic tonsillitis can last from months to years.

   Treatment of tonsillitis and adenoids include antibiotics, over-the-counter medications, and home remedies to relieve pain and inflammation, for example,  salt water gargle, slippery elm throat lozenges, sipping warm beverages and eating frozen foods (ice cream, popsicles), serrapeptase, papain, and andrographism Some people with chronic tonsillitis may need surgery (tonsillectomy or adenoidectomy ).

   Take the Allergies Quiz

   What are the causes of allergies? This online quiz challenges your knowledge of common food and household allergens, environmental triggers, allergic diseases and conditions, and allergy symptoms and treatments.

   Bacterial Infections 101

   Learn more about bacteria and the most common bacterial infections. Get more information on bacterial skin infections, which bacteria cause food poisoning, sexually transmitted bacteria, and more.

   CAT Scan

   A CT scan is an X-ray procedure that combines many X-ray images with the aid of a computer to generate cross-sectional and three-dimensional images of internal organs and structures of the body. A CT scan is a low-risk procedure. Contrast material may be injected into a vein or the spinal fluid to enhance the scan.

   Chronic Rhinitis

   Chronic rhinitis and post-nasal drip symptoms include an itchy, runny nose, sneezing, itchy ears, eyes, and throat. Seasonal allergic rhinitis (also called hay fever) usually is caused by pollen in the air. Perennial allergic rhinitis is a type of chronic rhinitis and is a year-round problem, often caused by indoor allergens, such as dust, animal dander, and pollens that may exist at the time. Treatment of chronic rhinitis and post nasal drip are dependent upon the type of rhinitis condition.

   Cold & Flu Quiz

   Aches? Pain? Fever? This Cold & Flu Quiz tests your knowledge on the difference between coming down with the common cold and sickness from influenza virus.

   Common Medical Abbreviations and Terms

   Doctors, pharmacists, and other health-care professionals use abbreviations, acronyms, and other terminology for instructions and information in regard to a patient's health condition, prescription drugs they are to take, or medical procedures that have been ordered. There is no approved this list of common medical abbreviations, acronyms, and terminology used by doctors and other health- care professionals. You can use this list of medical abbreviations and acronyms written by our doctors the next time you can't understand what is on your prescription package, blood test results, or medical procedure orders. Examples include:

       ANED: Alive no evidence of disease. The patient arrived in the ER alive with no evidence of disease. ARF: Acute renal (kidney) failure cap: Capsule. CPAP: Continuous positive airway pressure. A treatment for sleep apnea. DJD: Degenerative joint disease. Another term for osteoarthritis. DM: Diabetes mellitus. Type 1 and type 2 diabetes HA: Headache IBD: Inflammatory bowel disease. A name for two disorders of the gastrointestinal (BI) tract, Crohn's disease and ulcerative colitis JT: Joint N/V: Nausea or vomiting. p.o.: By mouth. From the Latin terminology per os. q.i.d.: Four times daily. As in taking a medicine four times daily. RA: Rheumatoid arthritis SOB: Shortness of breath. T: Temperature. Temperature is recorded as part of the physical examination. It is one of the "vital signs."

   CT Scan vs MRI

   CT scan (computerized tomography) is a procedure that uses X-rays to scan and take images of cross-sections of parts of the body. CT scan can help diagnose broken bones, tumors or lesions in areas of the body, blood clots in the brain, legs, and lung, and lung infections or diseases like pneumonia or emphysema.

   MRI (magnetic resonance imaging) is a procedure that uses strong magnetic fields and radiofrequency energy to make images of parts of the body, particularly, the organs and soft tissues like tendons and cartilage.

   Both CT and MRI are painless, however, MRI can be more bothersome to some individuals who are claustrophobic, or suffer from anxiety or panic disorders due to the enclosed space and noise the machine makes.

   MRI costs more than CT, while CT is a quicker and more comfortable test for the patient.


   Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.

   MRI Scan

   MRI (or magnetic resonance imaging) scan is a radiology technique which uses magnetism, radio waves, and a computer to produce images of body structures. MRI scanning is painless and does not involve X-ray radiation. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet.

   Nasal Airway Surgery

   Deviated septum surgery (septoplasty) and turbinectomy (nasal airway surgery) is performed on individuals who have a deviated or crooked septum or enlarged tissues (turbinates) within the nose. The goal of surgery is to improve breathing, control nosebleeds, relieve sinus headaches, and promote drainage of the sinus cavities. Risks and complications of surgery should be discussed with the surgeon prior to surgery.

   Natural Cold & Flu Remedies

   What natural remedies work for the flu and common cold? Many claim cold symptoms and flu symptoms can be relieved with Echinacea, zinc, neti pots, garlic, vitamin C, saltwater gargles, nasal strips, or bed rest. Find out what cold and flu treatments work the natural way, and what doesn't.


   Nosebleeds are common in dry climates during winter months, and in hot dry climates with low humidity. People taking blood clotting medications, aspirin, or anti-inflammatory medications may be more prone to nose bleeds. Other factors that contribute to nosebleed are

       trauma (including nose picking, especially in children), rhinitis (both allergic and nonallergic), and high blood pressure.

   First-aid treatments for a nosebleed generally do not need medical care. Frequent or chronic nosebleeds may require medical treatment such as over-the-counter (OTC) medication, and prevention of nose picking.

   Sinus Surgery

   Sinus surgery involves the precise removal of diseased sinus tissue with the improvement in the natural drainage channels by the creation of a pathway for infected material to drain from the sinus cavities. The sinus surgery information is provided to help you prepare for sinus surgery and to help you understand more clearly the associated benefits, risks, and complications.

   Sinuses Picture

   The sinuses are an air-filled cavity in a dense portion of a skull bone. See a picture of the Sinuses and learn more about the health topic.

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What home remedies can relieve sinus pressure?

Last reviewed Mon 26 March 2018

By Claire Sissons

Reviewed by Daniel Murrell, MD

   Sprays Neti pot Steam Acupressure Hydration Compression Essential oils Rest Outlook

A person can treat sinus pressure with medication, but plenty of home remedies may also help to ease symptoms and speed up recovery.

The sinuses are lined with a type of skin called mucous membrane. This membrane protects the body by producing mucus, which catches dirt and other particles that might otherwise cause illness.

The lining of the sinuses can swell if a person has an allergic reaction or infection. Swelling may lead to a feeling of pressure around the nose, cheeks, and above the eyes. These areas of the face may feel painful or tender.

Infections or allergies can lead to uncomfortable pressure in the sinuses. Clearing the nose can help to ease this symptom.

Below are natural alternatives to over-the-counter medications for sinus pressure.

  1. Saline nasal spray

Man using neti pot to relieve sinus pressure.

Saline nasal sprays are a popular remedy for sinus pressure and can be made at home.

Inhaling saline solution can help to clear a blocked nose.

A saline solution can easily be made at home using sterile water, salt, and baking soda. Combine the following ingredients:

   1/4 pint of clean water

   1/4 teaspoon (tsp) of salt

   1/4 tsp of baking soda

Sniff this into the nose from cupped palms, one nostril at a time.

Alternately, use a clean, dry spray bottle. Gently insert the nozzle into a nostril and spray in the solution. Repeat two to three times per day.

What are the best essential oils for allergies?

What are the best essential oils for allergies?

There are many essential oils that could help to relieve the symptoms of allergies. In this article, we look at the types of essential oils that could help with seasonal and skin allergies, along with the evidence to support their use.

Read now

  1. Neti pot

Some people use neti pots to rinse out the nose, which helps to keep the mucous membrane moist and relieve pressure in the sinuses. The device looks like a small pot with a long spout. They can be purchased online.


Pancreas And EPI Facts

Info On GastroDigestive Disorders

Such As EPI Due To Cystic Fibrosis.


Here is how to use a neti pot:

   wash the hands

   fill the pot with sterile water

   lean directly over a sink

   tilt the head sideways

   gently insert the spout into the highest nostril

   breathe through the mouth

   pour water into the nostril

Water will run from one nostril to the other, which should flush out pollen, bacteria, and other debris. A person should repeat this process on both nostrils.

It is essential to use sterile or distilled water, which can be bought at a drugstore, not tap water. Alternately, boil water and allow it to cool.

  1. Steam inhalation

Using steam to open the passages in the nose can help to relieve sinus pressure.

Steam inhalation is easy to do at home. Boil water, pour it into a large bowl and lean over, so the face is directly above the water. Cover the head with a towel, and breathe through the nose.

  1. Acupressure

Woman undergoing acupressure, back of neck being massaged.

Massaging pressure points at the base of the skull and top of the neck may help.

Acupressure is a key part of traditional Chinese medicine. It involves applying pressure to specific points in the body, to relieve pain or symptoms of illness. Scientists are not clear on whether acupressure works, but it may ease some symptoms.

Acupressure has long been used to treat colds, types of flu, and sinus problems. It can be done at home or by a professional practitioner.

Be careful not to apply too much pressure, causing pain or discomfort.

Here is how to use acupressure for sinus pressure:

   link the fingers of both hands together, forming the shape of a cup

   use the linked hands to cradle the back of the head, where the neck and skull join

   extend the thumbs and find the dips on either side of the spine

   use the thumbs to massage the area in small circles

   relax, breathing slowly and deeply

   do this for 4 to 5 seconds at a time

Using the fingertips to massage the cheeks and the bridge of the nose may also help to relieve pressure. This massage should be firm, but gentle.

  1. Hydration

Any time a person is unwell, it is essential to keep the body hydrated.

Keep the mucous membranes in the sinuses moist by drinking plenty of fluids. This helps them to work properly.

Water, fruit juices, and herbal teas are good alternatives to tea and coffee.

  1. Warm washcloth compression

Applying heat to the sinus area can also help to relieve pressure. One of the easiest ways to do this is using a warm washcloth.

Run a clean washcloth under reasonably hot water and wring it out. Fold it, and lay it across the bridge of the nose and cheeks for a few minutes.

  1. Essential oils

Menthol peppermint essential oil.

Menthol oil is thought to help open the nasal pasages, although research has not supported this.

Essential oils are natural oils derived from plants. The American Sinus Institute recommend using some essential oils to relieve sinus pressure.

Menthol creates a sensation that the nasal passages are opening.

Add a few drops of the oil to hot water, and gently breathe in the steam through the nose.

There are some anesthetic properties, but no scientific evidence proves that menthol causes the nasal passages to open.

Essential oils, including menthol, are available online. People should be sure to buy these oils from trusted sources, however.

  1. Rest and relax

Concentrating on work or studies can be difficult for a person with sinus pressure. Taking a break and getting plenty of rest can help the body to recover.

What is the outlook for sinus pressure?

If caused by an infection, such as sinusitis, the pressure should go away within a few weeks.

If caused by an allergy, sinus pressure may come and go. Taking antihistamines before coming into contact with an allergen, such as grass or pet fur, can prevent sinus pressure.

The natural remedies above can help to relieve sinus pressure and related discomfort. They can also help to speed recovery.

However, home remedies may not always work. If an infection has not gone away within 2 to 3 weeks, people should see a doctor for advice and treatment.

We picked linked items based on the quality of products, and list the pros and cons of each to help you determine which will work best for you. We partner with some of the companies that sell these products, which means Healthline UK and our partners may receive a portion of revenues if you make a purchase using a link(s) above.

Related coverage

What to do about a sinus headache A look at sinus headache, a condition where the area around the nose becomes painful. Included is detail on home remedies and the potential causes. Read now

Can neti pots be dangerous? Neti pots have recently increased in popularity. If used correctly, they can be beneficial, if used incorrectly, they can cause severe health issues. Read now

Everything you need to know about sinusitis Sinusitis is an inflammation of the paranasal sinuses. Symptoms usually resolve with home treatment, but sometimes medical help is needed. Read now

What to know about chronic sinusitis A look at chronic sinusitis, long-term inflammation in the sinuses. Included is detail on home remedies and possible complications of the condition. Read now

All about the common cold The common cold is a viral infectious diseases that infects the upper respiratory tract. Here, we explain the symptoms, causes, treatments, and more. Read now

Sinus Infection Symptoms







   Sore throat

   When to see your doctor



   In children

   Outlook and recovery


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.

Chronic vs. acute

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 in your sinuses

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.

Nasal discharge

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.


Nasal congestion

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.”

Sinus headaches

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.

Throat irritation and cough

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.

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, 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 for sinus infection

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.

Finding a doctor to treat your cold

If you can't treat your cold at home, seeing a primary care doctor is your best bet. Use the doctor search tool below, powered by our partner Amino, to find the right doctor for you based on factors like their experience and your insurance. Amino can also help book your appointment for free.

Healthline Partner Solutions

Video Chat With a Doctor About Your Sinus Infection

Your PlushCare doctor can prescribe medicines such as antibiotics and make other treatment recommendations. Insurance can be used or simply pay a flat fee.

Treating sinus infections

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

Other over-the-counter medicines that contain antihistamines and decongestants can help with sinus infections, particularly if you also suffer from allergies. Popular medicines of this kind include:





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.

Can sinus infections be prevented?

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.

Sinus infections in children

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.

Sinus infection 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.

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   Acute sinusitis. (2016, April 28)


   Chronic sinusitis. (2016, July 1)


   Millman, F. M. (2015, November 27). Sinus infection: prevention and treatment


   Pediatric sinusitis. (2015). Retrieved from


   Sinuses. (2016). Retrieved from


   Sinusitis (sinus infections). (2015, May 15)


   Sinus infection (sinusitis). (2015, April 17)


   Sinus information. (2016). Retrieved from


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Sinusitis means your sinuses are inflamed. The cause can be an infection or another problem. Your sinuses are hollow air spaces within the bones surrounding the nose. They produce mucus, which drains into the nose. If your nose is swollen, this can block the sinuses and cause pain.

There are several types of sinusitis, including

   Acute, which lasts up to 4 weeks

   Subacute, which lasts 4 to 12 weeks

   Chronic, which lasts more than 12 weeks and can continue for months or even years

   Recurrent, with several attacks within a year

Acute sinusitis often starts as a cold, which then turns into a bacterial infection. Allergies, nasal problems, and certain diseases can also cause acute and chronic sinusitis.

Symptoms of sinusitis can include fever, weakness, fatigue, cough, and congestion. There may also be mucus drainage in the back of the throat, called postnasal drip. Your health care professional diagnoses sinusitis based on your symptoms and an examination of your nose and face. You may also need imaging tests. Treatments include antibiotics, decongestants, and pain relievers. Using heat pads on the inflamed area, saline nasal sprays, and vaporizers can also help.

NIH: National Institute of Allergy and Infectious Diseases

Start Here

   Sinusitis (American Academy of Otolaryngology--Head and Neck Surgery)

   Sinusitis Q and A (American Rhinologic Society)

   Sinusitis: Overview (American Academy of Family Physicians) Also in Spanish

Diagnosis and Tests

   Computed Tomography (CT) -- Sinuses Video (American College of Radiology, Radiological Society of North America) Also in Spanish

   Panoramic Dental X-Ray (American College of Radiology, Radiological Society of North America) Also in Spanish

   Radiography of the Paranasal Sinuses (American Society of Radiologic Technologists) - PDF - In English and Spanish

Treatments and Therapies

   Decongestants: OTC Relief for Congestion (American Academy of Family Physicians) Also in Spanish

   Endoscopic Sinus Surgery (American Rhinologic Society)

   Get Smart: Know When Antibiotics Work - Sinus Infection (Sinusitis) (Centers for Disease Control and Prevention) Also in Spanish

   How to Use Nasal Sprays Properly (With Images) (American Society of Health-System Pharmacists)

   Humidifiers: Air Moisture Eases Skin, Breathing Symptoms (Mayo Foundation for Medical Education and Research) Also in Spanish

   Is Rinsing Your Sinuses With Neti Pots Safe? (Food and Drug Administration)

   Nasal Sprays: How to Use Them Correctly (American Academy of Family Physicians) Also in Spanish

   Nasal Wash Treatment (National Jewish Health) Also in Spanish

   Saline Sinus Rinse Recipe (American Academy of Allergy, Asthma, and Immunology) Also in Spanish

   Sinuplasty (Balloon Catheter Dilation) (American Rhinologic Society)

   Sinus Pain: Can Over-the-Counter Medications Help? (American Academy of Otolaryngology--Head and Neck Surgery)

   Sinus Rinsing and Neti Pots (Centers for Disease Control and Prevention)

   Sinus Surgery (American Academy of Otolaryngology--Head and Neck Surgery)

Related Issues

   Colds, Allergies and Sinusitis - How to Tell the Difference (American Academy of Allergy, Asthma, and Immunology) - PDF Also in Spanish

   Complications of Sinus Surgery (American Rhinologic Society)

   Complications of Sinusitis (American Rhinologic Society)

   Expectations of Sinus Surgery (American Rhinologic Society)

   Headaches and Sinus Disease (American Rhinologic Society)

   Post-Nasal Drip (American Academy of Otolaryngology--Head and Neck Surgery)

   Sinus Headaches (Mayo Foundation for Medical Education and Research) Also in Spanish

   Sinus Infection and Toothache: Any Connection? (Mayo Foundation for Medical Education and Research) Also in Spanish

   Stuffy Nose (American Academy of Otolaryngology--Head and Neck Surgery)


   Acute Sinusitis (Mayo Foundation for Medical Education and Research) Also in Spanish

   Chronic Sinusitis (Mayo Foundation for Medical Education and Research) Also in Spanish

   Fungal Sinusitis (American Academy of Otolaryngology--Head and Neck Surgery)

Statistics and Research

   FastStats: Sinus Conditions (National Center for Health Statistics)

Clinical Trials

   ClinicalTrials.gov: Sinusitis From the National Institutes of Health (National Institutes of Health)

Journal Articles References and abstracts from MEDLINE/PubMed (National Library of Medicine)

   Article: Diagnosis and management of pediatric sinusitis: A survey of primary...

   Article: Nasal saline irrigation in pediatric rhinosinusitis: A systematic review.

   Article: Microbiology and antibiotic therapy of subperiosteal orbital abscess in children...

   Sinusitis -- see more articles

Reference Desk

   Nasal Anatomy (American Rhinologic Society)

   Nasal Physiology (American Rhinologic Society)

   Sinus Anatomy (American Rhinologic Society)

   Sinuses / Sinusitis / Rhinosinusitis (American Academy of Allergy, Asthma, and Immunology)

Find an Expert

   American Academy of Allergy, Asthma, and Immunology

   American Academy of Otolaryngology--Head and Neck Surgery

   American Rhinologic Society

   Find an ENT (American Academy of Otolaryngology--Head and Neck Surgery)

   National Institute of Allergy and Infectious Diseases From the National Institutes of Health


   Difference between Sinusitis and a Cold (American Academy of Pediatrics) Also in Spanish

   Pediatric Sinusitis (American Academy of Otolaryngology--Head and Neck Surgery)

   Sinusitis (For Parents) (Nemours Foundation) Also in Spanish

   When Sinuses Attack! (For Kids) (Nemours Foundation)


   Sinusitis (For Teens) (Nemours Foundation) Also in Spanish


   Sinusitis: Special Considerations for Aging Patients (American Academy of Otolaryngology--Head and Neck Surgery)


   Adult Sinusitis (American Rhinologic Society)

Patient Handouts

   Saline nasal washes (Medical Encyclopedia) Also in Spanish

   Sinus CT scan (Medical Encyclopedia) Also in Spanish

   Sinus MRI scan (Medical Encyclopedia) Also in Spanish

   Sinus x-ray (Medical Encyclopedia) Also in Spanish

   Sinusitis (Medical Encyclopedia) Also in Spanish

   Sinusitis in adults - aftercare (Medical Encyclopedia) Also in Spanish

   Stuffy or runny nose - adult (Medical Encyclopedia) Also in Spanish

   Stuffy or runny nose - children (Medical Encyclopedia) Also in Spanish

Sinus Pain Attack!

A sinus illustration overlay of a woman with sinus pain.

Sinus problems and sinus-related symptoms are common reasons people see their doctors. Symptoms include pain in the forehead or between the eyes, toothache, feeling of fullness in the mid-face, stuffy nose, and congestion.

What Are Sinuses?

CT scan showing normal sinuses.

Your sinuses are air spaces in your skull and facial bones that make up the upper part of your respiratory tract from your nose into your throat. The sinuses are in your forehead (frontal sinuses), inside your cheekbones (maxillary sinuses), and behind the nose (ethmoid and sphenoid sinuses).

What Is Sinusitis?

Cilia lining of the sinus cavity mucus membrane.

Inflammation of the tissues lining the sinuses is called sinusitis. Infections with viruses or bacteria or allergies cause the majority of cases of sinusitis.

It May Start as a Cold

A close up of nostrils breathing in rhinovirus and pollen spores.

Most cases of sinusitis start off with the inflammation from a virus such as the common cold. This inflammation can lead to bacterial colonization and cause a bacterial sinus infection.

Sinusitis Symptoms

Woman with painful sinus pressure.

Pressure and pain in the sinuses (in different areas of the face or behind the eyes) are the main symptoms of sinusitis. More severe infections may lead to a yellow or green discharge from the nose, sore throat, headache, fever, and an overall feeling of fatigue.

Chronic Sinusitis

MRI of inflammation within the sinus cavity.

Chronic sinusitis is defined as inflammation of the sinuses that lasts for more than three months. It is characterized as chronic sinusitis with or without polyposis. Chronic sinusitis may be caused by allergies, abnormal sinus anatomy that leads to chronic blockage (polyps), or dental problems.

Nasal Polyps

Anterior rhinoscopy showing nasal polyps.

Nasal polyps are an overgrowth of tissue within the sinuses that can block the flow of mucus and air.

Nasal Decongestants

Man using nasal decongestant spray for sinus relief.

Nasal sprays and nasal decongestants can be used for relief of the symptoms of acute sinusitis. These medications help shrink the inflamed tissue and allow secretions and air to pass through more easily. Over-the-counter nasal spray decongestants should only be used for a maximum of three days. After this, the tissues can become more inflamed and lead to a disorder called rhinitis medicamentosa. Consult your doctor before using any drugs to treat your sinusitis. Combinations of oral medications and nasal anti-inflammatories may be better options to treat your sinusitis.

Antibiotics Usually Unnecessary

Illustration of the human rhinovirus responsible for the common cold.

Most cases of sinusitis are triggered by viruses such as the common cold virus or rhinovirus (pictured). Sinus inflammation triggered by viruses does not respond to antibiotics. Antibiotics should only be used in cases of sinusitis where a bacteria pathogen is suspected by your doctor or documented by a culture of the mucus from your sinuses.

Treating Allergy-Related Sinusitis

Woman using a sinus rinse system to help clear sinus symptoms.

Home remedies can help relieve some symptoms of sinusitis. Irrigation of the sinuses with a Neti-pot or squeeze bottle, or breathing in warm humidified air can help decrease symptoms of sinusitis. If symptoms are due to allergies, over-the-counter antihistamines may help.

When to Visit the Doctor

Photo of a child with runny nose.

If your sinusitis symptoms include the following, see your doctor immediately: fever, headache, change in vision or double vision, swollen eye socket, neck stiffness, severe sore throat, and a yellow or green mucus discharge. If you have any concerns or are unsure about your condition, contact your doctor.

Chronic Sinusitis Treatment Still a Puzzle

A doctor using an endoscope in the nasal cavity of patient.

Chronic sinusitis is often difficult to treat. There are many factors that can lead to chronic inflammation of your sinus passages, and eliminating these factors is the first step in treatment of chronic sinusitis. Long-term medications or even surgery may be necessary to control and treat symptoms.

Sinusitis Complications

An X-ray of a patient with acute sinusitis.

Sinusitis can become bad enough to cause serious medical complications. Infections can spread around the eye, into the middle ear, and even around the brain (meningitis).

Sinusitis Prevention

A man breathing through his nose.

You may not be able to completely avoid getting sinusitis, but there are ways to prevent it in some cases:

   Do not smoke

   Avoid dry environments

   Use a humidifier when needed

   Drink plenty of fluids

   Seek treatment for chronic allergies that can trigger sinus inflammation

WebMD does not provide medical advice, diagnosis or treatment. See additional information

© 2005-2018 WebMD, LLC. All rights reserved.

Diseases & Conditions

How to Relieve Sinus Pressure and Pain Naturally

By Melissa Conrad Stöppler, MD on 1/11/2017

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Sinus Relief the Natural Way


Pressure and pain from sinus problems can be mild or quite severe. The cause of these symptoms is often a cold, allergies, or sinusitis (sinus infection). Regardless of what causes your symptoms, relief may be closer than you think.

In the following slides, learn how to treat sinus problems with natural remedies and home remedies. We provide a variety of strategies to combat nasal congestion, from neti pots and saline nasal sprays to hydration and avoiding irritants, starting with humidifying your air.

Breathe Moist Air

For sinus pressure relief that lasts for hours, try keeping a humidifier on in your bedroom or other rooms where you spend a lot of time. Dry air can irritate your sinuses, but keeping air moist can help reduce congestion. Inhaling steam two to four times a day may help, too. Sit in the bathroom with the door closed and the shower running. Make sure the water is hot.

Avoid Smoke and Noxious Fumes


The air you breathe could be making your sinuses ache, depending on what that air is carrying. Avoid cigarette smoke and fumes from

   harsh cleaning products,


   hair spray, and


With a world full of industrial chemicals and people who smoke, how can you keep your sinus problems at bay? Here are a couple of tips:

   Don't let friends or family smoke in your home.

   Look for "green" cleaning products in unscented varieties. They're less likely to contain the harsh chemicals that can kick-start sinus pressure and pain.

Drink More Water


Finding out how to relieve sinus pressure may be as simple as grabbing a glass of cold water or juice. Doing so will help thin out mucus and encourage drainage. Hot tea is another good option.

Not all liquids are created equal, though. To relieve sinusitis symptoms, don't overdo caffeine or alcohol. Both can make you dehydrated. Alcohol can worsen sinus swelling. Aim for eight or more 8-ounce glasses of water or other healthy drinks each day.

Saline Nasal Wash


It's also called nasal irrigation, and it can help keep your sinuses clean and clear. To do this right, use a mild, sterile saline solution to flush out the mucus and allergens causing your congestion.

   Lean over the sink.

   Squirt the solution into one nostril.

   Let it drain through your nose cavity and out the other nostril.

   Keep your mouth open and don't breathe through your nose.

Nasal Wash: Neti Pots, Saline Nasal Spray and More


Many people find sinus relief through a saline nasal wash, but it does require some preparation. You can find a lot of these supplies at most drug stores, including

   rinse bottles,

   bulb syringes, and

   neti pots.

You can buy a pre-filled container or make your own saline solution.

Nasal Saline Solution Recipe

To make your own nasal saline solution, follow this simple recipe:

   16 ounces of sterile water (about a pint)

   1 tsp salt

   ½ tsp baking soda

Simply mix the lukewarm, sterile water with the salt. Some people add ½ teaspoon of baking soda to take the sting out of the salt, but this ingredient is optional.

What Are Sinuses?


When you have sinusitis, you may be wondering where your symptoms are actually taking place. That would be your sinuses, which are air-filled pockets found throughout your face. They are located

   below the surface of your cheeks,

   behind your forehead and eyebrows,

   on either side of the bridge of your nose, and

   behind your nose.

They can get clogged easily. Healthy sinuses are lined with a thin layer of mucus that traps


   germs, and

   other air particles.

Ideally, tiny hair-like cilia on the nasal lining cells sweep mucus and anything trapped in it out of the sinuses, down the back of your throat, and into the stomach.

What Causes Sinus Symptoms?


If you find yourself frequently dealing with sinus pain and sinus pressure, finding the cause is an important step toward finding sinus relief. Any time the tissue in your nose and sinuses gets swollen and inflamed, it can lead to sinus problems. Here are a few sinus problem causes to consider:

   Temperature changes



   The common cold


Pretty much anything that causes swelling in your sinuses or keeps the nasal cells' cilia from sweeping away mucus can cause problems.

Avoid Your Triggers


Allergies are one of the more common causes of sinus pressure and pain. You can't completely eliminate allergies, but you can avoid the allergens that cause them. Common sinus-stuffing allergens include

   pet dander,

   dust mites, and


If you don't know what allergens are setting off your sinus problems, try consulting an allergist. Allergists are physicians who specialize in identifying allergy triggers and treating allergies.

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You've had a stuffy nose for what feels like ages. It's gone on for more than just a few days, so you know it's not a cold. But which is it: sinusitis or allergies?

They have similar symptoms, so it's easy to confuse them. But there are key differences in the things that trigger them and the kind of treatment you get.

What Kicks It Off

With both sinusitis and allergies, your nose and sinuses get stuffed up, but it happens for different reasons.

If you have allergies, the passages of your nose and sinuses swell because they're trying to flush out "allergens." That's just a technical word for anything you're allergic to, like pollen, mold, dust mites, and pet dander.

Sinusitis usually develops because of allergies or a cold. Sometimes, but not often, it's from bacteria that cause an infection.


When you have allergies or a cold, your nose and sinuses get inflamed. That blocks mucus from draining, which can cause an infection -- not to mention pain and pressure.

If you have allergies, you're more likely to have sinus problems. That's because the inside of your nose and sinuses often swell up when you breathe in triggers.

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What It Feels Like

The symptoms of allergies and sinusitis overlap a lot. Both can give you a stuffy nose. If it's allergies, you may also have:

   Runny nose and sneezing

   Watery or itchy eyes


If it's sinusitis, besides a stuffy nose, you may have:

   Thick, colored mucus

   Painful, swollen feeling around your forehead, eyes, and cheeks

   Headache or pain in your teeth

   Post-nasal drip (mucus that moves from the back of your nose into your throat)

   Bad breath

   Cough and sore throat


   Light fever

See your doctor to figure out what's going on, because it's tricky to know for sure.

When It Comes and When It Goes

If you have allergies, you'll start feeling symptoms soon after you come into contact with the stuff you're allergic to. Your symptoms keep up as long as you're still surrounded by those triggers.

Allergies can happen any time of year. They may be "seasonal," which means you get them only in the spring or fall. Or they may be year-round. For instance, you might be allergic to pets or mold, which can be a problem no matter the season.

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Is It a Sinus Infection, a Cold, or Allergies?

Your nose is stuffed and your head is pounding. Here's how to tell if a cold, allergies, or a sinus infection is to blame.

By Diana Rodriguez

Medically Reviewed by Judy Mouchawar, MD, MSPH

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A stuffy nose and headache are common symptoms of many illnesses. So how can you tell whether the culprit is a sinus infection, a common cold, or allergies when the symptoms of these three conditions are so similar?

"It can sometimes be difficult even for doctors to differentiate," says Alan B. Goldsobel, MD, an allergist at Allergy and Asthma Associates of Northern California and an adjunct associate professor at Stanford University Medical Center in Stanford, California. But there are some key differences that can give you some clues. Get to know more about the symptoms of these three conditions to help you pinpoint the cause of your sinus congestion:

A Sinus Infection

   What it feels like: Sinus congestion can cause an aching sensation and a feeling of fullness in the middle of your face, says Dr. Goldsobel. A sinus infection may also be accompanied by other symptoms like post-nasal drip, green (or yellow) nasal discharge, aching in your teeth, fever, bad breath, and sinus pressure or a headache that worsens when you lean forward or lie down. Your face may also feel tender, and upon examination, a doctor should be able to see pus draining near the sinuses, says Fuad M. Baroody, MD, a professor of surgery and pediatrics and director of pediatric otolaryngology at the University of Chicago Medicine and Biological Sciences in Chicago, Illinois.

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   What triggers it: Bacteria or viruses trigger sinus infections. Colds, allergies, asthma, and other health conditions can also cause them.

   How long it lasts: Sinus infections may clear up on their own without treatment, but some might require medication. If your symptoms last for longer than seven to 10 days, your doctor may consider prescribing antibiotics.

A Cold


   What it feels like: You can expect a stuffy nose, but also some runny, discolored mucus, Goldsobel explains. You may also experience a sore throat, cough, sneezing, headache, or fatigue. Another sign is a rising temperature: Colds often trigger a fever, he says, but sometimes those fevers are so mild that people think they have allergies instead.

   What triggers it: A virus.

   How long it lasts: People usually fend off the cold virus (without treatment) within seven to 10 days, Baroody says. But if your symptoms have lingered past that window of time, you might have sinusitis. If you suspect you have a sinus infection, you should talk to your doctor.

An Allergic Reaction

   What it feels like: You may experience some nasal congestion with allergies, but it usually accompanies a runny nose (clear, watery discharge), sneezing, and itchy nose and eyes. Allergies never cause a fever, Goldsobel notes.

   What triggers it: Allergens cause an allergic reaction. Common indoor allergens include mold, dust, and animal dander, while outdoor triggers include pollen and ragweed.

   How long it lasts: If you have seasonal allergies, you may struggle with allergy symptoms throughout the spring and fall, Dr. Baroody says. If you're allergic to indoor allergens, you may experience symptoms year-round.

How to Treat Congestion

Because sinus infections, colds, and allergies share some similar symptoms, including congestion, medications like nasal sprays, oral antihistamines, and eye drops can help minimize your discomfort.

If allergies are to blame, do your best to avoid your known triggers and steer clear of any other potential irritants, such as smoke or air pollution. Long-term treatments like immunotherapy (allergy shots) can help desensitize you to allergens and improve symptoms over time.

When Colds and Allergies Cause Sinus Infections

Even if your sinus congestion is being caused by allergies or a cold, it doesn’t mean you won’t develop a sinus infection later on.

In fact, when people have colds or allergies, the lining of the nose will swell up, which prevents mucus from draining properly — and that can then lead to sinusitis, says Goldsobel. People with allergies and asthma may be more vulnerable to sinusitis, though it's not proven, Baroody says.

If you are at higher risk for sinus infections, you can take steps to prevent them. Don't let allergy symptoms spiral out of control. And, Baroody says, be on the lookout "for the symptoms of sinus infections, and treat them promptly."

Last Updated:12/1/2015

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Sinus Infection

Sinus infection is a major health problem. It afflicts 31 million people in the United States.

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Sinus infection (known as sinusitis) is a major health problem. It afflicts 31 million people in the United States. Americans spend more than $1 billion each year on over-the-counter medications to treat it. Sinus infections are responsible for 16 million doctor visits and $150 million spent on prescription medications. People who have allergies, asthma, structural blockages in the nose or sinuses, or people with weak immune systems are at greater risk.

Find an allergist to help with your sinus infection symptoms


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Sinus infection symptoms

A bad cold is often mistaken for a sinus infection. Many symptoms are the same, including headache or facial pain, runny nose and nasal congestion. Unlike a cold, a sinus infection symptoms may be caused by bacterial infections. It often requires treatment with antibiotics (drugs that kill the germs causing the infection).

Sinus infection diagnosis

If you think you have a sinus infection, see your allergist for proper diagnosis. In most cases, sinus infection treatment is easy. By stopping a sinus infection early, you avoid later symptoms and complications.

What is sinusitis?

Sinusitis is an inflammation of the sinuses. It is often caused by bacterial (germ) infection. Sometimes, viruses and fungi (molds) cause it. People with weak immune systems are more likely to develop bacterial or fungal sinus infection. Some people with allergies can have "allergic fungal sinus infection." Acute sinus infection lasts three to eight weeks. A sinus infection lasting longer than eight weeks is considered chronic.

The sinuses are air-filled cavities. They are located:

   Within the bony structure of the cheeks

   Behind the forehead and eyebrows

   On either side of the bridge of the nose

   Behind the nose directly in front of the brain

An infection of the sinus cavity close to the brain can be life threatening, if not treated. In rare cases, it can spread to the brain.

Normal sinuses are lined with a thin layer of mucus that traps dust, germs and other particles in the air. Tiny hair-like projections in the sinuses sweep the mucus (and whatever is trapped in it) towards openings that lead to the back of the throat. From there, it slides down to the stomach. This continual process is a normal body function.

A sinus infection stops the normal flow of mucus from the sinuses to the back of the throat. The tiny hair-like "sweepers" become blocked when infections or allergies cause tiny nasal tissues to swell. The swelling traps mucus in the sinuses.

Some people have bodily defects that contribute to sinus infection. The most common of these defects are:

   Deformity of the bony partition between the two nasal passages

   Nasal polyps (benign nasal growths that contain mucus)

   A narrowing of the sinus openings

People with these defects often suffer from chronic sinus infections.

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Common symptoms of sinus infection include:

   Postnasal drip

   Discolored nasal discharge (greenish in color)

   Nasal stuffiness or congestion

   Tenderness of the face (particularly under the eyes or at the bridge of the nose)

   Frontal headaches

   Pain in the teeth




   Bad breath

Sinus infection (sinusitis) is often confused with rhinitis, a medical term used to describe the symptoms that accompany nasal inflammation and irritation. Rhinitis only involves the nasal passages. It could be caused by a cold or allergies.

Allergies can play an important role in chronic (long-lasting) or seasonal rhinitis episodes. Nasal and sinus passages become swollen, congested, and inflamed in an attempt to flush out offending inhaled particles that trigger allergies. Pollen are seasonal allergens. Molds, dust mites and pet dander can cause symptoms year-round.

Asthma also has been linked to chronic sinus infections. Some people with a chronic nasal inflammation and irritation and/or asthma can develop a type of chronic sinusitis that is not caused by infection. Appropriate treatment of sinus infection often improves asthma symptoms.

How is sinus infection diagnosed?

Diagnosis depends on symptoms and requires an examination of the throat, nose and sinuses. Your allergist will look for:


   Swelling of the nasal tissues

   Tenderness of the face

   Discolored (greenish) nasal discharge

   Bad Breath

If your sinus infection lasts longer than eight weeks, or if standard antibiotic treatment is not working, a sinus CT scan may help your allergist diagnose the problem. Your allergist may examine your nose or sinus openings. The exam uses a long, thin, flexible tube with a tiny camera and a light at one end that is inserted through the nose. It is not painful. Your allergist may give you a light anesthetic nasal spray to make you more comfortable.

Mucus cultures: If your sinus infection is chronic or has not improved after several rounds of antibiotics, a mucus culture may help to determine what is causing the infection. Most mucus samples are taken from the nose. However, it is sometimes necessary to get mucus (or pus) directly from the sinuses.

Knowing what kind of bacteria is causing the infection can lead to more effective antibiotic therapy. A fungus could also cause your sinus infection. Confirming the presence of fungus is important. Fungal sinus infection needs to be treated with antifungal agents, rather than antibiotics. In addition, some forms of fungal sinus infection – allergic fungal sinus infection, for example – do not respond to antifungal agents and often require the use of oral steroids.

Your allergist may consider ordering a sinus CT. This test can help to define the extent of the infection. Your allergist may also send you to a specialist in allergy and immunology. The specialist will check for underlying factors such as allergies, asthma, structural defects, or a weakness of the immune system.

Biopsies: A danger of more serious types of fungal sinus infection is that the fungus could penetrate into nearby bone. Only a bone biopsy can determine if this has happened. Biopsies involving sinus tissue are taken with flexible instruments inserted through the nose.

Biopsies of the sinus tissue are also used to test for immotile cilia syndrome, a rare disorder that can cause people to suffer from recurrent infections, including chronic sinus infection, bronchitis and pneumonia.



Antibiotics are standard treatments for bacterial sinus infections. Antibiotics are usually taken from 3 to 28 days, depending on the type of antibiotic. Because the sinuses are deep-seated in the bones, and blood supply is limited, longer treatments may be prescribed for people with longer lasting or severe cases.

Overuse and abuse of antibiotics have been causing a major increase in antibiotic resistance. Therefore, patients with sinus symptoms should consider taking an antibiotic only if symptoms (including discolored nasal discharge) persist beyond 7-10 days.

Antibiotics help eliminate a sinus infection by attacking the bacteria that cause it, but until the drugs take effect, they do not do much to alleviate symptoms. Some over-the-counter medications can help provide relief.

Nasal decongestant sprays

Topical nasal decongestants can be helpful if used for no more than three to four days. These medications shrink swollen nasal passages, facilitating the flow of drainage from the sinuses. Overuse of topical nasal decongestants can result in a dependent condition in which the nasal passages swell shut, called rebound phenomenon.


Antihistamines block inflammation caused by an allergic reaction so they can help to fight symptoms of allergies that can lead to swollen nasal and sinus passages.

Nasal decongestants and antihistamines

Over-the-counter combination drugs should be used with caution. Some of these drugs contain drying agents that can thicken mucus. Only use them when prescribed by your allergist.

Topical nasal corticosteroids

These prescription nasal sprays prevent and reverse inflammation and swelling in the nasal passages and sinus openings, addressing the biggest problem associated with sinus infection. Topical nasal corticosteroid sprays are also effective in shrinking and preventing the return of nasal polyps. These sprays at the normal dose are not absorbed into the blood stream and could be used over long periods of time without developing "addiction."

Nasal saline washes

Nasal rinses can help clear thickened secretions from the nasal passages.


If drug therapies have failed, surgery may be recommended as a last resort. It is usually performed by an otolaryngologist. Anatomical defects are the most common target of surgery.

Your surgeon can fix defects in the bone separating the nasal passages, remove nasal polyps, and open up closed passages. Sinus surgery is performed under either local or general anesthesia, and patients often can go home on the same day.


Is the definition of sinusitis the same as sinus infection?

Essentially yes, the definition of sinusitis is the same as sinus infection.  “Itis” means inflammation or swelling often due to infection, and “sinus” is the location of the swelling on your face.  Sinuses are normally air-filled pockets in the bone of the face. They are found in your forehead, at the bridge of your nose, way behind your eyes and at the apples of your cheeks. If these air pockets become blocked with fluid, germ like viruses or bacteria (and sometimes fungus) can multiply in these dark hard-to-reach spaces — and then you have an infection.  

How long do sinus infections last?

There are two major forms of sinus infections (also called sinusitis):  acute and chronic. An “acute” sinus infection lasts anywhere from ten days up to eight weeks.  A “chronic” infection lasts even longer. It is ongoing — it may seem like it’s improving, and then it comes right back as bad as it was at first. Chronic sinus infections may drag on for months at a time. Both acute and chronic sinus infections can be viral or bacterial. Some long-standing infections are fungal.  

How do you get rid of a sinus infection?

First you need to know the cause of the sinus infection.  Is it viral or bacterial? If it’s viral, it should probably last less than two weeks. To get relief from sinus infection symptoms you can use nasal decongestant sprays, oral and topical antihistamines, nasal steroids and nasal saline washes. For a bacterial infection, antibiotics are usually prescribed.  But be careful here. Don’t jump to antibiotics too quickly. Due to the overprescribing of antibiotics in recent years, and the development of antibiotic resistance, allergists recommend only taking an antibiotic if the symptoms last more than seven to 10 days. If drug therapies don’t work for you, surgery might be recommended to repair defects in the bone separating the nasal passages, remove nasal polyps or open closed passages.

What causes sinus infections?

Sinus infections happen when you “catch a bug” and a virus, bacteria or mold settles in the sinuses and causes inflammation of the area lining your sinuses. The sinus cavity, which is like a dark cave, fills up with fluid and becomes blocked.  This is the perfect place for germs to grow. People who have nasal allergies already have this sinus irritation. If you have a weak immune system, you are more likely to develop sinus infection from bacteria or mold. Other things that can cause sinus infections are colds, seasonal allergies, nasal polyps or a deviated septum. With a deviated septum one side of the nose is shifted over, and it makes it hard to drain mucous, so the sinuses get backed up.

What are the symptoms of a sinus infection?

Many of the symptoms of a sinus infection are the same you’d experience with a bad cold. They include: postnasal drip (that thick mucus in the back of your throat), discolored nasal discharge (green mucous coming out of your nose), stuffy nose or nasal congestion and tenderness or pain in the face – usually under the eyes or around the nose. You can also have headaches, tooth pain, coughing from the post nasal drip, fever, fatigue, a bad smell in your nose or a bad taste in your mouth and bad breath. Symptoms such as a fever that won’t go away, a change in your eyesight, severe headaches and neck stiffness need immediate medical attention.

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When you suffer from allergies, or allergic rhinitis, you might experience a lot of uncomfortable symptoms. So when you feel under the weather, it can be difficult to tell if it’s just your allergy symptoms acting up or sinusitis (also known as a sinus infection). Here’s a quick look at the difference between allergies and a sinus infection.





What is it?

Inflammation in

the nose1


Inflammation of the sinuses

(located in the forehead,

cheekbones, and behind the nose)1

What causes it?

Indoor and

outdoor allergens1

Sinus infection (usually caused by

a virus or bacteria). But can also be caused by nasal polyps or a deviated

nasal septum.2

What are the symptoms?

Sneezing, runny nose,

nasal congestion, and itchy, watery eyes1

Thick yellowy mucus, sinus pressure (tenderness and swelling around the

eyes, cheeks, nose and forehead), and reduces sense of smell and taste1*

Did you know?

Your skull has four pairs of sinuses, or hollow spaces, called the paranasal sinuses. Sinuses help lighten the skull, warm and humidify inhaled air, and give resonance to the voice and shape to the face. They are lined with the same kind of tissue that lines the inside of your nose.1,3

*FLONASE® is not indicated to treat these symptoms.

Sources :

  1. Rhinitis and Sinusitis. (n.d.). Retrieved September 23, 2015, from https://www.aafa.org/display.cfm?id=9&sub=18&cont=239  
  1. Acute sinusitis causes. (n.d.). Retrieved October 27, 2015, from http://www.mayoclinic.org/diseases-conditions/acute-sinusitis/basics/causes/con-20020609

3.O'Rahilly, MD, R. (2008). The nose and paranasal sinuses. In Basic Human Anatomy (p. Ch. 52). Dartmouth Medical School. https://www.dartmouth.edu/~humananatomy/part_8/chapter_52.html


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Differences Between Sinusitis and Allergies

It’s spring time and you have a stuffy nose, sinus pain, fatigue and reduced sense of smell and taste. You head to the local pharmacy for over the counter medication to treat your allergies. There is only one problem, these are the symptoms of a sinus infection, not allergies. Most allergy patients can't tell the difference, according to a recent survey by the Asthma and Allergy Foundation of America.

In an online survey of more than 600 asthma and allergy patients, researchers found that about half of those surveyed self-diagnosed their symptoms as allergies when they actually had a sinus infection, or sinusitis.

The study shows how often people misdiagnose themselves. It's a natural response to go online and come up with our own diagnosis, but many patients come in convinced they have allergies, when really they have a sinus infection or vice versa.

Thirty-five million Americans suffer from allergies and over 7 million suffer from chronic sinus infections, yet most people can't tell the difference between these two conditions.

There is a lot confusion between sinus and allergy symptoms. This can lead to mistreated or untreated conditions, which can lead to chronic nasal congestion and associated symptoms that can affect quality of life as well as daytime performance.

Below is a chart that may help determine if you are suffering from allergies or a sinus infection. The best option is to schedule an appointment with one of our physicians who can help determine the cause of your symptoms and find a treatment plan to get the relief you need.

Differences between sinusitis and allergies

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