sinus that comes and goes

Overview

This is a condition where the sinuses (the air-filled spaces inside your face) become inflamed and infected, causing symptoms like a blocked nose, facial pain, and a runny nose that keep coming back. The problem goes away for a while, then returns, sometimes several times a year. It is often called recurrent sinusitis.

Yes, it is quite common. Many people have sinus infections every year, and some people get them again and again.

It can affect anyone, but it is more likely in people with allergies, asthma, a weakened immune system, or a structural problem inside the nose. It is also more common in adults than in young children.

Symptoms

Common symptoms

• A blocked or stuffy nose that makes it hard to breathe through your nose
• Thick yellow or green mucus coming from your nose or down the back of your throat
• Pain, pressure, or a dull ache around your cheeks, eyes, or forehead
• A headache that feels worse when you lean forward
• A reduced sense of smell or taste
• A cough that may be worse at night
• A feeling of fullness in your ears
• Fatigue or a general feeling of being unwell

Symptoms in children

• A blocked nose with mucus that lasts for more than a week
• A cough that continues day and night
• Irritability or fussiness, especially when lying down
• Swelling around the eyes or a fever without a clear cold
• Breath smelling bad, even after brushing teeth

Symptoms in older adults

• Less obvious symptoms like a mild headache, tiredness, or a persistent cough
• A dry mouth or a change in taste or smell
• More confusion or feeling 'off' than usual, especially if there is a fever
• A nasal blockage that can interfere with sleep or eating

Causes

Main causes

• Viral infections, such as a cold, that cause the sinuses to swell and block the small openings
• Bacterial infection that develops when a viral cold leaves trapped mucus in the sinuses
• Allergies that cause ongoing swelling in the nose and sinuses
• Nasal polyps (small, harmless growths inside the nose) that block the sinus passages
• A slightly bent nasal septum (the wall between the two nostrils) that affects drainage
• In rare cases, an infection from a tooth problem that can spread to the sinuses

Risk factors

• Having allergies or asthma
• A weak immune system from conditions like diabetes or treatments such as chemotherapy
• Smoking or being around secondhand smoke
• Frequent colds or upper respiratory infections
• Swimming in water that may contain irritating substances
• Recent upper respiratory infection, dental infection, or change in altitude or air pressure

When to see a doctor

See a doctor urgently if:

• If you have symptoms that last more than 10 days and are not getting better
• If you have severe pain in your face or head, especially behind one eye
• If you have a fever above 38°C (101°F) that lasts more than a few days
• If you experience changes in your vision or see double
• If you have swelling or redness around your eye

Book a routine appointment if:

• If you get more than four sinus infections in a year
• If sinuses are affecting your sleep, school, or work
• If you have allergies and they are not well controlled
• If you or your child keeps getting sinus infections even after treatment

Diagnosis

Your doctor will first talk to you about your symptoms, your past health, and how often the sinus problems come back. Then they will examine your nose and face. In most cases, this is enough to make a diagnosis. If you have recurrent episodes, your doctor may want to look inside your nose with a small camera to check for polyps, a deviated septum, or other causes.

Tests that may be done

• A nasal endoscopy, where a thin, flexible tube with a light and camera is passed gently into your nose
• Imaging scans, like a CT scan of your sinuses, if the cause is not clear or if you are a candidate for surgery
• Allergy tests, if allergies are thought to be a trigger
• A sample of mucus to test for bacteria, if your infections are very bad or do not improve with standard treatment

What to expect at your appointment

The doctor will ask about your symptoms and may press gently on your face to check for tenderness. A nasal endoscopy can feel a little weird but is not usually painful. If they recommend a CT scan, it is simple and takes only a few minutes. You will usually get answers and a plan on the same day.

Treatment

Treatment focuses on reducing inflammation, clearing mucus, and treating any underlying cause. Most recurrent sinusitis can be managed with self-care and, if needed, medicines that your doctor prescribes. If there is a clear bacterial infection, antibiotics may be used, but they are not always needed. The goal is to reduce the number of episodes and improve your quality of life.

Self-care at home

• Use a saline (salt water) nasal rinse or spray to keep your nasal passages moist and clear
• Breathe in steam from a bowl of hot water (with a towel over your head) or take a warm shower to help loosen mucus
• Place a warm, damp towel over your cheeks and forehead to ease pain
• Drink plenty of water to keep mucus thin
• Get enough rest to help your immune system recover
• Try to sleep with your head propped up to help drainage

Medical treatments

Your doctor may suggest a nasal steroid spray to reduce swelling in the nose, a short course of a decongestant (for adults), or a pain reliever to ease discomfort. If a bacterial infection is suspected, your doctor may prescribe an antibiotic. Always use any medication exactly as advised by your doctor or pharmacist. For people with allergies, antihistamines or allergy treatments may help prevent sinus attacks.

When is surgery considered?

If you have nasal polyps, a severely bent septum, or sinus openings that are too narrow, surgery may be an option. The operation (usually called endoscopic sinus surgery) makes the sinus openings larger so mucus can drain more easily. It is usually considered only after other treatments have not worked.

Living with this condition

You can live a full, active life even with recurrent sinusitis. The key is to learn what triggers your episodes and to treat them quickly. Having a plan with your doctor can help you feel more in control. If you notice the first signs of a blocked nose or facial pressure, start your self-care routine right away, like using a saline rinse and drinking extra fluids.

Lifestyle tips

• Use a humidifier in your bedroom, especially in winter when indoor air is dry
• Avoid smoky or very polluted environments
• If you have allergies, try to reduce allergens at home, like dust and pet dander
• Wash your hands often to reduce the chances of catching colds
• Quit smoking if you smoke, and ask for help to stop

Diet and exercise

A balanced diet rich in fruits and vegetables helps keep your immune system strong. Regular exercise can also help clear mucus, but you may want to avoid vigorous exercise during a severe episode. If you have allergies, some foods or drinks like alcohol may make congestion worse for you, so pay attention to what affects you.

Mental health and emotional wellbeing

Living with repeated sinus infections can be frustrating and tiring. It is normal to feel sometimes discouraged or worried. Talk to your doctor if you feel that your symptoms are affecting your mood or energy levels. You are not alone, and showing that you are managing a long-term condition is a very real thing.

Prevention

You cannot always prevent every sinus infection, but you can reduce how often they happen and how severe they are. Avoiding colds, controlling allergies, and keeping your nasal passages moist are the most effective steps.

Vaccines

Ask your doctor or pharmacist about vaccinations, such as the flu vaccine and pneumonia vaccine. Preventing respiratory infections can help prevent sinusitis.

Screening programmes

There is no routine screening test for sinusitis, but if you have recurrent episodes, your doctor may recommend seeing an ear, nose, and throat specialist for a more detailed assessment.

Complications

If left untreated

• Infection spreading to nearby areas, such as the bones around the eye or the brain (very rare)
• Meningitis, a serious infection of the lining around the brain and spinal cord (very rare)
• A collection of pus (abscess) inside the sinuses or around the eye
• Worsening of asthma or other lung conditions
• A permanent reduction in your sense of smell or taste

Long-term outlook

The outlook for recurrent sinusitis is generally very good. Most people can find a treatment plan that reduces the number of episodes and lets them lead a normal life. It may take a little time to find the right combination of self care, medicines, and sometimes surgery, but with the right support, you can feel better.

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