Understanding Sinus Infections: Causes, Symptoms, and Treatment Options
Sinus infections, or sinusitis, are a common condition that affects millions of people each year. They occur when the tissues lining the sinuses become inflamed or infected, leading to congestion, facial pressure, and nasal discharge. While many sinus infections resolve on their own, others require medical treatment—including prescription medications—to prevent complications or prolonged symptoms.
What Is a Sinus Infection?
A sinus infection occurs when the normally air-filled sinuses (located in the forehead, cheeks, and around the nose) become blocked and filled with fluid. This creates a perfect environment for viruses, bacteria, or even fungi to grow.
There are two main types of sinus infections:
- Acute sinusitis: Lasts up to 4 weeks and is often caused by a viral infection, such as the common cold.
- Chronic sinusitis: Lasts more than 12 weeks, can involve repeated infections, and may be related to allergies, nasal polyps, or structural issues.
Common Symptoms of a Sinus Infection
- Nasal congestion
- Thick yellow or green nasal discharge
- Facial pain or pressure (especially around the cheeks, forehead, and eyes)
- Headache
- Post-nasal drip (mucus dripping down the throat)
- Decreased sense of smell or taste
- Ear pressure or fullness
- Cough (worse at night)
- Fatigue or general malaise
- Fever (more common with bacterial infections)
When to See a Healthcare Provider
You should seek medical attention if:
- Symptoms last more than 10 days without improvement
- Symptoms worsen after an initial improvement (“double sickening”)
- You develop a high fever (≥102°F)
- Facial swelling or severe pain occurs
- Vision changes or confusion develop (rare but serious complications)
Treatment Options for Sinus Infections
1. Supportive Care (for Viral Infections)
Most acute sinus infections are viral and resolve on their own within 7–10 days. Supportive treatments include:
- Nasal saline rinses (e.g., neti pot or squeeze bottle)
- Over-the-counter decongestants (e.g., pseudoephedrine or oxymetazoline—limit nasal sprays to 3 days to avoid rebound congestion)
- Pain relievers (e.g., ibuprofen, acetaminophen)
- Hydration and rest
These treatments relieve symptoms while the body clears the infection naturally.
2. Prescription Antibiotics (for Bacterial Infections)
If a bacterial infection is suspected (persistent symptoms ≥10 days, high fever, or worsening symptoms), your provider may prescribe antibiotics, such as:
- Amoxicillin-clavulanate (Augmentin) – First-line for most cases
- Doxycycline – Alternative for penicillin-allergic patients
- Levofloxacin or Moxifloxacin – Reserved for resistant or complicated cases
Antibiotics are usually prescribed for 5 to 10 days, depending on severity and response.
3. Intranasal Corticosteroids
These are useful for chronic or recurrent sinusitis, especially when inflammation is prominent:
- Fluticasone (Flonase)
- Mometasone (Nasonex)
- Budesonide nasal irrigation (compounded)
These reduce swelling and improve sinus drainage. They may be used alongside antibiotics or as maintenance therapy.
4. Allergy Treatment (If Allergies Contribute)
If allergies are triggering or worsening sinus symptoms, management may include:
- Oral antihistamines (e.g., cetirizine, loratadine)
- Intranasal antihistamines (e.g., azelastine)
- Allergy testing or immunotherapy for long-term control
5. Referral for Imaging or ENT Evaluation
If you have chronic sinusitis, nasal polyps, or repeated infections, your provider may recommend:
- CT scan of the sinuses to assess structure or infection
- ENT referral for possible surgery (e.g., balloon sinuplasty, polyp removal)
Frequently Asked Questions About Sinus Infections
Viral sinus infections are contagious, as the underlying cold or flu virus can spread. Bacterial sinusitis itself is not usually contagious.
It’s difficult to tell without evaluation, but signs of a bacterial infection include:
- Symptoms lasting more than 10 days
- Sudden worsening after improvement
- High fever and facial pain
Your provider may diagnose based on history and exam.
No. Most sinus infections are viral and do not require antibiotics. Using antibiotics unnecessarily can lead to resistance and side effects. A healthcare provider will determine if antibiotics are appropriate.
Prevention tips include:
- Washing hands regularly
- Managing allergies
- Using humidifiers in dry environments
- Avoiding smoking or secondhand smoke
- Staying hydrated
- Using saline nasal rinses during cold or allergy season
Rarely, untreated or severe bacterial sinus infections can spread to nearby structures, causing:
- Eye infections
- Brain abscesses
- Bone infections (osteomyelitis)
Seek urgent care if you experience eye swelling, vision changes, confusion, or severe headache.
