Methodist Healthcare - April 05, 2021

Your head is throbbing, especially around your eyes. You can’t stop coughing, and for some reason, your breath is terrible. Blowing your nose is a mess.

Bad news: You could have a sinus infection. Most frequently triggered by the common cold, over 30 million American adults are diagnosed with sinusitis yearly.

So, what exactly are sinus infections? How can you tell if you have one? And – holy cow – how can you feel better as quickly as possible?

What is a sinus infection?

Your sinuses are hollow cavities found in the bones around your eyes and nose. When you have a sinus infection, the thin tissue that lines them – the mucous membrane – becomes inflamed. That inflammation leads to a buildup of mucus, which contributes to a stuffy nose and puts pressure on the surrounding areas. Thus, the characteristic sinus headache.

Sinusitis can be acute, subacute or chronic. Most common are acute infections, which last less than 4 weeks. Anything going over 12 weeks is defined as chronic sinusitis. Anything in between is typically called a subacute infection.

About 1 or 2 percent of sinus infections are bacterial. Up to 80 percent of these resolve on their own in under two weeks, while the rest may be treated by antibiotics, depending on the advice of your healthcare provider (HCP).

Not every cold causes a sinus infection, and not every sinus infection is caused by a cold. Both acute and chronic sinusitis can also be triggered by allergies, fungus, medical conditions and nasal issues like polyps or a deviated septum.

How can you tell if you have an acute sinus infection?

It’s tempting to label every nasal issue as a sinus infection, but that’s not always the case. Common symptoms of acute sinusitis include:

  • Headaches – and sometimes, toothaches
  • Pain or pressure, especially across your nose or around your eyes
  • Congestion, often accompanied by thick yellow or green snot
  • Coughing and/or a sore throat, frequently caused by postnasal drip
  • Problems with smell or taste
  • Feeling tired or weak
  • Fever
  • Halitosis

Many people believe that green snot means you have a bacterial sinus infection, curable only with antibiotics. Not true. Sage-colored mucus is common with viral infections and allergies and can happen when snot sits in your face for a while before being expelled.

There’s usually no need to see an HCP if your symptoms improve after a few days. A trip to your doctor may be necessary if you have a bacterial infection, but it can often be difficult to distinguish between that and a viral infection. If your symptoms last longer than 10 days or improve before worsening again, call your HCP.

If you suddenly experience any of these symptoms, it’s a sign to seek medical attention immediately, even if they’ve been present for fewer than seven days:

  • Abrupt vision changes
  • Sudden and serious pain around your eyes or face
  • Tenderness or swelling of the face
  • Stiff neck
  • Confusion
  • Continual high fever

How can you tell if you have chronic sinusitis?

Does it feel like your sinus infection just won’t quit? If you experience at least two of the following for 12 weeks or more – even though you’ve been treated – it may be chronic sinusitis:

  • A stuffed nose
  • Discharge of mucus or postnasal drip
  • Pain or pressure in your face
  • Problems with smell

Chronic sinus infections can be triggered by colds but are typically caused by long-term inflammation. Sometimes, when treatments to control that inflammation fail, people with chronic sinusitis need surgery to drain their mucus.

What can I do?

While you wait for your infection to run its course, you can take steps at home to feel better. Your goal, according to Ferrer: “Bringing that inflammation from the nose down and letting the mucus flow is probably one of the best things that patients can do.”

Look into nasal sprays

Store-bought saline nasal spray loosens up mucus, temporarily clearing it from your nasal passages. But, be wary of decongestant nasal sprays, like oxymetazoline. Using them for longer than three days could cause rebound symptoms – persistent stuffiness eased only by the spray itself. Dryness and addiction are also possibilities.

Embrace sinus rinses

Many sinus infection veterans swear by nasal irrigation systems, such as plastic squeeze bottles or teakettle-shaped pots. These devices are filled with a sterile saline solution and used to flush snot from your sinuses.

Sinus rinses are widely available and typically safe, as long as you handle them properly. Don’t use water directly from your tap. Instead use distilled water, a sterile saline solution or water that has been boiled and then cooled. Physicians suggest not using these for more than a week. Make sure the device is clean and dry for each application.

Try over-the-counter (OTC) medicines

Experts recommend analgesics including acetaminophen, ibuprofen, and aspirin to ease pain, as well as decongestants like pseudoephedrine to alleviate the pressure of congestion.

Many people find relief using mucolytics like guaifenesin, which thin and clear mucus. Others may opt for antihistamines, which dry out nasal passages. However, there’s not enough evidence that either work to treat acute sinusitis.

Speak with a medical professional about choosing the right OTC drug. Certain decongestants and analgesics may be unsafe if you have another underlying condition; they can also interact with your medications. If your doctor gives you the green light to try an OTC drug, always use them as directed, and not for more than a few days. If you have old antibiotics lying around, don’t be tempted to take them.

Take care of yourself

Pressing a warm compress to your face may help ease sinus pain. To help keep your airways moist, take warm showers and make it a point to inhale the steam. You can also:

  • Drink up. Dehydration encourages mucus production, so consume plenty of healthy liquids, as long as you don’t have any condition-related fluid restrictions. Water is always a good choice, and Ferrer recommends chicken noodle soup and hot tea with honey, ginger and lemon. Bonus: Warm beverages soothe sore throats, too.
  • Get some rest. To promote drainage, prop up your pillow or sleep on your side instead of your back.
  • Don’t imbibe. Alcohol contributes to dehydration and exacerbates sinus swelling.

Finally, you may want to avoid flying or scuba diving, since either can aggravate sinus pain.

How can I avoid future sinus infections

Once you’ve had a nasty sinus infection, you won’t want to relive the experience. To help prevent them from occurring again, get your annual flu shot and steer clear of people with colds or the flu. Use your humidifier. Live as healthfully as you can – get sufficient sleep, reduce stress and eat a wholesome diet with plenty of whole grains, lean proteins and fruits and vegetables. Avoid exposure to secondhand smoke and if you do smoke, take steps to quit. Last, but not least, always wash your hands.

Ultimately, sinusitis is a painful – and revolting – nuisance. But approaching them with these smart strategies could save you a world of hurt.