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Am Fam Physician. 1998;58(8):1805-1806

See related article on acute sinusitis.

What are sinuses? What do they do?

Sinuses are air spaces in the bones around your nose and eyes. The sinuses make your skull weigh less and improve the sound of your voice. They also make mucus, a fluid that helps warm the air you breathe and add moisture to it. Hair cells that are called cilia (sill-ee-ah) continually “sweep” mucus out of your sinuses into your nose.

What causes a sinus infection?

Anything that blocks your sinus openings or keeps the cilia from moving can cause a sinus infection, or acute sinusitis (sine-you-site-iss). A build-up of mucus and other secretions makes a good place for germs to grow. Common causes of sinus infections include the following:

  • Colds or upper respiratory infections

  • Hay fever or allergies

  • Air pollution and cigarette smoke

  • Nasal or dental procedures

  • Traveling at high altitudes or swimming under water

  • Hormone changes that come with puberty

  • Pregnancy or aging

  • Sinus blockages

  • Immune disorders, such as diabetes or AIDS

How do I know if I have acute sinusitis?

A cold that starts to get better and then gets worse may be a sign of a sinus infection. Pain that is on only one side of your face or pain that starts when you lean forward can also be a sign of acute sinusitis. Other symptoms include a fever, thick green or yellow nasal mucus, and an ache in your upper teeth.

How is sinusitis treated?

Some sinus infections get better on their own. Some may need to be treated with an antibiotic (a medicine that kills germs). Here are some other things you can do to help a sinus infection:

  • Get plenty of rest. When you go to sleep, try lying on the side that is least congested (where you can breathe the best), because lying down increases nasal congestion.

  • Sip hot liquids and drink plenty of fluids.

  • Apply moist heat by holding a hot, wet towel against your face or breathe in steam. (If you're inhaling steam, be sure to cover your entire face with a cloth or towel first, so you don't burn yourself.)

  • Rinse your nasal passages with salt water to remove excess mucus. Use over-the-counter saline nasal solutions or make your own salt water. Add 1/4 teaspoon of table salt to 1 cup of warm water. Mix well in a clean, empty squeeze bottle. Squirt the salt water into each side of your nose for several minutes three or four times a day.

  • Use over-the-counter medicines such as acetaminophen (Tylenol) for pain. Don't use aspirin if you're allergic to it or under age 20.

  • Talk with your doctor before using cold remedies. Some cold medicines can make a sinus infection worse by drying out mucous membranes and blocking sinus openings. Other medicines disturb your sleep, make you nervous or raise your blood pressure or pulse.

  • If you use a nose spray with a decongestant in it, don't use it for more than three days. If you use it for more than three days, your nasal swelling may get worse when you stop the medicine. Use a short-acting nasal decongestant (brand names: Neo-Synephrine, Afrin 4-Hour), since long-acting kinds (brand names: Dristan 12-hour, Afrin 12-hour) may slow healing.

Where can I get more information about sinusitis?

The following organizations can give you more information about sinusitis and what to do about it.

  • American College of Allergy, Asthma & Immunology

    85 West Algonquin Road, Suite 550

    Arlington Heights, IL 60005

    Telephone: 1-847-427-1200

    Internet address: http://www.acaai.org/

  • American Academy of Otolaryngology, Head and Neck Surgery

    One Prince St.

    Alexandria, VA 22314-3357

    Telephone: 1-703-836-4444

    Internet address: http://www.entnet.org/

  • National Jewish Medical and Research Center

    1400 Jackson St.

    Denver, CO 80206

    Telephone: 1-800-222-LUNG

    Internet address: http://www.njc.org

  • American Rhinologic Society

    c/o Frederick J. Stucker, M.D.

    Dept. of Otolaryngology

    LSU School of Medicine in Shreveport

    1501 Kings Highway, P.O. Box 33932

    Shreveport, LA 71130

    Telephone: 1-318-675-6262

    toll-free: 1-888-520-9585

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