What is sinusitis?

Sinusitis is a condition that may cause a stuffy nose, pain in the face, and yellow or green discharge (mucus) from the nose. The sinuses are hollow areas in the bones of the face. They have a thin lining that normally makes a small amount of mucus. When this lining gets infected, it swells and makes extra mucus. This causes symptoms.

Sinusitis can occur when a person gets sick with a cold. The germs causing the cold can also infect the sinuses. Many times, a person feels like his or her cold is getting better, but then he or she begins to feel sick again. This is called sinusitis.

What are the symptoms of sinusitis?

Common symptoms of sinusitis include:

• Stuffy or blocked nose
• Thick yellow or green discharge from the nose
• Pain in the teeth
• Pain or pressure in the face – This often feels worse when a person bends forward.

People with sinusitis can also have other symptoms that include:

• Fever
• Cough
• Trouble smelling
• Ear pressure or fullness
• Headache
• Bad breath
• Feeling tired

Most of the time, symptoms start to improve in 7 to 10 days.

Should I see a provider or nurse?

See your provider or nurse if your symptoms last more than 10 days, or if your symptoms get better at first but then get worse.

Sometimes, sinusitis can lead to serious problems. See your provider or nurse right away (do not wait 10 days) if you have:

• Fever higher than 102.5°F (39.2°C)
• Sudden and severe pain in the face and head
• Trouble seeing or seeing double
• Trouble thinking clearly
• Swelling or redness around one or both eyes
• Trouble breathing or a stiff neck

Is there anything I can do on my own to feel better?

Yes. To reduce your symptoms, you can:

• Take an over-the-counter pain reliever to reduce the pain
• Rinse your nose and sinuses with salt water a few times a day – Ask your provider or nurse about the best way to do this.

How is sinusitis treated?

Most of the time, sinusitis does not need to be treated with antibiotic medicines. This is because most sinusitis is caused by viruses – not bacteria – and antibiotics do not kill viruses. Many people get over sinus infections without antibiotics.

Some people with sinusitis do need treatment with antibiotics. If your symptoms have not improved after 10 days, ask your provider if you should take antibiotics. Your provider might recommend that you wait 1 more week to see if your symptoms improve. But if you have symptoms such as a fever or a lot of pain, he or she might prescribe antibiotics. It is important to follow your provider's instructions about taking your antibiotics.

What if my symptoms do not get better?

If your symptoms do not get better, talk with your provider or nurse. He or she might order tests to figure out why you still have symptoms. These can include:

• CT scan or other imaging tests – Imaging tests create pictures of the inside of the body.
• A test to look inside the sinuses – For this test, a provider puts a thin tube with a camera on the end into the nose and up into the sinuses.

Some people get a lot of sinus infections or have symptoms that last at least 3 months. These people can have a different type of sinusitis called "chronic sinusitis." Chronic sinusitis can be caused by different things. For example, some people have growths in their nose or sinuses that are called "polyps." Other people have allergies that cause their symptoms.

Lifestyle modifications — People with chronic rhinosinusitis who smoke cigarettes should stop.

People who have environmental allergies as a contributing factor to their sinus problems may be able to change things in their home or work conditions to reduce exposure to the specific allergens that bother them.

Daily nasal saline washing — Most people with chronic rhinosinusitis find that washing their nasal passages daily with saline (salt water) helps reduce symptoms. Washing the nose before applying medications also clears away mucus and reduces its interference with medications. The table provides instructions on how to make your own saline and perform nasal washes

Allergies

What are seasonal allergies?

Seasonal allergies, also called “hay fever,” are a group of conditions that can cause sneezing, a stuffy nose, or a runny nose. Symptoms occur only at certain times of the year. Most seasonal allergies are caused by:

• Pollens from trees, grasses, or weeds
• Mold spores, which grow when the weather is humid, wet, or damp

Normally, people breathe in these substances without a problem. When a person has a seasonal allergy, his or her immune system acts as if the substance is harmful to the body. This causes symptoms.

Many people first get seasonal allergies when they are children or young adults. Seasonal allergies are lifelong, but symptoms can get better or worse over time. Seasonal allergies sometimes run in families.

Some people have symptoms like those of seasonal allergies, but their symptoms last all year. Year-round symptoms are usually caused by:

• Insects, such as dust mites and cockroaches
• Animals, such as cats and dogs
• Mold spores

What are the symptoms of seasonal allergies?

Symptoms of seasonal allergies can include:

• Stuffy nose, runny nose, or sneezing a lot
• Itchy or red eyes
• Sore throat, or itching of the throat or ears
• Waking up at night or trouble sleeping, which can lead to feeling tired during the day

Is there a test for seasonal allergies?

Yes. Your provider will ask about your symptoms and do an exam. He or she might order other tests, such as allergy testing, which will help figure out what you are allergic to.

How are seasonal allergies treated?

People with seasonal allergies might use one or more of the following treatments to help reduce their symptoms:

• Nose rinses – Rinsing out the nose with salt water cleans the inside of the nose and gets rid of pollen in the nose. Different devices can be used to rinse the nose.
• Steroid nose sprays – Providers often prescribe these sprays first, but it can take days to weeks before they work. (Steroid nose sprays do not contain the same steroids that athletes take to build muscle). In the US, it’s also possible to get one steroid nose spray (Nasacort and Flonase) without a prescription. If you decide to try this medicine, you might need to take a nasal decongestant for a few days first. This will reduce swelling in the nose and make it easier for the steroid to get deep into your nose. Steroid nose sprays work best if you use them every day. Steroid nose sprays are more effective than other allergy medicines for congestion and post-nasal drip (which is when mucus runs down the back of your throat).
• Antihistamines – These medicines help stop itching, sneezing, and runny nose symptoms. Some antihistamines can make people feel tired.
• Allergy shots – Some people with seasonal allergies choose to get allergy shots. Usually, allergy shots are given every week or month by an allergy provider. They contain tiny amounts of allergens, such as pollen. Many people find that this treatment reduces their symptoms, but it can take months to work.
• Allergy pills (under the tongue) – For some types of pollen allergies, there are pills that work much like allergy shots. The pills are made to dissolve under the tongue. They are taken every day for several months of the year.

Can seasonal allergy symptoms be prevented?

Yes. If you get symptoms at the same time every year, talk with your provider or nurse. Some people can prevent symptoms by starting their medicine a week or 2 before that time of the year.

You can also help prevent symptoms by avoiding the things you are allergic to. For example, people who are allergic to pollen can:

• Stay inside during the times of the year when they have symptoms
• Keep car and house windows closed, and use air conditioning instead
• Take a shower before bed to rinse pollen off their hair and skin
• Wear a dust mask if they need to be outside