Sinus infection (sinusitis) symptoms

When you get a stuffy or runny nose, along with symptoms like cough and a low-grade fever, you might just think you’ve caught a cold. But if you also have pain or pressure in your sinuses, it could be a sinus infection.

So, which is it?

If you have a stuffy or runny nose that still sticks around after a cold or bout with allergies, and you start noticing facial pain or pressure in your sinuses, there’s a good chance you have sinusitis – otherwise known as a sinus infection. Fortunately, with the right care for the right type of sinusitis, relief can be on the way. We’ll give you more details about sinus infections, including how they’re caused, their symptoms, how to treat them and when to see your doctor. With the right approach, your days of breathing easy will return once again.

What causes a sinus infection?

Inside your head are spaces in the bones around your eyes, cheeks and nose. Known as your sinus cavities, they’re hollow, moist and usually problem free. But when you have a cold or allergies, the lining of these cavities become inflamed. This inflammation causes swelling, blocking off your sinuses’ normal drainage routes into your nose and throat. This comes at the worst possible time since your nose is already full of mucus due to your cold or allergies.

With all exits to your nose and throat mostly or completely blocked, mucus becomes stuck in your sinuses, giving you a feeling of stuffiness and pressure that can be downright miserable. When all goes well, once the inflammation goes down, your sinuses drain and go back to normal. But there are times when that buildup of mucus in your sinuses becomes a breeding ground for viruses, bacteria or fungi. If these germs take hold, your sinuses can remain inflamed even after your cold or allergies have run their course – resulting in a sinus infection that causes more swelling and pain as the viruses, bacteria or fungi grow.

Viral, bacterial and fungal sinus infections

As a condition, sinusitis is a broad term, describing sinus infections caused by viruses, bacteria and fungi. Viruses are usually the most common direct cause of sinusitis, with the cold virus itself causing the infection and resulting inflammation. But as anyone that has had fruit rot on their kitchen counter can confirm, food in a moist and warm place is a prime home for bacteria and fungus. During your cold or allergies, your reserve of mucus serves as fertile ground for bacteria or fungus to settle and multiply. While all three causes are unique, each has an available and effective treatment.

What are the symptoms of a sinus infection?

The biggest symptom of sinusitis is a stuffy or runny nose that is still going, even if other cold or allergy symptoms have stopped. You might also have yellow or green mucus dripping from your nose or going down the back of your throat.

The other big sign of a sinus infection is pain or pressure in your face – especially near the sinus cavities around your eyes, cheeks and nose. Both your persistent stuffy nose and face pain are due to the lining of your sinuses being inflamed and swollen by the infection, plugging drainage and building pressure.

This pain can also make your face more sensitive to touch, especially around your nose and eyes. Your sensitivity can also be triggered by leaning forward or moving your head, causing the pain and pressure to get worse.

Other symptoms to look for include:

Headache
Coughing that produces mucus
Fever
Tooth pain
A reduced sense of taste or smell
Bad breath

But is it still a cold, flu, allergies or even COVID-19?

Sinus infections do share symptoms with colds, the flu and COVID-19. The key thing to remember about sinusitis is that it usually doesn’t happen without something taking place first. A sinus infection is caused by inflammation that plugs up your sinuses and causes a backup of fluid – the kind of situation that can only really happen as the result of a cold, allergies or other similar condition.

So, if you do find yourself having symptoms of sinusitis but haven’t been sick with anything else recently, it’s worth it to see if you’re tracking with other signs of a cold or the flu. You should also take a quick inventory to see if you have any early symptoms of COVID-19. If so, get tested and get treatment as soon as possible. With early detection, you can get the medications necessary to have the best chances of getting better faster.

If you’ve been sneezing with a stuffy or runny nose along with irritated, watery eyes and itchy ears – all without a fever – you might be dealing with seasonal allergies. If that sounds more like what you have, especially if they’re symptoms that only happen during certain times of the year, check in with your primary care doctor. They can help confirm if you’re dealing with allergies, prescribe medications and connect you with an allergist to treat congestion from allergies.

How long does a sinus infection last?

The time it takes to bounce back from sinusitis depends on whether the infection you have is acute or chronic.

Acute sinus infections

Acute sinusitis comes on suddenly, usually by a virus or bacteria. Acute sinus infections caused by viruses (like the ones behind colds) are the most common. Fortunately, most of these infections go away on their own without any special treatment. In these cases, symptoms will start to clear up after seven days, gradually getting better until you recover completely in about four weeks.

When bacteria causes an acute sinus infection, it doesn’t clear up as quickly or completely on its own like infections caused by a virus. Bacterial infections typically last more than 10 days without any letup in symptoms and usually need antibiotics. The good news is that symptoms typically go away quickly once treatment begins.

Chronic sinus infections

A chronic sinus infection, sometimes called chronic sinusitis, some can last for 12 weeks or longer. They can be caused by fungal infections or untreated bacterial infections, the constant infection and inflammation of chronic sinusitis won’t go away on its own. Without treatment, it can lead to permanent changes in the lining of your sinuses that may make you prone to more long-lasting and severe infections in the future.

Yes, having sinusitis can be miserable. But it’s also very treatable – especially from home. The key is to know the symptoms you have, how long you have them, and when they’re getting worse. Doing the right things at the right time is essential to bouncing back from a sinus infection.

How to treat a sinus infection at home – the first several days

Many sinus infections clear up on their own, with symptoms usually starting to improve after two days. While that’s good news, you’re going to need help while you’re in the thick of feeling gross. Fortunately, there are plenty of things you can do in the meantime to help you feel better:

Start taking over-the-counter pain medicine like Tylenol, Advil or Aleve. These will help with the pressure and pain you’re feeling, along with any fever or headaches. Make sure to read the label and cycle between different medications for maximum relief. Also, avoid taking Tylenol for pain if you’re using cold or flu medicines that also use acetaminophen.
Use a decongestant nasal spray. Using a spray like oxymetazoline (Afrin) can also help with congestion during the first three days.
Breathe in warm, humid air. Take hot showers or baths throughout the day. If you have a humidifier, now is the perfect time to use it.
Try clearing your nasal passages with a saline solution (saltwater). Saline washes are excellent at helping to clear your nasal passages and reduce congestion. You can pick some up at your local pharmacy.
Press a warm, moist towel to your face for 5-10 minutes several times a day. The heat and moist air it creates can help reduce swelling and pain in your nasal passages.
Drink lots of water and other fluids. This can help thin your mucus and reduce congestion.

Using these home treatments together should give you relief pretty quickly. However, some techniques work well for some while others don’t. See what combination works best for you. If you’re finding that none of these are helping, your next move should be to make an appointment with your doctor.

When should you see a doctor for sinusitis?

After two days of taking care of your symptoms at home, you should start seeing some improvement. If you don’t feel like things are getting better, it’s time to see your primary care doctor, use an online clinic or head into urgent care. You should see someone sooner if:

You’re experiencing severe pain in the upper part of your face or your teeth
You have facial pain from the bridge of your nose to your lower eyelid
Over-the-counter medicines aren’t providing relief for your headaches
You have a fever of 101 degrees Fahrenheit or higher
Your normally clear, thin mucus is starting to turn thick and yellow or green

Taking care of sinus infections early can help keep them from turning into chronic infections, which take longer to treat.

If you thought you were in the clear after an illness but are still experiencing symptoms, you should make an appointment – especially if you’ve had cold symptoms for more than 10 days or mild face pain for more than a month.

How your doctor treats a sinus infection

When you’re in the exam room, your doctor will do a quick check of your symptoms to see if your infection is bacterial or viral. If it turns out that your infection is bacterial, your doctor will probably prescribe an antibiotic. Once you get it, make sure to take the entire amount prescribed to you – even if you start feeling better after a few days. Taking the entire amount helps to ensure that all of the bacteria causing your pain are wiped out and don’t return.

If it ends up that your infection is viral, you won’t be prescribed an antibiotic. (Antibiotics only work for bacterial infections.) But don’t despair – there is still plenty in your doctor’s toolbox to help you feel better. Prescription decongestants and corticosteroids can help reduce swelling and inflammation while mucolytics will help thin out your mucus, helping it to drain faster.

When is sinus surgery needed?

If the thought of surgery makes you more miserable, don’t worry – it’s only needed for more chronic or complex cases. If prescription treatments don’t work, your doctor will refer you to an otolaryngologist, also known as an ear, nose and throat (ENT) doctor. They can try other approaches to take care of your infection, including sinus surgery. There, they can remove swollen tissue, nasal polyps, growths, fluid or other blockages that make it difficult for your sinuses to drain and heal. Again, there are plenty of medications and treatments that doctors can use before surgery is considered.

Are sinus infections contagious?

It depends. If it’s caused by a virus, definitely. If you’re in the early stages of sinusitis, and it hasn’t been checked out by a doctor, it’s safe to assume that it’s viral. That means you can easily spread it to someone else when you sneeze or cough, releasing droplets of moisture through the air. To keep your sinus infection (and the cold that caused it) to yourself, take the usual precautions and cover your nose and mouth when you cough or sneeze, and wash your hands frequently.

If your doctor finds that your sinus infection is caused by bacteria or fungus, then it’s not contagious. While that doesn’t mean that you’ll spread it to friends and family, it’s not a free pass to sneeze openly in the air. Keep covering your mouth and washing your hands.

Sinus infection prevention

Even under the best of circumstances, you can still get a sinus infection. The key is to prevent your infection from becoming chronic. The sooner you recognize your symptoms, the sooner you can get the care you need before the infection spreads and gets worse. If you don’t feel better after two days of sinus infection symptoms, see your primary care doctor or head to urgent care.

That said, the best way to prevent a sinus infection is to take the same precautions you would with a cold or allergies:

Avoid direct contact with people who are sick with colds or other viral upper respiratory infections.
Wash your hands after touching common surfaces and before eating or touching your face.
If you breathe a lot of dry air, especially indoors during the winter, use a humidifier.
If you smoke, stop. If you’re around smoke, avoid it. Cigarette, cigar and pipe smoke can irritate the lining in your nose and sinuses, which can kick-start the processes leading to infection.
Avoid allergy triggers, in and out of season.
Talk to your primary care doctor or allergist about immunotherapy, including allergy shots.

Is online care an option?

Absolutely! Sinus infections are easy to diagnose and treat safely through an online or video interview. When you see a doctor or nurse practitioner through an online or video visit, you’ll be asked the same questions as you would if you were in person. They can also prescribe medication and set up a treatment plan to help get you feeling better right away.

When it’s time to see someone for your sinusitis symptoms, consider Virtuwell.com – our online clinic that’s available day and night. Our certified nurse practitioners diagnose and treat more sinus infections than any other condition.

If you want to see your primary care doctor, you can set up a primary care appointment. And if you don’t want to leave the house, you can make it a video visit.