Acute sinusitis (sinus infection)

What causes sinusitis?

Most cases of sinusitis are caused by a virus (like what would cause a cold or flu, although occasionally, a bacteria can be to blame.

Sinusitis commonly occurs after a cold. Other typical triggers include:

• Allergies, particularly if these tend to cause nasal congestion, runny nose or stuffiness

• Structural problems in the nose (like a narrowing around the sinuses, or an obstruction in the nose like a nasal polyp)

• Smoking

Symptoms of sinusitis

• Pain, pressure and/or tenderness in the area where the sinuses are located (across the lower forehead, to the sides of the nose, around the eyes and across the cheeks)

• Blocked/congested nose

• Discharge/mucus from the nose

• Temperature

• Headache

• Loss or reduction in sense of smell

• Pain in the upper teeth

• Bad breath

Symptoms of sinusitis usually resolve on their own within 2-3 weeks.

Treatment for sinusitis

Most cases of sinusitis are viral, and will resolve on their own with time and self-care. They usually should not require antibiotics.

To help relieve symptoms, try these sinusitis treatments:

• Get plenty of rest and drinking plenty of fluids

• Take regular paracetamol or ibuprofen medication to reduce pain and/or temperature

• Inhale steam through your nose. Do this by having a hot, steamy shower, or by placing your head over a bowl of boiled water with a towel over the bowel and your head to inhale the steam

• Use saline nasal washes. This is a salt water solution you can buy from a pharmacy

• Use a nasal decongestant spray or drops. These can be bought from a pharmacy. They’re very effective at reducing nasal congestion, but should not be used for longer than 7 days. Regular use for longer than a week can cause increased problems with congestion

• Use an over the counter antihistamine. This is useful if you’ve identified an allergic trigger to your sinusitis

• Use a nasal steroid spray. This can be bought from a pharmacy, and it reduces inflammation and swelling in the lining of the nose and sinuses

If your symptoms are not settling, a GP can prescribe a stronger form of a nasal steroid spray. Some people need to use these for several months to get complete control of their symptoms.

In rare cases, an antibiotic may be needed. This might be if your GP suspects a bacterial infection, you have very severe symptoms, or are at risk of complications or severe infection (for example, if you have a weakened immune system).

Occasionally, sinusitis symptoms do not clear completely and last for many weeks or even months. In these cases, it becomes known as chronic sinusitis. Patients with chronic sinusitis may be referred to an ear, nose and throat specialist (ENT) for assessment – if they’ve been treated consistently for several months with steroid nasal sprays and are not showing improvement. In rare cases, surgery may be needed.

When to see a GP

• If your symptoms are causing you severe pain, or medications like paracetamol or ibuprofen are not helping

• If you’ve severe symptoms like an uncontrollable high temperature, bleeding from the nose, or feel sick and unwell in yourself

• If your symptoms have not started to improve after 7 days

• If you are getting recurrent episodes of sinusitis

What is acute sinusitis?

The sinuses are small, air-filled cavities located behind the forehead, sides of the nose and cheekbones. Acute sinusitis is inflammation of the lining of one or more or these sinuses – usually caused by an infection.

Fluid within the sinuses usually drains out and down into the nose. But when the lining of the sinuses is inflamed, it swells and can obstruct this drainage channel. Fluid builds up in the sinuses which can cause pain, pressure and nasal congestion.