Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2016;94(2):online

See related article on acute rhinosinusitis

What is sinusitis?

The sinuses are hollow spaces between the bones of your face. Sinusitis (“sine-you-SITE-iss”) is what happens when the sinuses are infected by a virus, bacteria, or both. Sinusitis is sometimes called rhinosinusitis or a sinus infection.

What are the symptoms?

Patients with sinusitis may have pain or pressure in their forehead or cheeks, or around their eyes. They may also have thick, cloudy mucus coming from their nose, aching teeth, or a stuffy nose. They may have a fever. Patients with sinusitis often report having a cold that was getting better, but then they started feeling worse again. This is known as double sickening.

What causes it?

Sinusitis often happens after a common cold. When you catch a cold, the lining of the sinuses becomes swollen, and the mucus becomes thick and sticky and doesn't drain very well. The built-up mucus is a good place for bacteria to grow. These bacteria can cause a sinus infection.

How is it treated?

Treatment for sinusitis depends on what caused it. You will feel better by helping the sinuses drain. Drink plenty of fluids to keep the mucus thin. Get plenty of rest. You can prop yourself up with a pillow. Also, try sleeping with the pain-free side of your face on the pillow. Use moist heat to help loosen mucus by holding a warm, wet towel against your face or breathing in steam. For example, you can sit in the bathroom with a warm shower running. A saltwater nasal spray or Neti pot can help loosen mucus, and over-the-counter pain relievers such as acetaminophen or ibuprofen can help with sinus pain and headaches.

Do not take antihistamines such as diphenhydramine (one brand: Benadryl), loratadine (one brand: Claritin), or cetirizine (one brand: Zyrtec) for sinus symptoms because they make mucus thicker and harder to drain. Do not use a nasal spray with a decongestant in it for more than three days. If you do, the swelling in your sinuses may get worse when you stop using it.

If you have allergies, ask your doctor about prescription nasal sprays that have steroids.

Your doctor may prescribe antibiotics if he or she thinks bacteria are causing your sinus symptoms. It is important to take the antibiotic as your doctor tells you and to take all of the medicine until it is gone.

When should I call my doctor?

Call your doctor if your symptoms last more than seven to 10 days or if your symptoms are getting worse. Also call if you have a fever greater than 101.5°F, a very bad headache that isn't helped with over-the-counter pain medicines, or changes in vision or swelling around your eyes, or if your symptoms continue after you have finished taking all of the antibiotics your doctor prescribed.

Where can I get more information?

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