Sinus Infections: What You Need to Know
Sinus infections, also known as sinusitis, often follow a cold or other respiratory infection. If you have sinus congestion that refuses to go away even after your other cold symptoms have improved, it is a good idea to go to the doctor to find out whether you have a sinus infection. Both children and adults suffer from these infections, which are rarely dangerous but can be very frustrating.
What Are Sinus Infections?
These terms may help you understand sinus infections.
- Sinuses: Connected hollow spaces in the bones of your face.
- Antibiotics: Medicines that kill bacteria but not viruses.
- Decongestants: Medicines that relieve congestion.
Sinus infections occur when viruses or bacteria infect the sinuses, causing their lining to swell and produce excessive amounts of mucus, which can result in congestion, pain, and a feeling of pressure in the face.
Stages and Types of Sinus Infections
Sinus infections come in two main types: acute and chronic. In cases of acute sinusitis, recovery occurs within four weeks. Chronic sinusitis lasts more than 12 weeks, and other illnesses often cause it.
- Viral: These sinus infections usually last between 7-10 days, though with proper care, relief from symptoms can begin between 5-7 days. Because they are ineffective against viral infections, antibiotics cannot be used to treat this type of sinusitis.
- Bacterial: These sinus infections typically last ten days or longer, with symptoms sometimes worsening after a week. If you have a bacterial sinus infection, your doctor will prescribe an antibiotic to treat it, which will help ease symptoms and prevent contagiousness.
- Allergic: Sometimes sinus infections can be caused by allergies and allergy triggers, in which case, they should be treated as one would treat severe allergies. Allergic sinusitis can often lead to chronic sinusitis, and it can be seasonal or year-long.
Symptoms and Causes
Sinus infections are caused by bacteria or viruses growing inside the sinuses. It is not easy to tell which type you have, as they both have similar symptoms. Viruses cause nine out of ten sinus infections in adults and between five and seven out of every ten sinus infections in children. Bacteria cause the rest.
Viral sinus infections usually start to get better after five to seven days, but they may last two to four weeks before fully resolving. On the other hand, while bacterial sinus infections also often continue longer than a week, they may even start to get worse after that time. Whereas viral infections usually get better on their own, bacterial infections sometimes require antibiotics.
“Acute or early sinusitis or rhinosinusitis is usually viral in origin. Common viruses include rhinovirus, parainfluenza, and influenza (flu) virus,” said Alexea M. Gaffney-Adams, MD, an Infectious Disease Specialist and Primary Care Provider based in Stony Brook, New York.
Acute viral sinusitis often occurs after you have another respiratory virus, such as a cold. The cold virus causes mucus inside your sinuses to become sticky and thick, which means it cannot easily drain through your nose. Bacteria or viruses can grow in the trapped mucus, leading to a sinus infection.
“Bacterial infection develops after a prolonged period of viral illness and is usually characterized by the presence of fever associated with common signs of sinus infection including nasal congestion associated with facial pain and pressure, nasal discharge with thick nasal secretions,” said Dr. Gaffney-Adams. “Discoloration of the nasal secretions is not useful in distinguishing viral from bacterial infections.”
Common bacteria leading to sinus infections include Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae, according to Dr. Gaffney-Adams. These bacteria can also infect the lower respiratory tract and may lead to pneumonia or bacterial bronchitis.
Here are some symptoms of sinus infections:
- Pain and pressure in the forehead, nose, cheeks, or between the eyes
- Nasal congestion or runny nose
- Sore throat
- Coughing, particularly at night
- Bad breath
- Reduced ability to smell and taste
Prevention and Risks
Most sinus infections occur after a cold or other respiratory infection, so the best way to protect yourself is to avoid getting a cold. Washing your hands frequently and limiting contact with others who are sick can limit your exposure to cold viruses.
People with weak immune systems or who take medication to suppress their immune systems — for example, after an organ transplant — have a higher than average risk of getting a sinus infection. Allergies can also raise your risk. If these risk factors apply to you, it is even more important to practice good hygiene (washing hands, etc.) to avoid getting sick.
Children are more likely to get a sinus infection if they go to daycare, use a pacifier, or breathe in secondhand smoke. Protect your kids by banning smoking in your home.
Diagnosis and Tests
If you think you have a sinus infection, healthcare professionals will ask about your symptoms and perform physical examinations to provide a diagnosis. Sometimes, they swab the inside of the nose and use this sample to test for bacterial or viral infections.
Treatments, Procedures, and Medication
Most sinus infections get better on their own without treatment from a doctor. While you are recovering from a sinus infection, get plenty of rest and drink plenty of fluids to thin the mucus in your sinuses.
These medications are only effective against bacterial infections; they cannot cure viral infections.
Over-the-counter pain medicines, such as ibuprofen and acetaminophen, can reduce the pain and headaches caused by sinus infections. Meanwhile, over-the-counter decongestants can help thin the mucus in your sinuses so it can drain more easily. Avoid taking antihistamines, which can make the mucus thicker and prevent it from draining, unless you have allergic sinusitis, as antihistamines can relieve allergy symptoms.
“It is a perfectly acceptable option for a patient to elect to medically treat each infection as it arises. The problem is this does nothing to deter future infections and keeps you in a reactive treatment loop,” said Madan Kandula, MD, an otolaryngologist, in an interview. He went on to explain that for cases of chronic sinusitis, surgery may also be a suitable option, as it can treat the underlying cause of the sinusitis and prevent further occurrences of the illness.
“For those with a history of allergies, it may be worthwhile to pursue immunotherapy and determine if getting the allergic reactions under control lessens the likelihood for future sinusitis while improving the efficacy of any treatments,” Dr. Kandula added.
Healthy Lifestyle Tips
Some people use a device called a neti pot to flush out their nose when they have a cold or sinus infection. When used correctly, these devices can help you feel better. However, it is crucial to use only distilled or sterilized water to rinse your nose. Tap water may contain bacteria, so it isn't suitable. Your stomach acid kills the bacteria when you drink tap water, but those bacteria could cause a severe infection if they enter your sinuses.
A safer way to relieve the symptoms of a sinus infection is to inhale steam. Take long, hot showers, or fill a bowl with hot water and lean your head over it. Be careful not to put your face too close to very hot water, as steam can scald your skin.
Placing a warm, wet towel against your face can help to relieve the pain caused by sinus infections.
Food- and Nutrition-Based Approaches to Prevention and Management
When you have a sinus infection, it is essential to drink plenty of fluids to keep your mucus thin. Water is an excellent choice, whereas alcoholic and caffeinated beverages are not as hydrating.
According to the CDC, children who drink from a bottle while laying down are more likely to get sinus infections. Keep your baby positioned upright while they feed and do not put them to bed with a bottle.
No special diet can prevent or cure sinus infections. Doctors usually recommend eating a varied diet with plenty of fruits and vegetables to get the nutrients you need for a healthy immune system.
What Type of Doctors to See
Seeing a doctor is not always necessary when you have a sinus infection. For the first seven days, you can treat the infection at home using steam and over-the-counter medication. Pharmacists can advise what is appropriate for you or your child to use.
See a doctor if your symptoms last more than a week or you have any of the following:
- Temperature above 100.4 F.
- More than four sinus infections in the past year.
- Symptoms that are not relieved by over-the-counter medications.
- If a child under three months has a fever, you should call a doctor right away.
According to Dr. Gaffney-Adams, “Patients with chronic sinusitis may benefit from evaluation with an Allergy/Immunologist to assess for chronic allergic sinusitis and Otolaryngologist or ENT for consideration for surgical debridement of infected sinuses or correction of structural abnormalities that lead to increased risk of recurrent sinusitis.”
Sinus infections can make you feel tired and miserable, but they usually start to get better after a few days. By taking care of yourself at home and knowing when to see your doctor, you can manage your sinus infection and keep yourself or your child safe.
About the Expert Contributors:
Madan Kandula, MD, of ADVENT is a specialist in Wisconsin who provides sinus procedure training for other physicians from around the country. He has been published on today.com, and regularly draws patients from out of state for sinus procedures.
Alexea Gaffney-Adams, MD, is Board Certified in Infectious Diseases, Internal Medicine, and Pediatrics. She previously worked as an Infectious Diseases consultant at Stony Brook Primary Care and Stony Brook University Hospital.
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- Cleveland Clinic: Killer Sinus Infection? How to Tell If Yours Is Viral or Bacterial
- FDA: Is Rinsing Your Sinuses With Neti Pots Safe?
- American Academy of Family Physicians: Sinus Infections (Sinusitis)
- CDC: Sinus Infection (Sinusitis)
- Medical News Today: Sinus infection: Symptoms, types, and complications
- Sage Journals: Clinical Practice Guideline (Update): Adult Sinusitis Executive Summary