Sinus Infection (Sinusitis): Causes, Symptoms & Treatment
Sinusitis is inflammation of the tissue lining the sinuses. Acute sinusitis often develops after a viral upper respiratory infection, while some cases are caused by bacteria. Symptoms commonly include nasal congestion, facial pressure, and nasal drainage.
This guide explains what causes sinus infections, how to recognize the symptoms, the treatment options available, and when it’s time to see an ENT.
- Most sinus infections are viral and clear up within about 10 days.
- See an ENT if symptoms last more than 10 days, keep coming back, or don’t improve with treatment.
- Treatment ranges from home care and saline rinses to prescription medication and, for chronic cases, in-office procedures.
Struggling with ongoing sinus pressure or congestion? Our Orange County ENT team can help you find lasting relief.
Viral vs. Bacterial Sinus Infections
Not all sinus infections are the same, and the difference matters for treatment. The large majority of sinus infections are viral — often following a common cold — and do not respond to antibiotics. A smaller number are bacterial, and these are the cases most likely to need prescription treatment.
A bacterial sinus infection is more likely when:
- Symptoms last more than 10 days without improving.
- Symptoms improve and then suddenly get worse again (sometimes called “double worsening”).
- Symptoms are severe — such as a fever of 102°F (39°C) or higher, thick discolored discharge, or intense facial pain — for three to four days in a row.
Because the two types are treated differently, an accurate diagnosis helps you avoid unnecessary antibiotics. For a deeper comparison, read our guide on the difference between viral and bacterial sinus infections.
| Feature | Viral sinus infection | Bacterial sinus infection |
|---|---|---|
| How common | The large majority of cases | A smaller share of cases |
| Usual trigger | Often follows a cold or upper-respiratory virus | May develop after a lingering viral infection |
| Duration | Usually improves within about 10 days | Often persists beyond 10 days or worsens after improving |
| Fever | Low-grade or none | May occur; high fever can be a sign of more severe illness |
| Typical approach | Rest, fluids, and symptom relief; antibiotics not helpful | May require prescription treatment; evaluated by a provider |
This table is for general education and isn’t a substitute for a medical evaluation.
Sinus Infection Symptoms and When to See an ENT
- Nasal congestion or a blocked, stuffy nose
- Facial pain, pressure, or tenderness around the eyes, cheeks, forehead, or nose
- Thick nasal discharge that may be yellow or green
- Postnasal drip (mucus draining down the back of the throat)
- Reduced sense of smell or taste
- Headache, cough, fatigue, or bad breath
- Upper tooth pain or a feeling of fullness in the ears
Acute vs. chronic sinusitis
Sinusitis is often grouped by how long symptoms last. Acute sinusitis comes on quickly and usually resolves within four weeks. Chronic rhinosinusitis involves symptoms that persist for 12 weeks or longer and is diagnosed based on the symptom pattern along with objective findings from an ENT examination, nasal endoscopy, or imaging when appropriate. Recurrent acute rhinosinusitis generally refers to four or more distinct episodes in a year, with symptoms clearing between episodes.
When to see an ENT
Consider scheduling an appointment with an ENT if:
- Symptoms last longer than 10 days without improving
- Symptoms improve and then return or get worse
- You have four or more sinus infections in a year
- Symptoms continue for 12 weeks or more (chronic sinusitis)
- Sinus infections keep interfering with sleep, work, or daily life
Seek care right away if you notice:
- Swelling, redness, or pain around one or both eyes
- Vision changes, such as double or blurred vision
- A severe or worsening headache, stiff neck, or confusion
- A high or persistent fever
These can be signs of a more serious infection that needs prompt medical attention.
Sinus Infection Treatment Options
Home care and symptom relief
- Saline nasal rinses or sprays to flush irritants and thin mucus
- Staying well hydrated and resting
- A humidifier or steam to ease congestion
- A warm compress over the face to relieve pressure
- Over-the-counter pain relievers or decongestants, used as directed
Ask your provider or pharmacist before starting a new medication, especially decongestant sprays, which shouldn’t be used for more than a few days.
Medical treatment
When symptoms are persistent or severe, a provider may recommend intranasal corticosteroid sprays to reduce inflammation, or antibiotics when a bacterial infection is confirmed or strongly suspected. Antibiotics are not helpful for viral infections, so they’re used selectively.
In-office and surgical options
For selected patients with chronic or recurrent sinusitis that remains uncontrolled despite appropriate medical treatment, an ENT may consider procedures such as balloon sinus dilation or functional endoscopic sinus surgery (FESS). Candidacy depends on the diagnosis, symptoms, anatomy, treatment history, and objective findings from examination, nasal endoscopy, or CT imaging when appropriate.
Learn more about our sinusitis treatment in Orange County, including balloon sinuplasty, to see which options may be right for you.
When Sinusitis Becomes Persistent or More Serious
Some patients develop persistent sinonasal inflammation lasting 12 weeks or longer. Chronic rhinosinusitis is a distinct condition that can affect breathing, smell, sleep, and quality of life and may require evaluation by an ENT.
Rare spread to nearby areas
In rare cases, a bacterial sinus infection can spread to tissues around the eyes or, even less commonly, other nearby structures. Swelling around the eye, vision changes, severe headache, stiff neck, confusion, or other rapidly worsening symptoms require prompt medical attention.
Is It a Sinus Infection, a Cold, Allergies, or COVID-19?
These conditions share symptoms, which makes them easy to confuse. This quick comparison can help you tell them apart — though only a provider can give you a diagnosis.
| Symptom | Sinus infection | Cold | Allergies | COVID-19 |
|---|---|---|---|---|
| Facial pressure/pain | Common | Sometimes | Sometimes | Can occur |
| Thick, colored discharge | Can occur | Can occur | Usually clear | Can occur |
| Fever | Possible | Sometimes | No | Possible |
| Itchy eyes/sneezing | Uncommon | Sometimes | Common | Can occur |
| Loss of smell/taste | Possible | Sometimes | Sometimes | Can occur |
| Typical duration | Varies by cause | Often 7–10 days | Can persist with exposure | Varies |
Symptoms alone cannot always distinguish sinusitis from a cold, allergies, or COVID-19. The duration and progression of symptoms, exposure history, testing when appropriate, and clinical evaluation can help clarify the cause. Nasal mucus color by itself does not determine whether an infection is viral or bacterial.
Sinus Infections in Children
Children can get sinus infections too, but the signs may look a little different. Parents often notice a cold that lasts longer than 10 days, a lingering daytime cough, nasal discharge, irritability, or low energy. If your child’s symptoms are severe, persistent, or keep returning, a pediatric-friendly ENT evaluation can help identify the cause and the right next step.
Natural Remedies and At-Home Relief
- Saline rinses or a neti pot used with distilled or previously boiled water
- Steam from a warm shower or use of a humidifier
- Staying hydrated to keep mucus thin
- Elevating your head while sleeping
- Warm compresses over the sinuses
Home remedies can relieve symptoms but don’t replace medical care when symptoms are severe or long-lasting.
How to Help Prevent Sinus Infections
- Manage allergies, which can lead to sinus inflammation
- Wash your hands often during cold and flu season
- Use a humidifier to keep nasal passages from drying out
- Avoid cigarette smoke and known irritants
- Stay current on recommended vaccinations
Frequently Asked Questions
How do I know if I have a sinus infection?
A sinus infection usually causes nasal congestion, facial pressure or pain, and thick nasal discharge, often along with reduced sense of smell, headache, or postnasal drip. Symptoms that persist for more than 10 days without improvement, or improve and then worsen, can raise suspicion for acute bacterial sinusitis and are a reason to consider medical evaluation.
How long does a sinus infection last?
Most sinus infections improve within about 10 days, especially viral ones. Acute sinusitis generally resolves within four weeks. When symptoms last 12 weeks or longer, it’s considered chronic sinusitis and should be evaluated by an ENT.
When is a sinus infection serious?
A sinus infection may be serious if you have swelling or redness around the eyes, vision changes, a severe or worsening headache, a stiff neck, confusion, or a high, persistent fever. These symptoms need prompt medical attention. Infections that keep returning or won’t clear should also be evaluated.
Are sinus infections contagious?
The infection itself isn’t passed person to person, but the viruses that often lead to sinus infections — like cold viruses — are contagious. Good hand hygiene helps reduce the spread of those underlying infections.
What’s the difference between a sinus infection and a cold?
A common cold can cause nasal congestion, drainage, and even facial pressure because the nasal and sinus tissues become inflamed. Acute bacterial sinusitis becomes more likely when symptoms persist beyond 10 days without improvement, are severe for several days, or improve and then worsen.
Can a sinus infection go away on its own?
Many viral sinus infections clear up on their own with rest, fluids, and symptom relief. If symptoms are severe, last more than 10 days, or keep coming back, it’s best to see a provider.
Ready to breathe easier?
Our Orange County ENT team offers personalized evaluation and treatment for sinus infections and chronic sinusitis.