Do Your Symptoms Point to a Sinus Infection?

Sinus infections are surprisingly common (practically as common as an ordinary cold), affecting around 1 in 8 adults in the U.S. The following raise your risk of being that 1 in 8:

• A cold
• Allergies
• Smoking and exposure to secondhand smoke
• Structural problems within the sinuses (such as growths on the lining of the nose or sinuses, known as nasal polyps)  

And although experts can’t say for certain, there’s reason to believe that people become more susceptible to sinus infections with age. “There are many ideas about why some older adults might be more prone to sinus infections or might have a more difficult time clearing a sinus infection,” says David Conley, M.D., associate professor of otolaryngology at Northwestern University’s Feinberg School of Medicine. Among the potential reasons is that the lining of the nose and sinuses, which provides a barrier against infections, becomes thinner over time, Conley says. And for some older adults, mucus often becomes thicker. Plus, a weakened immune system or taking drugs that weaken the immune system increases your risk of sinusitis.

How to treat sinusitis

The best way to get over a sinus infection? Wait it out. A viral sinus infection — the kind that’s caused by, say, a cold that progresses — usually gets better on its own within 14 days. To treat symptoms, the American Academy of Otolaryngology-Head and Neck Surgery recommends the usual suspects: acetaminophen or ibuprofen for pain and fever, decongestants to help you breathe easier and nasal saline sprays or what’s known as sinus irrigation with a neti pot to help remove mucus.

If your sinus woes last longer than 14 days, however, you probably have a bacterial sinus infection, which is “caused by a structural issue in your nose, a viral issue or an inflammatory/allergic issue,” Iloreta says. One of these typically sets the stage for a bacterial infection, “and there’s a domino effect.” At that point, you should see your doctor.

An antibiotic isn’t always the answer

Although antibiotics are often the go-to treatment for all sinus infections, they’re effective in treating only bacterial infections.

Research published in Annals of Family Medicine found that bacteria cause around 1 in 3 sinus infections, yet the majority of sinusitis sufferers are prescribed antibiotics. That sort of unnecessary antibiotic use is more than just pointless; it’s one of the leading contributors to antibiotic-resistant infections, according to the Centers for Disease Control and Prevention. Probably 7 in 10 people with a sinus infection who seek treatment from their doctor are prescribed an antibiotic and shouldn’t be, Iloreta says.

“The over-prescription of antibiotics is setting patients up for worse infections in the future if they don’t truly have a bacterial infection,” he adds. “The microbiome is the normal bacteria in your nose — we have hundreds of thousands of species of bacteria in our body that are good for us — and even just one dose [of antibiotics] changes it significantly. Oftentimes that change will predispose you to having worse bacterial infections.”

To diagnose a bacterial sinus infection, your doctor will typically look at the symptom duration. Both viral and bacterial infections tend to produce the same symptoms; a combination of headache, fatigue, ear pain, cough, loss of smell, general malaise and difficulty sleeping is common, Iloreta says. But sinusitis caused by a virus tends to clear faster.

Preventing a sinus infection

To prevent sinus infections altogether, borrow strategies from your cold-prevention playbook.  Most notably, “practicing hand hygiene is the easiest way to prevent a sinus infection,” Iloreta says. “Sinus infections come from chronic allergies, or chronic inflammation in the nose, so by treating your allergies — taking antihistamines, avoiding pollen exposure — you’ll also help prevent subsequent sinus infections.”  

Kimberly Goad is a New York–based journalist who has covered health for some of the nation’s top consumer publications. Her work has appeared in Women’s Health, Men’s Health and Reader’s Digest. ​