15285 Acute Sinusitis

Overview

Acute sinusitis is a short-term swelling or infection of the sinuses — small, air-filled spaces behind your cheeks, nose, and forehead. It usually happens after a cold and causes mucus to build up, leading to facial pain, stuffiness, and a runny or blocked nose. Most of the time it gets better on its own within a few weeks.

Yes. Acute sinusitis is very common — many people get it at least once in their lifetime, often after a cold or flu-like illness.

Anyone can get acute sinusitis, but it is more likely if you have allergies, a deviated septum (a slightly crooked nasal passage), nasal polyps, a weakened immune system, or if you smoke.

Symptoms

Common symptoms

• Stuffy or blocked nose
• Runny nose with thick, yellow or green mucus
• Pain, pressure, or a dull ache around your forehead, cheeks, or eyes
• Headache
• Reduced sense of smell
• Cough, especially at night
• Mild fever (less than 39°C / 102°F)
• Bad breath or a bad taste in your mouth
• Tooth pain (usually in the upper back teeth)

Symptoms in children

• A stuffy or runny nose that lasts more than 7 to 10 days
• Mild fever
• Irritability or fussiness
• Cough, especially at night
• Puffiness around the eyes, sometimes with yellow or green nasal discharge

Symptoms in older adults

• Symptoms may be less obvious than in younger adults
• Fatigue or feeling unwell
• A mild fever or cough
• Confusion or changed mental state, which can happen at any age
• Often the classic facial pain may be less severe or absent

Causes

Main causes

• A viral infection, such as a cold or flu, that inflames the sinus lining and traps mucus
• A bacterial infection that develops when sinuses stay blocked for a long time (less common)
• Blockage of the sinus openings due to swelling, mucus, or growths (like polyps)

Risk factors

• Allergies like hay fever
• A previous cold or respiratory infection
• Smoking or exposure to second-hand smoke
• Weak immune system from certain medications or health conditions
• Dental infection in the upper teeth
• Being around polluted air or sudden changes in air pressure
• Nasal polyps or structural issues like a deviated septum

When to see a doctor

See a doctor urgently if:

• Call your local emergency number if you have severe eye swelling, vision changes, a severe headache, stiff neck, confusion, or trouble breathing
• Seek same-day medical care if you have a very high fever, symptoms that worsen quickly, or you have a weakened immune system
• If your face is very swollen and painful, or you feel extremely unwell, see a doctor right away

Book a routine appointment if:

• Symptoms last more than 10 days without getting better
• Symptoms start to improve, then suddenly get worse
• You have recurrent sinusitis — more than 3 or 4 episodes per year
• Facial pain or pressure interferes with your sleep or daily life

Diagnosis

A doctor usually diagnoses acute sinusitis based on your symptoms and a quick physical exam. They will ask about how long you've had symptoms, whether you've had a cold, and if you have any underlying conditions like allergies. They may gently press on your cheeks and forehead to check for tenderness and look inside your nose with a small light.

Tests that may be done

• No tests are needed for most cases of acute sinusitis
• In unusual or complicated cases, a doctor might order an imaging test (like a CT scan) to look at the sinuses in more detail
• A nasal swab can help identify bacteria if a bacterial infection is suspected
• Allergy testing may be helpful if you have repeated episodes linked to allergies

What to expect at your appointment

A visit for sinusitis is usually straightforward. The doctor will talk through your symptoms, examine you, and give advice about self-care. They may prescribe a medicine only if they suspect a bacterial infection or a complication. In most cases, the doctor will reassure you that home care is enough and that the sinusitis should clear up within a few weeks.

Treatment

The main goal of treatment is to relieve symptoms and help your sinuses drain. Since most cases are caused by viruses, antibiotics are not usually helpful. Home remedies and over-the-counter or pharmacy-recommended medicines can make you more comfortable while your body fights the infection.

Self-care at home

• Get plenty of rest and drink lots of fluids (water, herbal tea, or clear broth) to keep the mucus thin
• Place warm compresses (a clean cloth soaked in warm water) over your forehead and cheeks for a few minutes at a time to ease pain
• Breathe in steam from a bowl of hot water or a warm shower to moisturize the nasal passages
• Use a saline (saltwater) nasal spray or rinse to help clear mucus — ask your pharmacist for guidance
• Prop your head up with an extra pillow at night to help sinus drainage
• Use a humidifier in your bedroom to keep the air moist

Medical treatments

For fever or pain, you can use a pharmacy-bought pain reliever or fever reducer — ask your pharmacist which one is suitable for you. A doctor may also suggest a nasal steroid spray to reduce inflammation, or prescribe antibiotics if they believe a bacterial infection is present. Always take any prescribed medicine exactly as directed and finish the full course if antibiotics are given.

When is surgery considered?

Surgery is rarely needed for acute sinusitis. It may be considered only in rare cases where a complication develops, such as an abscess, or if there is an anatomical problem (like a nasal polyp) that blocks the sinuses and keeps coming back. Talk to your specialist if you worry about this.

Living with this condition

During an acute episode, try to keep your routine light. Rest, drink enough fluids, and use the self-care measures described above to ease symptoms. You may need to take time off work or school for a few days, especially if you have a fever or feel too unwell to concentrate.

Lifestyle tips

• Avoid smoke, strong fumes, and polluted air, as these can irritate your sinuses further
• Use a saline nasal rinse regularly during an episode, especially if you are prone to allergies
• Keep your living space clean and well-ventilated to reduce dust and allergens
• Wash your hands often to avoid spreading viruses to others
• Sleep with your head elevated to help drainage

Diet and exercise

Drink plenty of fluids — water, broth, and unsweetened tea — to keep the mucus thin. Eat balanced meals as you feel able. Gentle exercise like walking is fine if you have energy, but avoid strenuous activity if you have a fever or feel very unwell. Ease back into exercise gradually once you recover.

Mental health and emotional wellbeing

Having a blocked nose, facial pain, and poor sleep can feel tiring and frustrating — especially if symptoms linger. It's normal to feel a bit low. Be kind to yourself, rest, and talk to family or friends about how you're feeling. If you notice ongoing low mood or anxiety, speak with your doctor.

Prevention

Not every episode can be prevented, but you can lower the risk by washing your hands regularly, avoiding touching your face, staying away from people with colds or flu, and managing allergies well. Avoiding tobacco smoke is one of the most helpful steps.

Vaccines

Keeping up to date with recommended vaccines, like the flu vaccine and COVID-19 vaccines, can help prevent the viral infections that often lead to sinusitis.

Screening programmes

There is no routine screening test for acute sinusitis. The best approach is early self-care and seeing a doctor if symptoms are severe or long-lasting.

Complications

If left untreated

• Rarely, the infection can spread beyond the sinuses to nearby tissues, such as around the eyes (orbital cellulitis)
• It can spread to the bones of the skull (osteomyelitis) — again, very rare
• In extremely rare cases, it can reach the brain or its linings (meningitis or a brain abscess)
• Untreated bacterial sinusitis could, in uncommon cases, result in chronic inflammation if not resolved

Long-term outlook

The vast majority of people with acute sinusitis recover fully within 2 to 4 weeks, with or without medical treatment. Even when symptoms feel unpleasant, simple self-care and time are enough for most. Serious complications are very rare, and if you seek care when symptoms are severe, doctors can treat them effectively.

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