Sinusitis patient overview

Overview

Sinusitis is swelling and inflammation of the lining of your sinuses — the air-filled spaces behind your forehead, cheeks, and eyes. When the sinuses become blocked and filled with fluid, germs can grow and cause infection. This is often called a sinus infection.

Yes, sinusitis is very common. Many people have at least one episode in their lifetime.

Sinusitis can affect people of all ages, but it is more common in adults than in young children. People with allergies, asthma, or a weakened immune system are at higher risk.

Symptoms

Common symptoms

• Blocked or stuffy nose
• Pain and tenderness around your eyes, forehead, or cheeks
• Thick yellow or green mucus from your nose or down the back of your throat
• Headache
• Toothache
• Reduced sense of smell
• Cough, especially at night
• Fever
• Bad breath

Symptoms in children

• Runny nose that lasts more than 10 days
• Low-grade fever
• Irritability or fussiness
• Coughing during the day and night
• Ear pain or pulling at ears

Symptoms in older adults

• Symptoms may be less obvious; they might only feel tired or have a headache
• Confusion or change in mental state can be a sign of a more serious infection
• Fever may be absent or low-grade

Causes

Main causes

• Viral infections, like the common cold or flu
• Bacterial infection (less common, usually after a viral infection)
• Fungal infection (rare, mostly in people with weakened immune systems)
• Allergies (allergic rhinitis) that cause ongoing swelling
• Nasal polyps or a deviated septum

Risk factors

• Having a cold or flu
• Allergies like hay fever
• Asthma
• Smoking or exposure to secondhand smoke
• Weakened immune system from diabetes, HIV, or medications
• Structural problems in the nose, such as a deviated septum

When to see a doctor

See a doctor urgently if:

• Symptoms that get worse instead of better after 10 days
• Severe headache or facial pain
• Fever that lasts more than 3-4 days or is very high

Book a routine appointment if:

• Mild symptoms that last more than 2 weeks
• You have recurrent sinusitis (several episodes a year)

Diagnosis

Your doctor will ask about your symptoms and examine your nose and sinuses. They can usually diagnose sinusitis based on your history and a physical exam.

Tests that may be done

• Nasal endoscopy — a thin, flexible tube with a camera is gently inserted into your nose to look inside your sinuses
• Imaging tests like a CT scan — if chronic or complicated sinusitis is suspected
• Swab of nasal discharge — to check for bacteria or fungi (rarely needed)

What to expect at your appointment

The doctor will ask when your symptoms started, how severe they are, and if you have any other health conditions. They may press gently on your cheeks and forehead to check for tenderness. Most people do not need special tests.

Treatment

Treatment depends on whether the sinusitis is likely viral or bacterial. Most cases do not require antibiotics. The focus is on relieving symptoms and helping your sinuses drain.

Self-care at home

• Get plenty of rest to help your body fight the infection
• Drink lots of fluids to keep mucus thin
• Use a saline nasal spray or rinse to flush out mucus
• Apply a warm, moist cloth to your face to ease pain
• Breathe in steam from a hot shower or bowl of warm water
• Avoid smoking and secondhand smoke

Medical treatments

For pain and fever, over-the-counter pain relievers (like paracetamol or ibuprofen) can help — always follow the instructions on the label. Your doctor may recommend nasal corticosteroid sprays to reduce swelling. In some cases if a bacterial infection is confirmed, a short course of antibiotics may be prescribed. Do not ask for antibiotics unless your doctor advises they are needed.

When is surgery considered?

Surgery is rarely needed. It may be considered if you have chronic sinusitis that does not improve with other treatments, or if there is a structural problem like nasal polyps or a deviated septum. A procedure called functional endoscopic sinus surgery (FESS) can open up the sinuses and improve drainage.

Living with this condition

For most people, sinusitis is a temporary condition. Once it clears, you can return to normal activities. If you have chronic sinusitis, you may need to manage flares with self-care and medications as advised by your doctor.

Lifestyle tips

• Use a humidifier at home to keep air moist
• Avoid known allergens like pollen, dust mites, or pet dander
• Wash your hands often to reduce the chance of infections

Diet and exercise

Eating a healthy diet with plenty of fruits and vegetables supports your immune system. Drinking warm fluids can help soothe symptoms. While you are ill, rest is more important than exercise. Once you feel better, gentle activity can help you recover.

Mental health and emotional wellbeing

Dealing with chronic sinusitis can be frustrating and tiring. The constant discomfort may affect your mood and sleep. If you feel low or anxious, talk to your doctor — they can suggest support.

Prevention

You cannot always prevent sinusitis, but you can reduce your risk. Avoiding colds and flu, managing allergies, and not smoking are key steps.

Vaccines

Getting the annual flu vaccine and staying up to date with other recommended vaccines can help reduce the number of viral infections that often lead to sinusitis.

Screening programmes

There is no routine screening test for sinusitis. If you have frequent episodes, your doctor may check for underlying causes like allergies or a weak immune system.

Complications

If left untreated

• Chronic sinusitis that lasts for months
• Spread of infection to bones or tissue around the eye (orbital cellulitis)
• Rarely, infection can spread to the brain or cause a brain abscess

Long-term outlook

While sinusitis can be uncomfortable, the outlook is generally very good. Most cases resolve on their own or with simple treatment. Even chronic sinusitis can be managed effectively. Serious complications are rare, especially if you seek medical help when needed.

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