Sinusitis
Your health expert: Mr Jonathan Hughes, Consultant Ear, Nose and Throat/Head and Neck/Thyroid Surgeon
Content editor review by Rachael Mayfield-Blake, Freelance Health Editor, August 2023
Next review due August 2026
Sinusitis is when the lining of your sinuses becomes inflamed and swollen, usually because of a sinus infection. If you have sinusitis, you may have a blocked nose and pain in your face. Sinusitis usually goes away on its own after a few weeks. But if not, treatments can help.
Where the sinuses are found
What are the sinuses | how they work - watch in 1 minute 32
This video explores what are sinuses are, how they work, and where they are in our body.
About sinusitis
Your sinuses are air-filled spaces behind your forehead and in your cheekbones. They’re connected to the inside of your nose. Doctors don’t know exactly why we have sinuses – there are probably lots of reasons. These include reducing the weight of your skull and keeping the air that you breathe in warm and moist.
You have four main pairs of sinuses.
- Maxillary sinuses inside your cheekbones.
- Frontal sinuses on either side of your forehead, above your eyes.
- Ethmoid sinuses behind the bridge of your nose, between your eyes.
- Sphenoid sinuses set deeply behind the upper part of your nose and between your eyes.
The lining of your sinuses makes mucus. Usually, this mucus drains away through your nose and throat. But if the sinus lining swells up because of an infection or allergy, this can cause a blockage, and the mucus can’t drain away.
Sinuses can also get blocked by nasal polyps. These are fleshy swellings of the lining of your nose or sinuses. For more information, see our FAQ: What are nasal polyps?
Sinusitis is common; you can get it at any age.
Types of sinusitis
Sinusitis can be acute (short-lasting) or chronic (long-lasting).
- Acute sinusitis is sinusitis that gets better within 12 weeks. But most people feel better within four weeks. Acute sinusitis may be triggered by an infection with a virus, such as a cold.
- Chronic sinusitis is sinusitis that lasts for longer than 12 weeks. It often starts off as acute sinusitis that doesn’t get better. It may be caused by an allergy.
Some people have repeated flare-ups of sinusitis – four or more a year. This is called recurrent sinusitis.
Causes of sinusitis
Acute sinusitis is caused by an infection of the lining of your sinuses. Most people with acute sinusitis have a viral sinus infection, such as a cold or flu.
Chronic sinusitis often starts off as acute sinusitis. But it may also be linked to:
- allergies
- a blockage in your nose or sinuses (such as nasal polyps)
- smoking
- asthma
- hay fever
- infections in your teeth and gums
- sports (such as swimming and diving)
- injuries to your teeth, nose or cheeks
- conditions that affect the way your body gets rid of mucus (such as cystic fibrosis)
- having had previous sinus surgery
Symptoms of sinusitis
The main symptoms of sinusitis are pain and a feeling of pressure in your face. If you have acute sinusitis, your pain may be much worse than if you have chronic sinusitis.
Where you feel the pain and pressure depends on which of your sinuses is affected. You may notice the pain in:
- your forehead
- the top of your jaw, teeth and cheeks
- between and behind your eyes
Other symptoms of sinusitis can include:
- a blocked or stuffy nose
- mucus coming from your nose (clear or a brown/yellow/green colour)
- a feeling that mucus is slowly dripping down the back of your throat (postnasal drip)
- changes to your sense of smell
- a high temperature (fever)
- a cough
- a sore throat
- bad breath
- feeling generally unwell
Viral and bacterial sinusitis often have the same symptoms. But you may be more likely to have bacterial sinusitis if:
- your symptoms last for more than 10 days
- your pain is very bad and in one place (such as over your teeth and jaw)
- your symptoms got better for a while and then came back again
- you have a blocked nose
Diagnosis of sinusitis
A GP will ask you about your symptoms and examine you. They’ll feel for any tenderness over your sinuses. They may also look up into your nose for signs of inflammation or a blockage.
You don’t usually need any other tests for your GP to diagnose sinusitis.
Your GP may also check whether something else is causing your symptoms, because sinusitis symptoms can be like symptoms of other conditions. These include an allergy, or problems with your teeth.
Your GP may refer you to an ear, nose and throat (ENT) specialist doctor if:
- you have chronic sinusitis and your treatment hasn’t worked
- acute sinusitis keeps coming back
- you have complications of sinusitis
Your ENT specialist may suggest you have a test called a nasal endoscopy. In this test, they’ll put a narrow, flexible, tube-like telescopic camera into your nose, which will help them to find any blockages. Your doctor will explain more about what’s involved.
Your doctor may ask you to have other tests too, such as a CT scan. This can help them rule out other problems and be sure you have sinusitis.
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Self-help for sinusitis
Self-help for acute sinusitis
Acute sinusitis usually gets better on its own within 10 days to a month and your symptoms will usually start to improve after about five days. You may feel like you have a cold that’s taking longer than usual to clear up.
There are things you can do to ease your symptoms.
- Take over-the-counter painkillers such as paracetamol or ibuprofen. These will ease pain and any fever.
- You can try a decongestant nasal spray if your nose is very blocked. But only use this for three to five days at most.
- Rinse your nose with a warm saltwater solution – a pharmacist can show you the best way to do this.
- Drink plenty of fluids and get lots of rest.
- Put a warm face cloth on your sinuses.
Some people try steam inhalation to clear their blocked sinuses, but there’s no proof if this really helps.
Ask a pharmacist for more advice on self-help for sinusitis.
Contact a GP if:
- your symptoms aren’t getting better after three weeks
- your symptoms keep getting worse
- you feel very unwell
Self-help for chronic sinusitis
If you have chronic sinusitis, it may take a while for you to get better, sometimes several months.
You may find your symptoms get worse every now and then in what’s called an acute flare-up. The self-help measures for acute sinusitis may ease them (Self-help for acute sinusitis). If these don’t help to ease your symptoms, contact your GP.
Other self-help measures for chronic sinusitis include the following.
- Stopping smoking – ask a pharmacist for advice on quitting smoking – and stay away from places where other people smoke.
- Avoid things you’re allergic to (if possible).
- Taking care of your teeth, because chronic sinusitis can be linked to a dental infection.
- Make sure you drink enough to stay hydrated.
- Don’t go scuba diving.
Treatment for sinusitis
Sinusitis will usually get better on its own but there are different sinusitis treatments to ease the symptoms. The best option for you will depend on what type of infection you have (if any) and whether you have acute or chronic sinusitis.
Medicines
Acute sinusitis
Your doctor may suggest you try a nasal corticosteroid spray if:
- your symptoms last for 10 days or more
- your symptoms don’t improve over time
You’ll usually use the spray for two to four weeks – a pharmacist can show you how.
Sinusitis is usually caused by a viral sinus infection, so antibiotics are unlikely to help. Even bacterial sinusitis often clears up on its own without antibiotics. Your doctor will only recommend an antibiotic if:
- you have symptoms for more than 10 days, with no improvement
- your symptoms get much worse
- you are very unwell
- you have a low immune system or a high risk of complications
Chronic sinusitis
If you have medical conditions linked to chronic sinusitis, it’s important to treat them. These include conditions like asthma, hay fever and dental infections. This treatment should help your sinusitis symptoms.
Another chronic sinusitis treatment that may help your symptoms is a nasal corticosteroid spray, especially if you have hay fever too. You may use this for up to three months.
Your doctor may suggest you take antibiotics for three to four weeks. The aim is to treat a bacterial sinus infection.
If these measures don’t work, your GP may refer you to an ear, nose and throat (ENT) specialist.
Surgery for chronic sinusitis
Most people with chronic sinusitis don’t need surgery. Your ENT specialist will usually only suggest you have an operation if other treatments haven’t worked. An operation aims to unblock your sinuses so the mucus drains out of your nose more easily.
There are two main types of surgery for chronic sinusitis.
- Functional endoscopic sinus surgery (FESS). Your surgeon will use a thin, flexible endoscope to see inside your sinuses. They’ll unblock your sinuses by removing some of your bone and mucus lining.
- Balloon sinuplasty. Your surgeon will put a small, flexible tube into your sinus and inflate a balloon on the end of it. This will unblock your sinus.
If nasal polyps are causing a blockage in your nose or sinuses, you may need to have surgery to remove them. For more information on polyps, see our FAQ: What are nasal polyps?
If your doctor recommends an operation, they’ll talk to you about the benefits and risks.
Complications of sinusitis
Acute sinusitis usually goes away on its own without causing any problems. But sometimes the symptoms don’t go away and it becomes chronic sinusitis.
Rarely, an acute sinus infection can spread. Rare complications of acute sinusitis include the following.
- Infection of the soft tissue around your eye. Your eyelid may become red, painful and swollen.
- Infection of the bones in your face. You may have pain and your face may feel tender.
- Infection in or around your brain. You may get a bad headache, stiff neck, high temperature or be sick (vomit).
These complications are serious. If you feel very unwell or think you may have one of these complications, get medical help right away.
Chronic sinusitis can affect your quality of life. You may have problems sleeping and feel very tired. You may find it difficult to work or enjoy social activities. Some people get depression. Speak to you doctor if you’re finding it hard to cope with chronic sinusitis.
Prevention of sinusitis
You may be able to lower your risk of getting sinusitis by doing the following.
- Wash your hands well, especially after being in close contact with someone who’s unwell.
- Don’t smoke and avoid smoky places or areas with heavy air pollution.
- Try to steer clear of any allergy triggers you have.
If you keep getting sinusitis because of an allergy, you may find it useful to have allergy tests. Your GP or ear, nose and throat (ENT) specialist may be able to refer you to an allergy clinic.
Your sinuses are air-filled spaces around your nose and eyes. They are found:
- inside your cheekbones
- behind your forehead, above your eyes
- behind the bridge and upper part of your nose and between your eyes
- set deeply behind the upper part of your nose and between your eyes
The main symptoms of sinusitis are pain and a feeling of pressure in your face. You may also get a blocked or stuffy nose, and green or yellow mucus coming from your nose. And you may have a high temperature, a cough and generally feel unwell.
See our symptoms of sinusitis section for more information.
If you fly and have sinusitis, it can cause pain in your sinuses due to the pressure changes inside the cabin. It’s best to delay your flight until your symptoms have gone away (if possible). If you have to fly, use a decongestant spray just before the flight. And make sure you get a good night's sleep before you travel, drink plenty of fluids but don’t have any alcohol or caffeine.
Nasal polyps are fleshy swellings of the lining of your nose and sinuses that look like small grapes. Polyps can block your sinuses, which may increase your risk of a sinus infection. You can usually treat nasal polyps with a nasal corticosteroid spray, but it’s possible you may need surgery to remove them.
Nasal decongestant sprays are used rather than tablets to treat sinusitis. Oral decongestants (tablets or capsules) reduce blood flow to the nose, whereas a spray can target the medicine to just the lining of your nose to reduce inflammation.
See our treatment of sinusitis section for more information.
Sinusitis will usually go away on its own but there are treatments that can ease your symptoms. You can ease pain and a fever with over-the-counter painkillers, such as paracetamol or ibuprofen. And a decongestant nasal spray may help if your nose is very blocked. Sinusitis medicines include a nasal corticosteroid spray and if other treatments don’t work, surgery.
See our self-help for sinusitis and treatment of sinusitis sections for more information.
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