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Sinusitis is a common condition defined as inflammation of the paranasal sinuses. Sinus cavities produce the mucus that nasal passages need to work effectively.
Sinusitis can be acute or chronic. Causes of sinus inflammation include viruses, bacteria, fungi, allergies, and an autoimmune reaction.
Although uncomfortable and painful, sinusitis often goes away without medical intervention. However, if symptoms are severe and persistent, a person should consult their doctor.
According to the Centers for Disease Control and Prevention (CDC), United States doctors made a primary diagnosis of chronic sinusitis for 4.1 million people in 2016. In 2018, 28.9 million people in the U.S. reported a sinusitis diagnosis in the previous 12-month period. That amounted to 11.6% of the population.
A sinus is a hollow space in the body. There are many types of sinuses, but sinusitis affects the paranasal sinuses, the spaces behind the face that lead to the nasal cavity.
The lining of these sinuses has the same composition as the lining of the nose. The sinuses produce a slimy secretion called mucus. This mucus keeps the nasal passages moist and traps dirt particles and germs.
Sinusitis occurs when mucus builds up, and the sinuses become irritated and inflamed.
Symptoms vary depending on how long a condition lasts and how severe the symptoms are.
The symptoms include:
- nasal discharge, which may be green or yellow
- a postnasal drip, where mucus runs down the back of the throat
- facial pain or pressure
- blocked or runny nose
- sore throat
- bad breath
- a reduced sense of smell and taste
- tenderness and swelling around the eyes, nose, cheeks, and forehead
Sinusitis can stem from various factors, but it always results from fluid becoming trapped in the sinuses, allowing germs to grow.
The most common cause is a virus, but a bacterial infection can also lead to sinusitis. Triggers can include allergies and asthma, as well as pollutants in the air, such as chemicals or other irritants.
Fungal infections and molds can cause fungal sinusitis.
The following may increase a person’s risk of developing sinusitis:
- having a previous respiratory tract infection, such as a cold
- nasal polyps, which are small benign growths in the nasal passage that can lead to obstruction and inflammation
- seasonal allergies
- sensitivity to substances such as dust, pollen, and animal hair
- having a weakened immune system due to medication or a health condition
- having a deviated septum
The septum is the bone and cartilage that divides the nose into two nostrils. When this becomes bent to one side, either through injury or growth, it can increase the risk of sinusitis.
There are different types of sinusitis, and they can last for various lengths of time.
Acute sinusitis is temporary and can happen when a person has a cold or a seasonal allergy. Symptoms usually go away within 7–10 days but can last up to 4 weeks.
Chronic sinusitis is when symptoms last more than 12 weeks or return three times within a year. Over 50% of people with moderate-to-severe asthma also have chronic sinusitis.
Recovery time and treatment depend on the type of sinusitis.
People can usually manage sinusitis at home. However, they should see a doctor if symptoms:
- last longer than 10 days without improving
- include severe symptoms that do not go away with over-the-counter (OTC) medication
- include vision changes or swelling around the eyes
- worsen after improving
- include a fever that lasts longer than 3–4 days or is over 101.5°F (38.6°C)
There may be other symptoms. If a symptom causes concern, seek medical help.
A doctor may make a diagnosis by:
- asking about symptoms
- carrying out a physical examination
- using an endoscope to see inside the nasal passages
- ordering an MRI or CT scan to check for structural problems, in some cases
- carrying out an allergy test to identify possible triggers
The doctor may visually examine the nasal cavity with a light source or a small, handheld device with a light attached called an otoscope. They can also use this device to examine the ears.
If symptoms persist, a person may need to see an ear, nose, and throat specialist for a more in-depth examination.
Examples of these remedies and medications include:
- Nasal irrigation: Rinse and clear the nasal passages with salt water or a saline solution. A neti pot is one way to do this. Always use clean water and sterile equipment.
- Rest: Sleep or rest with the head and shoulders raised on a pillow. Sleep with the pain-free side of the face on the pillow, if possible.
- Warm compresses: Apply gently to the affected areas to relieve swelling and discomfort.
- Pain relief: Acetaminophen or ibuprofen can reduce pain and fever.
- Steam inhalation: Place a hot, moist towel on the face or inhale steam from a bowl of hot water.
- Essential oils: Adding a few drops of menthol or eucalyptus oil to the hot water or towel may help. Never swallow an essential oil or apply it directly to the skin.
- Decongestant tablets and sprays: These may reduce swelling and allow the sinuses to drain. Use for up to 3 days only, or symptoms may worsen after stopping the use of the product. Decongestant tablets and sprays are available to purchase online.
- OTC nasal corticosteroids: This type of nasal spray may reduce nasal and sinus inflammation.
Antihistamines, such as cetirizine (Zyrtec) and loratadine (Claritin), are usually not suitable options. They can cause the mucus to harden, making symptoms worse.
A doctor or pharmacist can advise about these options and how to use them.
Treatment options depend on how long the condition lasts.
Acute and subacute sinusitis
If symptoms persist or are severe, a doctor may prescribe treatment.
If a bacterial infection is present, a doctor may prescribe antibiotics. If symptoms remain after finishing the antibiotics, the person should return to the doctor.
Chronic sinusitis is not usually due to bacteria, so antibiotics are unlikely to help. Reducing exposure to triggers, such as dust mites, pollen, and other allergens, may relieve symptoms.
Corticosteroid sprays or tablets may help manage inflammation, but these often need a prescription and medical supervision. Long-term use of these medications can lead to adverse effects.
A doctor may recommend surgery if other treatments have not worked.
However, surgery may not resolve the problem completely. The person may need to continue other treatments after surgery to stop sinusitis from returning.
In children, surgery should be a last resort for sinusitis. If a doctor recommends surgery to treat sinusitis in a child, it may be best to get a second opinion before going ahead.
Insurers may require a person to provide in-depth evidence that the surgery is for sinusitis and not a cosmetic procedure to improve the nose’s appearance.
The following tips may help prevent sinusitis:
- practicing good hand hygiene
- avoiding smoking and secondhand smoke
- keeping vaccinations up to date
- staying away from people with colds and other respiratory infections
- using a humidifier to moisten the air at home and keep it clean
- maintaining air conditioning units to prevent mold and dust from collecting
- avoiding and managing allergens when possible
Sinusitis is a common problem that affects many people and has various causes. In most cases, it is mild, and a person can treat it with home or OTC remedies.
If sinusitis causes severe symptoms or persists for several weeks, a doctor can help find a solution.