sinus infection that comes and goes

Overview

A sinus infection that comes and goes means you get inflammation and infection in your sinuses (air-filled spaces in your face) several times a year, or the infection never fully goes away. It can make you feel blocked up, with facial pain and a runny or stuffy nose.

Yes, sinus infections are very common. Many people have one or two each year, and some people are more prone to having them again and again.

Anyone can get a sinus infection, but you are more likely to have them if you have allergies, asthma, structural problems inside your nose, or smoke.

Symptoms

Common symptoms

• Stuffy or blocked nose
• Thick yellow or green discharge from the nose or down the back of the throat
• Pain, pressure, or a feeling of fullness in the face, often around the cheeks, eyes, or forehead
• Reduced sense of smell
• Headache
• Bad breath

Symptoms in children

• Runny nose lasting more than a week
• Cough that gets worse at night
• Irritability and fussiness
• Ear pulling or tugging
• Breathing through the mouth

Symptoms in older adults

• Feeling confused or changed mental state compared with usual
• Less obvious fever
• Weakness or feeling unwell
• Purulent nasal discharge
• Worsening of other health conditions such as asthma or COPD

Causes

Main causes

• Viral infections (often after a cold)
• Bacterial infections when sinuses stay blocked
• Allergic inflammation
• Nasal polyps or a deviated septum (structural issues)
• Fungal sinus infection in people with weakened immune systems

Risk factors

• Allergic rhinitis (hay fever)
• Asthma
• Smoking or exposure to secondhand smoke
• A weak immune system due to illness or medicines
• Narrow sinus openings due to anatomy
• Dental infections

When to see a doctor

See a doctor urgently if:

• If your symptoms last more than 10 days without improving
• If you have a fever above 39°C (102.2°F) for more than 3 days
• If you have severe pain or swelling in the face
• If you have symptoms that get better and then suddenly get worse

Book a routine appointment if:

• If you get more than 4 sinus infections in a year
• If you have symptoms that keep returning despite treatment
• If you want a review of your allergy management or medication
• If nasal symptoms affect your sleep or daily life

Diagnosis

A doctor will ask about your symptoms and examine your head, nose, and face. They may use a light to look inside your nose and gently press on your sinuses. Usually that is enough to make a diagnosis.

Tests that may be done

• An endoscopy: a thin tube with a light and camera is passed through your nose to see inside the sinuses
• Allergy skin or blood tests to check for allergic triggers
• A CT scan, which takes detailed X-ray images, if symptoms are frequent or unusual
• A mucus sample to test for bacteria or fungus if an infection is severe or keeps coming back

What to expect at your appointment

The doctor will listen to your history and may ask you to keep a symptom diary. You may need to try a nasal rinse or spray before further tests. If the diagnosis is not clear, you may be referred to an ear, nose, and throat (ENT) specialist.

Treatment

Treatment aims to reduce inflammation, clear mucus, and control triggers. Many people start with home care and over-the-counter options, but your doctor might recommend prescribed medicines. You may need to treat any underlying problem like allergies or a structural blockage.

Self-care at home

• Use a saltwater nasal rinse or nasal spray to help clear mucus (ask your pharmacist for guidance)
• Drink plenty of fluids to keep the mucus thin
• Breathe steam from a bowl of hot water (carefully) or take a warm shower to moisten the air
• Apply a warm, moist cloth over your face for comfort
• Get plenty of rest and sleep with an extra pillow to keep your head elevated
• Avoid cigarette smoke and strong chemical fumes

Medical treatments

Your doctor may prescribe a course of antibiotics if there is a bacterial infection. They may also recommend nasal corticosteroid sprays to reduce swelling, medicines to manage allergies, or in some cases antifungal medicines. Always take prescribed medicines exactly as directed, and discuss any concerns with your pharmacist or doctor. Do not use over-the-counter decongestants for more than a few days without advice.

When is surgery considered?

If your sinus infections keep returning despite medical treatment, and you have blockage caused by nasal polyps or a deviated septum, surgery to enlarge the sinus openings or remove polyps can help. This is not the first step and is only considered after other options have been tried.

Living with this condition

Living with a sinus infection that comes and goes can be frustrating. Keep a note of when symptoms appear and what helps. You may find it useful to identify triggers like colds, weather changes, or allergies.

Lifestyle tips

• Stay well hydrated throughout the day
• Use a clean humidifier in dry rooms
• Practice good handwashing to avoid colds
• Avoid known allergy triggers such as dust, pollen, or pet hair
• Quit smoking and avoid secondhand smoke

Diet and exercise

Eating a balanced diet with fruit and vegetables can support your immune system. Gentle exercise like walking can help keep mucus moving, but avoid vigorous exercise if you feel unwell. There is no special diet proven to cure sinus infections, but staying hydrated with water is important.

Mental health and emotional wellbeing

Repeated infections can make you feel tired, low, or frustrated. It is normal to feel this way. Talk to your doctor if symptoms of worry or low mood persist. You might also find relaxation techniques, meditation, or breathing exercises helpful.

Prevention

You cannot always prevent sinus infections, but you can reduce their frequency. Managing allergies, avoiding smoking, and staying healthy can make a difference. Use nasal rinses after exposure to dust or allergens if recommended.

Vaccines

There is no vaccine specifically for sinus infections, but keep your routine vaccinations up to date, including the flu vaccine and COVID-19 vaccine, to reduce the risk of upper respiratory infections that can lead to sinusitis.

Screening programmes

There is no routine screening for sinus infections. Talk to your doctor if you notice a pattern of frequent symptoms.

Complications

If left untreated

• The infection could spread to nearby areas, such as the eye socket, bone, or brain
• You may develop a collection of pus called an abscess
• Chronic sinusitis can affect your quality of life and sleep
• In rare cases, infection can lead to meningitis

Long-term outlook

Most sinus infections clear up completely, even when they come back. With the right treatment and supportive care, most people see big improvement. If surgery is needed, it is usually very helpful. Your doctor can guide you through options, and there is a lot you can do to keep symptoms under control.

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