What’s causing your sinus trouble?
- Mayo Clinic Health Letter Editors
- 3 hours ago
- 4 min read
Every year, about 29 million adults in the U.S. — or 1 out of 8 — are diagnosed with a sinus infection, also called sinusitis. An estimated one-fifth of all prescribed antibiotics are intended to treat sinusitis.
Your sinuses are four pairs of air-filled interconnected cavities located between your eyes and nose. What goes on inside them — a microscopic battle between infection- and inflammation-causing antigens and the body’s defense forces — can have a serious impact on your health and comfort.
What causes sinus congestion?
Your sinuses make mucus, which flows into your nasal passages to clean and moisturize them. Little hairs called cilia line the inside of your sinuses. These hairs are constantly sweeping mucus through small openings (ostia) that drain into your nose and throat.
Sinus pain and discomfort typically starts when your sinuses become irritated and inflamed, causing swelling that can narrow or close off the openings. This makes it hard for mucus to drain out of your sinus cavities. Mucus and air pressure build, causing a feeling of stuffiness and congestion. Sinus trouble often starts on one side, with the inflamed section painful to the touch, and spreads to the other side.
How a cold can trigger a sinus infection
The most common cause of sinusitis is the common cold, which is caused by a virus. Most people can typically fight off this infection within 7 to 10 days, and their sinus symptoms get better.
However, viral colds sometimes can lead to bacterial sinus infections, because the stagnant, moist environment of a blocked sinus cavity gives bacteria a place to thrive.
Other causes of sinusitis include:
Nasal allergies (allergic rhinitis)
Fungal infections
Exposure to air pollution or cigarette smoke
Can you treat sinus infections with antibiotics?
Most sinus infections get better with rest, time, and home remedies such as nasal sprays, decongestants and pain relievers. Most sinus infections are caused by viruses, and antibiotics do not work on viruses.
Antibiotics would only be considered if a bacterial infection developed. Usually, a bacterial infection diagnosis is not made until 5 to 10 days after symptoms start.
Symptoms of a bacterial sinus infection include:
Mucus that is thick and often yellow or greenish in color
A tender area on the face or sinuses, mainly on one side of the face
Pain in the upper teeth that is worse on one side of the face
Symptoms that last seven days or more, particularly when they first improve and then worsen
Sinusitis that lasts more than 12 weeks despite medical treatment is called chronic sinusitis.
How to tell the difference between sinus headaches and migraines
Migraines and headaches from sinusitis are easy to confuse because the symptoms may overlap. But studies have shown that most people who see their healthcare team for sinus headaches find out they have migraines instead.
For both migraines and sinusitis headaches, the pain often gets worse when you bend forward. Migraines also can be accompanied by various nasal symptoms — including congestion, facial pressure and a clear, watery nasal discharge. These are due to the autonomic nervous system playing a role in a migraine attack.
However, a sinus infection usually doesn’t come with nausea or vomiting or get worse from noise or bright light. Instead, these are all common features of migraines.
6 home remedies to relieve sinus infection symptoms
In addition to seeing your care team, you can take other steps to help ease symptoms of sinusitis:
Apply heat, either by putting a warm compress on your face or by breathing steam from a pot of hot water or in the shower.
Drink plenty of water and other fluids to thin and loosen mucus.
Avoid tobacco, which can dry out the sinuses.
Avoid alcohol, which can cause sinus pressure.
Use nasal corticosteroid sprays. Options such as fluticasone (Flonase Allergy Relief, others), budesonide (Rhinocort Allergy) and mometasone (Nasonex 24HR Allergy) may speed healing for some people who have bacterial sinus infections with milder symptoms or who have allergies as an underlying cause. The sprays are available without a prescription. They should be used daily until symptoms go away.
Take nonprescription pain relievers such as acetaminophen (Tylenol, others).
How sinus problems affect your eyes and ears
Watery or puffy eyes — Generally speaking, blocked sinuses don’t cause your eyes to water.
Tear ducts near your eyes also drain through the nasal cavity, but they use a separate system from your sinuses.
Further, blocked sinuses typically don’t cause eye bags or puffiness. However, allergies often can cause eye puffiness. Talk with your primary care team or an allergist about treatment options.
Ear infections — An ear infection caused by a sinus infection isn’t as common as people may think. Most likely, someone gets a head cold (viral rhinitis), which can cause both an ear infection and a sinus infection. While these infections may occur at the same time, both are caused by the head cold.
Treatment options for chronic sinusitis relief
It usually isn’t possible to cure chronic sinusitis. But you can often manage symptoms with:
Nasal irrigation — This involves gently squirting or pouring a warm, purified saltwater solution into your nose with a squeeze bottle, bulb syringe or neti pot. This technique can be very effective. Your care team may recommend adding medication to the saltwater solution to help fight inflammation or infection.
Nasal corticosteroids — These sprays are used daily to reduce sinus inflammation. If the nonprescription options listed earlier don’t work, ask your care team about a prescription-strength spray.
Injected medications — Dupilumab (Dupixent), mepolizumab (Nucala) and omalizumab (Xolair) are injected medicines for treating people with chronic sinusitis who have nasal polyps that aren’t helped by corticosteroids. Nasal polyps are small, painless growths inside the nose or sinuses that often develop along with chronic sinusitis.
Allergy treatments — Avoiding allergens, taking an antihistamine medication and getting allergy shots are options for tackling sinus inflammation due to allergic rhinitis.
