Sinusitis in children

Overview

Sinusitis in children is when the sinuses — small air-filled spaces inside the bones around the nose and eyes — become swollen and inflamed. This often happens after a cold or allergy and can make breathing through the nose difficult.

Yes, sinusitis in children is very common. Many children will have at least one episode, especially during winter months or after a viral infection like a cold.

Sinusitis can affect children of any age, but it is most common in older children and teenagers whose sinuses are more developed. Younger children may still have underdeveloped sinuses, but they can get a similar condition called rhinosinusitis.

Symptoms

Common symptoms

• Stuffy or runny nose (often with thick yellow or green mucus)
• Cough that may get worse at night
• Facial pain or pressure around the nose, eyes, or forehead
• Headache
• Fever
• Bad breath
• Loss of sense of smell

Symptoms in children

• Irritability or fussiness
• Trouble sleeping due to cough or stuffy nose
• Reduced appetite
• Ear pain or pressure
• Breathing through the mouth
• Crying more than usual

Symptoms in older adults

• This section is not relevant for the main topic of children, but older adults can experience sinusitis with similar symptoms, often with more persistent headache and facial pain. For specific guidance, consult a healthcare provider.

Causes

Main causes

• Viral infections (like the common cold) that cause swelling and blockage of the sinus openings
• Allergies (like hay fever) that make the lining of the nose swell
• Bacterial infection, which can happen when a cold lasts more than 10 days or gets worse
• Structural problems in the nose, such as a deviated septum (rarely in children)

Risk factors

• Attending daycare or school (more exposure to viruses)
• Being around second-hand smoke
• Having allergies or asthma
• Weakened immune system
• Using a pacifier after age 2 (may increase infections, but link is not strong)
• Recent upper respiratory tract infection

When to see a doctor

See a doctor urgently if:

• Your child has symptoms that last more than 10 days and are not improving
• Your child has a fever above 38.5°C for more than 3 days
• Your child has severe headache or facial pain
• Your child has swelling or redness around one or both eyes
• Your child is very drowsy or confused

Book a routine appointment if:

• Symptoms are mild but you want advice on how to manage at home
• Your child has had several episodes of sinusitis in a short time (recurrent)
• You suspect allergies may be contributing

Diagnosis

A doctor or nurse will ask about your child's symptoms and examine them. They may look inside the nose with a small torch (otoscope) and feel around the face. In most cases, tests are not needed.

Tests that may be done

• Your child's doctor may take a swab from the nose to check for bacteria if the infection is severe or not getting better.
• Imaging tests like X-rays or CT scans are rarely needed and only if the doctor suspects complications.

What to expect at your appointment

The doctor will ask you questions about your child's symptoms, such as how long they have had them, whether they have a fever, and if there is any facial swelling. They may also check your child's ears and throat. The visit usually takes 10 to 15 minutes.

Treatment

Treatment for sinusitis in children focuses on relieving symptoms and letting the body fight the infection. Most cases are caused by viruses, so antibiotics do not help. Self-care at home is the main treatment.

Self-care at home

• Make sure your child rests and gets plenty of sleep.
• Give your child lots of fluids (water, clear soups) to stay hydrated and thin mucus.
• Use a cool-mist humidifier in the room or sit with your child in a steamy bathroom (with hot water running) to help loosen mucus.
• Use saline (salt water) nasal drops or sprays to rinse the nose and keep it moist.
• Warm compresses on the face can ease pain and pressure.
• Elevate the head of your child's bed slightly to help drainage.
• Encourage gentle nose blowing, if your child is old enough.

Medical treatments

If the doctor suspects a bacterial infection (symptoms lasting more than 10 days or severe), they may prescribe antibiotics. These are usually taken for 10 to 14 days. Your doctor will advise on the best course. Pain relief such as paracetamol or ibuprofen can be used for fever and pain, using the child's weight-appropriate dose. Always follow your doctor's advice and never give aspirin to children.

When is surgery considered?

Surgery is rarely needed for sinusitis in children. It may be considered if your child has recurrent severe infections, polyps (non-cancerous growths in the nose), or if there is a complication like an abscess. The most common surgery is called endoscopic sinus surgery. This discussion would happen with a specialist (an ENT doctor).

Living with this condition

Sinusitis can make your child uncomfortable, but you can help them manage the symptoms. Keep the nose clear with saline drops, encourage fluids, and ensure your child gets enough rest. Avoid exposing your child to smoke or strong irritants.

Lifestyle tips

• Keep your home smoke-free.
• Wash hands often to prevent spreading germs.
• Avoid known allergens if your child has allergies.
• Teach your child to blow their nose gently, not forcefully.
• Use a proper dose of children's pain relief if needed, and follow the instructions.

Diet and exercise

A healthy diet with plenty of fruits and vegetables can support the immune system. Your child does not need to avoid any specific foods. Light activity, like playing, is fine if they feel well. Rest is more important during the acute phase.

Mental health and emotional wellbeing

Sinusitis can make children feel irritable, tired, and frustrated. It may affect sleep and appetite. Reassure your child that it will pass. If symptoms last a long time or keep coming back, your child may feel worried. Talk to your doctor if you notice changes in mood or behaviour.

Prevention

You can reduce the risk of sinusitis by preventing colds and managing allergies. Wash hands often, avoid sharing cups, and keep your child away from smoke. If your child has allergies, following the treatment plan (like antihistamines) can help prevent sinusitis.

Vaccines

Getting the flu vaccine each year (if recommended for your child) can reduce the chance of developing a cold that could lead to sinusitis. The pneumococcal vaccine also protects against some bacterial infections. Ask your doctor about recommended vaccines.

Screening programmes

There is no routine screening for sinusitis in children. It is diagnosed when symptoms occur. If your child has recurrent or severe sinusitis, your doctor may refer them to a specialist for further assessment.

Complications

If left untreated

• Spread of infection to the eye socket (orbital cellulitis) — swelling, redness, pain around the eye
• Infection spreading to the bones of the skull (osteomyelitis) — very rare
• Meningitis (inflammation of the lining of the brain) — rare but serious
• Chronic sinusitis (symptoms lasting more than 12 weeks) — less common in children

Long-term outlook

The outlook for most children with sinusitis is excellent. With proper home care and, if needed, medical treatment, the infection usually clears up completely. Even in cases of complications, early treatment is very effective. Most children do not have long-term problems.

Find support

International organisations

• World Health Organization ↗

Local organisations

• NHS ↗ · UK
• Royal College of Paediatrics and Child Health ↗ · UK

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