Sinusitis: Symptoms, treatment and when you need antibiotics

Book an appointment

 Facial pain, a permanently blocked nose and a throbbing headache can make you feel completely miserable. It is easy to wonder if you are dealing with a standard cold or a more severe infection. Recognising the specific symptoms helps you manage the discomfort effectively at home. It is also important to know when self-care is not enough, so you can get the right medical advice and understand when a doctor's consultation or a prescription is truly necessary. 

 

Man pinching the bridge of his nose while sitting at his laptop, appearing unwell

What is sinusitis and how does it happen?

Sinusitis is an infection or swelling of the sinuses, which are the small, air-filled cavities located behind your cheekbones and forehead. This common condition typically occurs when the delicate lining of these cavities becomes inflamed, leading to facial pain or pressure.

Sinuses explained

The human skull contains four main pairs of sinuses. These are the frontal sinuses in the lower forehead, maxillary sinuses in the cheekbones, ethmoid sinuses between the eyes, and sphenoid sinuses behind the nose. Their main job is to produce a thin layer of mucus. This mucus traps dirt, dust and germs, keeping the inside of your nose moist and protecting your body from infection.

Blockage to infection

Sinusitis begins when the delicate lining of your sinuses becomes inflamed. This inflammation is usually triggered by a viral cold or an allergy. As the lining swells, it blocks the tiny openings that normally allow mucus to drain into your nose. The trapped mucus builds up, creating a warm, moist environment. Infection can develop, although most cases are viral, which leads to the painful symptoms of a sinus infection.

Differentiating sinusitis from other conditions

Sinusitis is distinguished from a cold, allergies or COVID-19 by the highly localised location of your facial pain and how long your symptoms persist.

Key differences in symptoms

The most distinct sign of sinusitis is persistent facial pressure and pain. This discomfort is typically felt across your forehead, cheeks or around your eyes. It often worsens when you move your head. In contrast, a common cold causes widespread symptoms like a sore throat, sneezing and a tickly cough. Allergies usually present with itchy eyes, a clear runny nose and sneezing, but without the facial pain.

Comparing symptom duration and severity

A normal viral cold usually peaks and improves after five to seven days. Acute sinusitis symptoms often last longer. The NHS explains that sinusitis usually takes two to three weeks to get better. If your symptoms persist for more than 10 days, or if you start to feel better and then suddenly get worse, you are likely dealing with a sinus infection rather than a simple cold.

Condition

Facial Pain/Pressure

Nasal Discharge

Fever

Cough

Itchy Eyes

Typical Duration

Sinusitis

Can be mild to severe

Thick, yellow or green

Sometimes

Sometimes

Uncommon

Often 2 to 3 weeks

Common Cold

Mild or absent

Clear, then thick

Mild

Common

Uncommon

Usually improves within 1 to 2 weekss

Allergies

Mild or absent

Clear and watery

No

Rare

Very common

Varies

COVID-19

Sometimes

Clear

Common

Very common

Uncommon

Varies, cough and tiredness can last longers

Symptoms of sinusitis

The primary symptoms of a sinus infection include facial pain, thick nasal mucus and a blocked nose, all caused by swelling and fluid build-up inside your sinuses.

Facial pain when bending over

The intense pain of sinusitis is caused by pressure building up inside your blocked sinus cavities. Pain often feels worse when bending over.. Mucus colour

It is common to experience a runny or blocked nose with a sinus infection. Your nasal discharge might be clear, yellow or green. Many people assume that green mucus automatically means you have a bacterial infection that requires a prescription. This is a myth. Green or yellow mucus is simply a sign that your immune system is fighting an infection. The NHS notes that sinusitis is commonly viral, and discoloured mucus happens in viral infections too.

Headache and toothache

Alongside facial pain, you may experience a persistent headache, a severely blocked nose and a reduced sense of smell. Toothache is also surprisingly common. This happens because the roots of your upper teeth sit very close to your maxillary sinuses in your cheeks. When these specific sinuses swell, they press on the nerves above your teeth.

Symptoms in children

Sinusitis is uncommon in young children. Seek urgent help if a child has a fever with swelling or redness around the eye, or is unusually drowsy. If your child has symptoms of sinusitis and is under 11 years old, they should see a GP.

Home treatments for sinusitis

You can effectively treat sinusitis symptoms at home with self-care methods that focus on reducing inflammation, thinning trapped mucus and managing your pain while your immune system clears the infection.

Saline nasal rinses

Washing out your nose with a saltwater solution is an excellent way to clear excess mucus.

  1. Boil one pint of tap water and let it cool completely.
  2. Mix in half a teaspoon of salt and half a teaspoon of bicarbonate of soda.
  3. Wash your hands thoroughly.
  4. Stand over a sink and use a sinus rinse bottle, neti pot or a clean syringe to gently squirt the solution into one nostril.
  5. Let the water drain out of the other nostril, then repeat on the opposite side.
  6. Use fresh boiled and cooled water each time and clean the device after use.
Young man pinching the bridge of his nose against a blue background, appearing to have a headache

Painkillers and decongestants

Simple over-the-counter painkillers like paracetamol or ibuprofen, if considered safe for you to take, can effectively manage facial pain and reduce a fever. The NHS advises self-care with painkillers as a first line treatment. You can also ask a pharmacist about decongestant nasal sprays or tablets. These help unblock your nose, but you should not use decongestant sprays for more than a week. Overusing them can cause rebound congestion, making your blocked nose worse. Decongestants are not suitable for everyone and you should discuss using them with a pharmacist or online GP if you take other medications or have chronic health problems.

Rest and hydration

Getting plenty of rest helps your body fight the underlying virus. Drink lots of water and non-caffeinated fluids throughout the day. Applying a warm, damp flannel to your face for a few minutes at a time can also provide soothing relief for throbbing facial pressure.

When should I speak to a GP or Advanced Clinical Practitioner (ACP)?

You should seek medical advice if your sinusitis symptoms:

  • Are very severe or getting worse
  • Don’t improve after 10 days
  • Keep coming back
  • Are accompanied by persistent pain, swelling, or a high fever

A doctor or ACP can prescribe treatments such as steroid nasal sprays, antihistamines, or antibiotics if a bacterial infection is suspected. In rare cases, chronic sinusitis may require specialist treatment, such as surgery to widen the sinuses or remove blockages. If you’re wondering how to treat sinusitis that keeps coming back, a chronic sinusitis treatment plan — and more general treatment for sinusitis — should always be built around your doctor’s advice rather than guesswork.

 

Why antibiotics are rarely needed

Our online clinicians frequently help patients who are surprised to learn that antibiotics will not cure their sinus pain. Most sinusitis is caused by a virus. Antibiotics only kill bacteria, meaning they have no effect on viral infections. UKHSA guidance advises that most acute sinusitis is self-limiting and antibiotics provide only a marginal benefit. Unnecessary use of antibiotics also contributes to antibiotic resistance, which is a major public health concern.

 

How can I avoid getting sinusitis?

Preventing sinusitis can be challenging since it often follows a cold or flu. However, you can reduce your risk by:

If you do catch a cold, take care of yourself by resting, staying hydrated, and treating your symptoms with over-the-counter products.

 

What else could be causing my symptoms?

The symptoms of sinusitis may indicate another condition, such as nasal polyps. Nasal polyps are soft, painless growths inside the nose that can block the sinuses and cause:

  • A blocked or runny nose
  • A reduced sense of smell
  • Nosebleeds

Nasal polyps need to be diagnosed by a doctor or ACP and can be treated with steroid nasal sprays, tablets, or surgery if necessary.

Frequently asked questions

Here are direct answers to some of the most frequently asked questions about sinusitis.

Sinusitis is usually classed by how it behaves over time. Most people develop symptoms that clear within a few weeks — this is called acute sinusitis. If symptoms last 12 weeks or more, it’s chronic sinusitis, and if it comes back repeatedly, doctors call this recurrent sinusitis, meaning your sinusitis can recur several times a year.

Rhinosinusitis is the more clinically precise term doctors sometimes use instead of sinusitis, since the nose and sinuses are usually inflamed together rather than separately. It reflects that sinusitis is an inflammatory condition that’s often infectious in origin, and covers the same sinusitis-related symptoms — blocked nose, facial pressure, and thickened mucus — that most people simply call sinusitis.

Your doctor might suggest decongestant-use short-term, saline-irrigate daily, or, in persistent cases a minimally invasive procedure — to remove any nasal-polyp-related blockages or  septum-related deviation.

See a UK GP today

Skip the wait — book an online appointment and get expert advice from a UK-registered clinician in as little as 2 hours. 

Related Topics