Sinusitis is inflammation of the nasal sinuses leading to a buildup of secretions in the cavities surrounding the nose, eyes, and cheekbones, causing symptoms like headache, runny nose, and facial pressure.

This inflammation can be caused by a viral infection and is very common in cases of the flu (influenza). It can also be caused by bacterial or fungal infections or even allergies.

Sinusitis is treated by a primary care provider or otolaryngologist (ENT) who may recommend nasal irrigation, nasal sprays, analgesics, oral corticosteroids, or antibiotics. Treatment will vary based on the type of sinusitis and the severity of symptoms.

provider's thumbs pressing on female patient's sinuses

Common symptoms

The main symptoms of sinusitis are:

Thick, yellow nasal secretions;
Stuffy nose;
Facial pressure;
Headache;
Cough that is worse at night;
Loss of smell.

Sinusitis may also affect the sinuses on only one side of the face, a condition known as unilateral sinusitis. Sinusitis affecting the sinuses on both sides of the face is called bilateral sinusitis.

It is important to consult your primary care provider or an ENT if you are experiencing sinus infection symptoms in order to identify the cause and get started on the best treatment.

Symptom checker

Use the symptom checker below to see whether your symptoms could be caused by sinusitis (select all that apply):

1. Facial pain, especially around the eyes or nose
2. Constant headache
3. Head heaviness, especially when bending down
4. Nasal congestion
5. Fever above 38º C (or 100.4º F)
6. Bad breath
7. Yellow or green nasal discharge
8. Cough that worsens at night
9. Loss of smell

This symptom checker is only a tool and should not be used to diagnosis any condition or take the place of an appointment with your primary care provider or an ENT.

Confirming a diagnosis

The diagnosis of sinusitis is made by a primary care provider or ENT based on an evaluation of symptoms, such as when they started and how long they have lasted; medical history; and a physical exam, including palpation of the nasal sinuses to check for sensitivity and tenderness in the area.

Common tests

A provider may also order other more specific tests for sinusitis, such as:

Nasal endoscopy: a thin tube is inserted through the nose to observe the interior of the sinuses to identify other conditions, such as nasal polyps, that can also cause sinusitis;
Computerized tomography (CT scan): evaluates for the presence of a deeper inflammation that cannot be identified with nasal endoscopy and allows for visualization of the sinus anatomy;
Nasal swab: a provider collects a sample of your nasal secretions to send to the lab for analysis to check for the presence of microorganisms like bacteria or viruses;
Allergy test: allergy tests help identify allergic causes of sinusitis when a nasal swab is negative for viruses and bacteria, for example.

The diagnosis of sinusitis is largely clinical. X-rays are not typically indicated as a CT scan is superior in confirming a diagnosis of sinusitis.

Different types

Sinusitis can be classified into different types based on duration of symptoms or the cause of inflammation. These include:

1. Acute sinusitis

Acute sinusitis is a type of sinusitis that lasts for less than 4 weeks and is typically caused by a virus or allergy.

2. Chronic sinusitis

Chronic sinusitis is a type of sinusitis lasting more than 3 months that is usually caused by bacteria.

This type of sinusitis can also happen as a consequence of acute sinusitis that is left untreated or not treated appropriately.

3. Subacute sinusitis

Subacute sinusitis is a type of sinusitis characterized by symptoms lasting between 4 weeks and 3 months.

4. Bacterial sinusitis

Bacterial sinusitis is caused by bacteria like Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis that invade the sinuses and multiply, typically due to an upper respiratory infection or allergy flare.

In addition to the typical symptoms of sinusitis, bacterial sinusitis may present with bad breath, a bad smell in the nose, and a fever that can last for 10 days or up to 4 weeks.

5. Viral sinusitis

Viral sinusitis is the most common type of sinusitis and is caused by viruses like influenza or rhinovirus that lead to an accumulation of secretions in the nose and sinuses, resulting in symptoms.

6. Allergic sinusitis

Allergic sinusitis is caused by allergies to mites, dust, chemical products, or foods and is more common in people with allergic rhinitis. Symptoms include nasal congestion, buildup of phlegm, and blocked sinuses.

7. Fungal sinusitis

Fungal sinusitis is a rare type of sinusitis primarily caused by the Aspergillus fungus and other types of fungi like Mucor, Rhizopus or Rhizomucor that also cause mucormycosis.

This type of sinusitis may happen more frequently in people with a weakened immune system, such as people with diabetes or HIV, people taking corticosteroids or immunosuppressants, and people undergoing chemotherapy.

8. Odontogenic sinusitis

Odontogenic sinusitis is a type of sinusitis caused by an infection of the upper teeth that spreads to the sinuses due to the proximity of the sinuses to the upper dental arch.

This type of sinusitis can be acute or chronic and is generally caused by dental surgery, tooth extraction, implants, or periodontal disease.

9. Rhinosinusitis

Rhinosinusitis is inflammation of the nasal sinuses and nasal mucosa at the same time and can be acute, chronic, or recurrent.

Rhinosinusitis typically develops due to viral or bacterial infections but can also be caused by allergies or nasal polyps.

10. Recurrent sinusitis

Recurrent sinusitis is a type of acute sinusitis that happens four or more times a year and is typically caused by allergic rhinitis, a deviated septum, or narrowing of the nasal sinuses.

11. Barosinusitis

Barosinusitis is a rare type of sinusitis caused by rapid changes in atmospheric pressure and is more common in pilots and divers.

Changes in atmospheric pressure can cause a difference in pressure between the sinuses and the external environment, resulting in injury to the sinuses.

In addition to the usual symptoms of sinusitis, barosinusitis can also cause watery eyes or nose bleeds.

Main causes

The main causes of sinusitis are:

Viral, bacterial, and fungal infections;
Allergies to mites, dust, animal dander, pollution, chemical products, or foods;
Allergic rhinitis;
Nasal polyps, a deviated septum, or enlarged adenoids;
Dental problems.

Other factors like smoking, HIV, a weakened immune system, anatomical variations in the sinuses, and cystic fibrosis can increase the risk for sinusitis.

What are the signs of severe sinusitis?

Sinusitis is considered to be severe when symptoms are intense, such as pain or fever lasting for more than 3 days, or prolonged, lasting for 10 days or longer.

Treatment options

Treatment of sinusitis is managed by an ENT or primary care provider with the goal of alleviating symptoms and combating the cause of the inflammation.

The main treatments for sinusitis include:

1. Nasal irrigation with normal saline

Nasal irrigation with 0.9% normal saline helps thin out secretions in the sinuses to make them easier to eliminate, relieving pain and pressure in the face.

This type of treatment may be recommended by your provider as a complementary therapy for all types of sinusitis.

2. Nebulizers

Nebulizer treatments may be recommended by your provider for management of acute, subacute, or chronic sinus. Nebulizer treatments help moisten the sinuses and thin out secretions, making them easier to eliminate.

Nebulizer treatments can be done using normal saline or essential oils from medicinal plants like eucalyptus.

In some cases, a provider may prescribe medications in the form of a nebulizer.

3. Medications

Medications for sinusitis may be prescribed by a healthcare provider to help relieve pain and fight infections.

Sinusitis medications may include decongestants or corticosteroids in the form of a nasal spray, anti-inflammatories, antipyretics, or antihistamines.

Antibiotics may also be prescribed in the case of bacterial sinusitis or antifungals in the case of fungal sinusitis.

4. Surgery

Surgery may be indicated in cases of recurrent or chronic sinusitis and involves opening up the sinuses and allowing secretions to drain.

This surgery may also be done in more serious cases of sinusitis involving complications like an abscess.

Home remedies

Home remedies like drinking mint and nettle juice or turmeric tea may help reduce inflammation of the sinuses and relieve symptoms of sinusitis due to their anti-inflammatory, expectorant, and antiseptic properties.

Self-care tips

Self-care tips that are recommended to help alleviate symptoms of sinusitis faster include:

Avoiding spending a lot of time in closed spaces or polluted or dusty areas;
Drinking at least 2 L (eight 8-oz glasses) of water per day;
Applying warm compresses to the face;
Avoiding or quitting smoking;
Avoiding contact with substances or foods that trigger allergic sinusitis.

Other self-care tips include natural ways to help alleviate symptoms and speed up recovery, such as resting, drinking warm teas, and eating anti-inflammatory foods.

Sinusitis: Symptoms, Causes & Treatment