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Sinusitis
- Reviewed by Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
Sinusitis refers to inflammation of one or more of the sinuses, most often caused by infection. Sinusitis can leave you with nasal congestion, facial pain, and headaches. You may also experience loss of smell or taste, fever, cough, or bad breath.
Most cases of sinusitis are acute, meaning they last less than three weeks. Acute sinusitis may clear on its own, but home remedies and over-the-counter medication can help to relieve symptoms.
In some cases, symptoms last longer or may recur multiple times per year. This is called chronic sinusitis. With chronic sinusitis, it’s important to look for the underlying cause when possible because that is what guides treatment.
What is sinusitis?
The sinuses are the hollow cavities behind the facial bones around the nose and eyes. The mucus they produce helps trap foreign particles like dust and bacteria and moistens the nasal passages.
Under healthy conditions, mucus is a thin, watery fluid that flows freely from the sinuses into the upper part of the nose. However, when sinuses become inflamed or infected, the mucus becomes thick and sticky, so it can't flow through the tiny openings leading to the nose. Fluid builds up, causing pressure and pain and eventually sinusitis.
Sinusitis can be triggered by:
● viral infections, such as a common cold
● bacteria
● allergies (dust, mold, pollen, fungi)
● air pollution, cigarette smoke, and other irritating fumes
● dental infections
● narrowed nasal passages.
Sinusitis itself is not contagious, but the underlying causes can be. Most sinus infections are triggered by viruses or bacteria, which can spread from person to person.
Acute sinusitis is more common than chronic sinusitis and is often caused by a cold.
Allergies often cause chronic sinusitis. Polyps, nasal tumors, and nasal fractures can also lead to chronic sinusitis. People with asthma, cystic fibrosis, or immune system problems are at a higher risk for chronic sinusitis.
What are the symptoms of a sinusitis?
Painful facial pressure is the main symptom of a sinus infection. Depending on which sinus is involved, the pain may be in the forehead, over the cheek, in the upper jaw and teeth, behind the eyes, or at the top of the head. Sinus pain usually increases when you bend forward. Other common symptoms include:
- a foul taste or bad breath caused by mucus dripping into your throat from the back of your nose.
- loss of smell or taste
- headache
- fever
- achiness
- fatigue
How is sinusitis treated?
Your doctor can diagnose sinusitis by asking about your symptoms and checking for:
- tenderness in the areas of your face overlying your sinuses
- inflammation and mucus in your nose and throat
- nasal polyps or a deviated septum
Many people with sinusitis can quickly recover with home remedies and over-the-counter medication. For example:
Hydration. Drinking plenty of water helps keep mucus thin and loose.
Inhaling steam. Boil water, pour the water into a pan, and bend over the pan with a towel over your head to inhale the steam. Another option is to linger in a hot shower.
Decongestants. Over-the-counter decongestants can open the sinuses by reducing swelling, allowing them to drain. Examples include tablets containing pseudoephedrine (Sudafed) and nasal sprays containing oxymetazoline (Afrin, Dristan) or phenylephrine (Zicam). Check with your doctor before taking oral decongestants, especially if you have high blood pressure or a heart condition, as they can cause side effects, such as insomnia, racing pulse, and jitteriness.
Saline nasal sprays. These non-medicated nasal sprays add moisture to the nasal passages and thin mucus secretions.
Nasal irrigation. Rinsing your nasal cavity with a neti pot or another sinus-rinsing system can clear sinuses and relieve symptoms.
Sinus pain can be managed by applying a warm compress on your face and taking over-the-counter pain relievers such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve).
What if sinus symptoms persist?
If these strategies don’t improve acute sinusitis symptoms or you are rapidly feeling worse, call your doctor for advice. When either of these situations occurs, doctors often prescribe a course of antibiotics to combat a possible bacterial infection. In addition, you may benefit from an over-the-counter or prescription corticosteroid nasal spray to relieve nasal swelling and sinus inflammation.
If have mechanical blockage from nasal polyps or a deviated septum or you develop chronic sinusitis, your doctor can refer you to an ear, nose, and throat (ENT) doctor — also known as an otolaryngologist. Nasal polyps and other blockages can be removed with endoscopic sinus surgery, in which small scopes and instruments are used to visualize and operate through the nasal passages to the sinuses. Endoscopic sinus surgery can also widen sinus openings to improve drainage.
If chronic sinusitis is allergy-related, an allergy specialist can test you for specific allergies and prescribe treatment.
Recent Articles
Hospice care: Overview of a compassionate approach to end-of-life care
Foot pain: A look at why your feet might hurt
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Wildfires: How to cope when smoke affects air quality and health
Forearm workouts: Strengthening grip for everyday function
Depression symptoms: Recognizing common and lesser-known symptoms
Medication side effects: What are your options?
Independent living with home care assistance: Balancing autonomy and support
Dialysis: What to expect from this life-changing — and lifesaving — treatment
The BEEP program: Keep your balance
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