long lasting sinus infection

Overview

A long-lasting sinus infection, also called chronic sinusitis, is when the air-filled spaces inside your face (sinuses) stay inflamed and swollen for 12 weeks or longer, even with treatment.

Yes. It is one of the most common long-term health conditions in the UK and affects millions of people worldwide.

It can affect anyone, but it is more common in adults, slightly more common in women, and especially common in people with asthma, allergies, or a weakened immune system.

Symptoms

Common symptoms

• A blocked or stuffy nose that doesn't go away
• Thick, coloured nasal discharge or postnasal drip
• Pain, pressure, or a full feeling in your face, especially around the cheeks, eyes, or forehead
• A reduced sense of smell or taste
• A headache that feels worse when you bend forward
• A persistent cough, often worse at night
• Bad breath or a bad taste in your mouth
• Fatigue or a feeling of being generally unwell

Symptoms in children

• Constant sniffing, mouth breathing, or snoring
• Irritability and difficulty sleeping
• A cough that won't go away
• Ear pain or a feeling of pressure in the ears
• Reduced appetite or feeding poorly

Symptoms in older adults

• Symptoms may be less obvious, such as mild confusion or forgetfulness
• A loss of interest in food
• Tiredness and low energy
• Less specific facial discomfort rather than severe pain

Causes

Main causes

• Allergic rhinitis (hay fever) or year-round allergies
• Nasal polyps — soft, non-cancerous growths in the nose
• A deviated septum — a bend in the wall inside the nose that blocks drainage
• Persistent inflammation from asthma or an autoimmune condition
• In some cases, a fungal or bacterial infection that keeps coming back
• Reflux of stomach acid into the nose and sinuses (acid reflux)

Risk factors

• Having asthma or frequent allergies
• Smoking or being around second-hand smoke
• Weak immune system due to illness or certain medications
• Dental infection in the upper teeth
• Structural issues in the nose from injury or birth
• Cystic fibrosis or similar conditions that affect mucus

When to see a doctor

See a doctor urgently if:

• If you have any emergency warning signs such as eye swelling, vision changes, or severe headache
• If you have a high fever with facial pain
• If your symptoms are severe or getting worse quickly

Book a routine appointment if:

• If your symptoms have lasted more than 10 days
• If your symptoms keep coming back
• If over-the-counter remedies and home care have not helped after a couple of weeks

Diagnosis

Your doctor will ask about your symptoms, look inside your nose with a small light, and gently press on your face to check for tenderness. They may also look into your ears, throat, and the back of your nose.

Tests that may be done

• A mucus sample to check for bacteria or fungus
• Allergy testing to see if allergies are causing the inflammation
• A CT scan of your sinuses to look for blockages or polyps
• Nasal endoscopy – a thin, flexible tube with a camera to look inside your sinuses

What to expect at your appointment

The diagnosis is usually based on your symptoms and a physical exam. You may not need every test. If you are referred to a specialist, they will explain each step and make sure you understand what is happening.

Treatment

Treatment aims to reduce inflammation and help your sinuses drain. It often starts with self-care and simple measures. If these aren't enough, your doctor may add prescription treatments. Surgery is only considered when other treatments have not worked.

Self-care at home

• Rinse your nasal passages with a saline (salt-water) nasal rinse every day using a bulb syringe or a rinse bottle from your pharmacist
• Use a steam inhaler or take a warm shower to help loosen mucus
• Place a warm, damp flannel over your face for a few minutes to ease pain
• Drink plenty of water to thin the mucus
• Try to raise the head of your bed slightly to help sinuses drain at night

Medical treatments

Your doctor may prescribe a steroid nasal spray to reduce swelling, or an allergy treatment such as antihistamines or allergy shots. If a bacterial infection is confirmed, a short course of antibiotics may be used. For some people, a medication that helps thin mucus or a short course of oral steroids might be suggested. Always ask your doctor or pharmacist about how to use any treatment.

When is surgery considered?

If medicines and home care don't improve your symptoms after several months, your doctor may refer you to an ear, nose and throat (ENT) specialist. They may consider a procedure called functional endoscopic sinus surgery to open up the blocked sinuses. This is a common and generally safe operation, but you should discuss the risks and benefits with your specialist.

Living with this condition

Make daily nasal rinsing a habit, avoid things that trigger your symptoms, and take your prescribed treatments exactly as directed. Keeping a symptom diary can help you and your doctor see what works.

Lifestyle tips

• Don't smoke and avoid second-hand smoke
• Use allergy-proof covers on pillows and mattresses if you have dust mite allergies
• Keep windows closed during high pollen days if you have hay fever
• Use a saline spray before flights or in dry environments

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables and whole grains. Some people find spicy foods help clear the nose temporarily, but there is no strong evidence for any special diet. Gentle exercise, like walking, can boost your mood and help you feel better overall.

Mental health and emotional wellbeing

Living with a long-lasting health problem can feel frustrating and tiring. You may struggle with poor sleep, low energy, or feelings of sadness. Talk to your doctor if you feel anxious or low, and consider joining a support group for people with sinus or allergy conditions.

Prevention

You can reduce the chance of having long-lasting sinus problems by managing allergies, avoiding smoke, and practicing good hand hygiene to avoid repeated viral infections. It is not always possible to prevent it completely.

Vaccines

Staying up to date with recommended vaccinations, such as the annual flu vaccine and COVID-19 boosters, can help prevent viral infections that could, in turn, make sinus inflammation worse. Ask your doctor about what is recommended for you.

Screening programmes

There is no routine screening test for long-lasting sinus infection, but if you have ongoing symptoms, a doctor can assess you properly.

Complications

If left untreated

• In rare cases, the infection can spread to the area around the eyes or the brain and cause swelling or vision problems
• Loss of sense of smell that may not fully return
• Repeated or worsening sinus infections
• Reduced quality of life due to chronic pain, poor sleep, and fatigue

Long-term outlook

For most people, a long-lasting sinus infection can be managed well with the right treatment. While it may be a long-term condition, many people find significant improvement, and serious complications are rare.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.