Ear, Nose and Throat

10 Things to Know About Sinusitis

Originally published April 2, 2021

Last updated April 26, 2024

Reading Time: 5 minutes

A woman with sinus pressure puts her hands on her nose

The pain and pressure of a sinus infection is nothing to sneeze at. Here’s how to know if you have one and how to cope.

You have a cold, and just when you think you’re getting better, it gets worse. You have pain and pressure in your face, and it’s hard to breathe out of your nose. You might have a sinus infection, also called sinusitis, which affects 1-8 adults every year.

“A sinus infection has similar symptoms to the common cold, which is a viral infection of the nose and throat,” says Kevin Hur, MD, a rhinology specialist at Keck Medicine of USC. “However, a sinus infection is limited to just your nose and can be either a viral, bacterial or fungal infection.”

Dr. Hur shares what you need to know about sinusitis and when you should see a doctor.

1. Sinusitis is not a regular cold — but colds can cause sinusitis.

Your sinuses, which are hollow spaces in the bones around your nose, are lined with mucus that traps bacteria, dust and allergens and drains out through your nose.

When your sinuses become inflamed due to a cold, mucus can’t drain, so it builds up and can lead to sinusitis, which can be viral or bacterial.

“Sinusitis is inflammation of the lining of the sinuses, which leads to swelling that can cause obstruction and an accumulation of mucus,” says Dr. Hur, an assistant professor of clinical otolaryngology – head and neck surgery at the Keck School of Medicine of USC.

“Sinusitis can be caused by allergies, nasal polyps, infections or a weakened immune system from medications or illness,” he says.

2. Sinusitis can cause a range of symptoms.

Symptoms of sinusitis can include:

  • Nasal drainage
  • Postnasal drainage (when mucus drips down the back of your throat)
  • Nasal obstruction
  • Facial pain and tenderness, which is especially worse when you bend over
  • Upper tooth pain
  • Headache
  • Cough
  • Bad breath
  • Fever
  • Lethargy
  • Loss of smell or taste
  • Ear pressure


3. Sinus infection symptoms follow a different path than colds.

You may be able to tell if you have a sinus infection, depending on how your symptoms progress.

Most cases begin as a common cold, and symptoms usually go away in 7 to 10 days. In some cases, a bacterial infection develops.

“Typically, the length of symptoms helps us tell if the patient has a sinus infection or a cold,” Dr. Hur says. “Cold symptoms usually improve within one to two weeks, though a cold can evolve into a sinus infection, which generally lasts longer without treatment. Also, a cold can affect other areas beyond the nose, such as the throat.”

If you have bacterial sinusitis, you might experience the following:

  • Fever greater than 102 degrees Fahrenheit
  • Nasal drainage or postnasal drainage that looks very discolored or thick, like pus
  • A “double worsening,” meaning that you start to get better but then feel worse again

4. Sinusitis can be chronic.

An acute sinus infection is the type that follows a cold and lasts for less than four weeks. It is often caused by a bacterial infection.

Chronic sinusitis, on the other hand, lasts for more than 12 weeks, despite medical treatment. People with allergic rhinitis or asthma may be more prone to chronic sinusitis, which also can be due to infection, allergies, a fungus or, in rare cases, an immune system deficiency.

Nasal polyps or structural problems in the nasal passages can also lead to a chronic sinusitis.

5. Sinus infections can be contagious.

Unfortunately, others may be able to catch your sinus infection, depending on what’s behind it.

Viral infections can be contagious, but chronic sinusitis is often not. “Bacterial sinusitis is not contagious, but you can spread viruses, which are a common cause of sinus infections,” Dr. Hur says.

Throwing away dirty tissues after use and washing your hands can help prevent spreading sinusitis.

6. Sinusitis symptoms can be treated at home.

The good news is there are home remedies and over-the-counter treatments that can help in relieving sinus pressure, when it starts. “Initial medications used to treat sinus infections include nasal sprays, sinus irrigations and decongestants,” Dr. Hur says.

Up to 70% of people with acute sinusitis recover without prescribed medications. Other treatment options that may help include a sinus saline rinse, over-the-counter pain relievers for adults over 18, getting plenty of rest and staying hydrated.

Decongestant nose sprays and drops are also sold over the counter, but they shouldn’t be used for more than 3 days. Your body may become dependent on them, and you may experience rebound congestion, in which your nose feels even more congested when you stop using them.

You can also try putting a warm, damp washcloth on your face or inhaling steam over the sink or in the shower several times a day to help relieve inflammation in your sinuses.

7. A sinus rinse can help relieve your symptoms — but it should be done properly.

If you try a sinus rinse with a bulb syringe, saline rinse bottle or neti pot, use a prepared salt packet or homemade saline solution instead of plain water. If making it yourself, use only distilled or boiled and cooled water to make sure organisms in tap water don’t further contribute to sinus problems.

According to the American Academy of Allergy, Asthma & Immunology, you can mix 3 teaspoons of pickling or canning salt that contains no iodide, anti-caking agents or preservatives with 1 teaspoon of baking soda, then add 1 teaspoon of that mixture to 1 cup of lukewarm sterile water. For children, use a half-teaspoon with 4 ounces of water.

Also, make sure to clean your nasal irrigation system afterward.

8. Sinusitis may require a call to your doctor.

Although many sinus infections go away on their own, you may need to see a doctor if:

  • You have severe symptoms from the beginning
  • You start to get better but then feel worse again
  • Have symptoms that last more than 10 days

“You should seek care from a doctor if sinusitis impacts your quality of life and hasn’t improved with over-the-counter treatments,” Dr. Hur says.

9. Sinusitis may or may not need antibiotics.

You might not need antibiotics; however, for acute sinusitis due to a bacterial infection, antibiotics can help decrease the length of symptoms and lessen their severity.

“If a sinus infection lasts more than one to two weeks, it is more likely to be a bacterial infection, so antibiotics and/or oral steroids may need to be prescribed,” Dr. Hur says. “Sinus infections that do not improve with antibiotics may need to be treated with surgery.”

Talk to your doctor to see whether or not you should be treated with antibiotics.

10. You can lessen your chances of sinusitis.

Prevention for a sinus infection often starts with preventing the cold that might lead to it: Wash your hands, avoid people who are sick, and keep your body in good shape by eating healthy.

You can also help keep sinuses moist by using a humidifier and drinking plenty of fluids. In addition, control allergies and avoid smoking and secondhand smoke.

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Tina Donvito
Tina Donvito is a freelance writer covering health, culture, travel and parenting.