Chronic sinusitis
Informed by recognized medical guidance
Overview
Chronic sinusitis is a long-term swelling of the sinuses, the air-filled spaces inside your face and skull. This swelling can block the sinuses, causing mucus to build up and making it hard to breathe through your nose. It lasts for 12 weeks or more, even with treatment.
Key facts
- Chronic sinusitis is inflammation of the sinuses that lasts longer than 12 weeks.
- Symptoms include a stuffy or runny nose, facial pain or pressure, and reduced sense of smell.
- It is different from acute sinusitis, which usually follows a cold and clears up in a few weeks.
- Treatment focuses on reducing swelling and helping the sinuses drain, often with self-care and medicines.
Yes, chronic sinusitis is common. It affects millions of people worldwide and can occur at any age.
It can affect anyone, but it is more common in people with allergies, asthma, nasal polyps (small growths in the nose), a weakened immune system, or structural problems inside the nose.
Symptoms
- Sudden, severe headache or facial pain
- Swelling or redness around the eyes or forehead
- High fever with chills
- Vision changes, such as double vision or vision loss
- Stiff neck or difficulty moving the neck
- Shortness of breath or trouble breathing
- ⚠Symptoms that get worse after a few days of improvement
- ⚠Severe headache that does not go away with over-the-counter pain relief
- ⚠Fever lasting more than 3-4 days
- ⚠Any signs of infection spreading, like swelling or redness outside the nose area
Common symptoms
- Stuffy or blocked nose that makes it hard to breathe through the nose
- Thick, discolored mucus from the nose or dripping down the back of the throat (postnasal drip)
- Pain, tenderness, or pressure around the eyes, cheeks, forehead, or teeth
- Reduced sense of smell and taste
- Cough, which may be worse at night
- Bad breath (halitosis)
- Fatigue and feeling generally unwell
Symptoms in children
- Common cold symptoms that last more than 10 days
- Nasal congestion and runny nose with thick yellow-green mucus
- Irritability or fussiness
- Cough, especially at night
- Ear pain or pressure
- Reduced sense of smell and taste
Symptoms in older adults
- Symptoms may be less pronounced, such as mild stuffiness or postnasal drip
- Fatigue, weakness, or confusion (which can be mistaken for other conditions)
- Facial pain or headache may be absent or less severe
- Increased risk of complications like sinus infections spreading to nearby areas
Causes
Main causes
- Persistent inflammation from allergies, asthma, or other immune conditions
- Nasal polyps (small growths) that block the sinus openings
- Structural issues like a deviated septum (crooked wall inside the nose)
- Repeated or untreated acute sinus infections
- Fungal infections, especially in people with weakened immune systems
Risk factors
- Allergies (hay fever, allergic rhinitis)
- Asthma
- Nasal polyps
- Frequent colds or respiratory infections
- Smoking or exposure to secondhand smoke
- Problems with your immune system (e.g., HIV, diabetes)
- Exposure to environmental pollutants
- Dental infection or poor dental health
When to see a doctor
See a doctor urgently if:
- You have any of the emergency symptoms listed above.
- You have a high fever (over 38.5°C) that does not come down with rest and fluids.
- You have sudden vision changes or swelling around the eye.
Book a routine appointment if:
- Your symptoms last longer than 10-14 days without improving.
- You have had more than 4 episodes of sinusitis in one year.
- Symptoms are affecting your daily life, sleep, or work.
- You suspect you may have allergies or asthma.
Diagnosis
Your doctor will ask about your symptoms and medical history, and examine your nose and sinuses. They may press on your face to check for tenderness and look inside your nose with a lighted tool.
Tests that may be done
- Nasal endoscopy – a thin, flexible tube with a camera is gently inserted into the nose to see the sinus openings.
- Imaging tests – such as a CT scan, which takes detailed pictures of your sinuses.
- Allergy testing if allergies are suspected.
- Sometimes a sample of mucus is taken to check for infection (culture).
What to expect at your appointment
The doctor will rule out other causes like allergies or nasal polyps. Most diagnoses are made based on your symptoms and history. Imaging helps when the diagnosis is unclear or if surgery is being considered.
Treatment
Treatment for chronic sinusitis aims to reduce inflammation, relieve symptoms, and help the sinuses drain. It often starts with self-care and medicine, and may include other approaches if needed.
Self-care at home
- Saline nasal irrigation (rinsing the nose with a saltwater solution) – ask your pharmacist for a suitable device.
- Steam inhalation – breathe in steam from a bowl of hot water or a warm shower to loosen mucus.
- Warm compresses – apply a warm, damp cloth to your face to ease pain.
- Drink plenty of water and other clear fluids to thin mucus.
- Rest and elevate your head while sleeping.
- Avoid smoking and secondhand smoke.
Medical treatments
Your doctor may recommend nasal sprays or rinses that contain anti-inflammatory medicine (corticosteroids) to reduce swelling. They may also suggest other medicines like antihistamines for allergies or, if needed, a short course of antibiotics for a bacterial infection. Always use medicines as directed by your doctor.
When is surgery considered?
If symptoms continue despite medical treatment, or if there are polyps or a structural problem, surgery (called functional endoscopic sinus surgery, or FESS) might be an option. This procedure opens the sinuses and removes blockages. It is usually only considered after other treatments have not worked.
Living with this condition
Living with chronic sinusitis means managing ongoing symptoms. Learn your triggers (like pollen, dust, smoke) and avoid them. Keep your home humidified and clean. Use treatments as prescribed to keep symptoms under control.
Lifestyle tips
- Use a humidifier at night to keep nasal passages moist.
- Clean your home regularly to reduce dust mites and mould.
- Avoid triggers like strong perfumes, cleaning fumes, or smoke.
- Practice good hand hygiene to reduce colds.
- Manage allergies with antihistamines or allergy shots if advised.
Diet and exercise
There is no special diet for sinusitis, but a balanced diet supports your immune system. Some people find that dairy products thicken mucus – try cutting back to see if it helps. Regular exercise may help clear the sinuses by moving mucus, but listen to your body if you feel unwell.
Mental health and emotional wellbeing
Chronic symptoms can be frustrating and affect your quality of life. It is normal to feel tired, irritable, or down. Talk to your doctor if you feel your mood is suffering – they can offer support or refer you to a counselor.
Prevention
You cannot always prevent chronic sinusitis, but you can reduce flare-ups by controlling allergies, avoiding triggers, and treating colds early. Good hygiene (handwashing) helps prevent infections.
Vaccines
Talk to your doctor about annual flu shots and pneumococcal vaccines, as these can help prevent infections that might trigger sinusitis.
Screening programmes
There is no routine screening for chronic sinusitis. If you have frequent sinus issues, see your doctor for an evaluation.
Complications
If left untreated
- Worsening of symptoms – constant pain, loss of smell, and fatigue.
- Spread of infection to the area around the eye (orbital cellulitis) or the brain (meningitis) – rare but serious.
- Bone infection in the face (osteitis).
- Increased risk of asthma attacks in people with asthma.
Long-term outlook
With proper management, most people with chronic sinusitis can control their symptoms and live a normal life. It may take time and patience, but treatments can make a big difference. While the condition can be persistent, it is rarely dangerous. Stay in touch with your healthcare team and follow your treatment plan.
Find support
International organisations
Local organisations
- NHS – Your local services ↗ · United Kingdom
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 9, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.