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Sinus Infection: Symptoms, Causes, Treatments

Marion Sereti

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July 5, 2023
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A woman blowing her nose due to sinus infection she has
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What are Sinus Infections? Sinuses are air-filled cavities in the skull. They are hollow spaces situated within the bones of the skull and face, encompassing areas like the forehead, cheeks, and the region behind the nose. Sinus infections, also known as sinusitis1 or rhinosinusitis, are when the tissues lining the sinuses become inflamed and swollen, due to attack by a bacteria or virus, response to allergens, or pre-existing conditions like cystic fibrosis.

Normally, the sinuses are free from bacteria and other microbes, and the mucus produced by the lining of the sinuses can usually drain out, allowing air to circulate freely. However, if the sinus openings become obstructed or if too much mucus accumulates, it can create an environment conducive to the growth of bacteria and other harmful germs, making it difficult to breathe.

Sinus infections can affect the different types of sinuses in the head, including the:

  • Maxillary sinuses – Located in the cheekbones
  • Frontal sinuses – Located above the eyebrows
  • Ethmoid sinuses – Located between the eyes and behind the nose
  • Sphenoid sinuses – Located deep in the skull, behind the ethmoid sinuses
An image showing the structure of sinuses
Source: Cappello, Z. J., Minutello, K., & Dublin, A. B. (2018). Anatomy, head and neck, nose paranasal sinuses.

Addressing sinus infection issues is important because, if left untreated, sinus infections can lead to a range of complications, as you will find out later in this article.

Sinus Infection Symptoms

The signs and symptoms of a sinus infection can vary depending on the severity and duration of the condition, but some of the classic sinus infection symptoms2:

  • Post-nasal drip
  • Runny/stuffy nose – Nasal discharge that is discolored and has a greenish hue
  • Congestion
  • Face sensitivity, pain, or pressure
  • Headaches
  • Cough
  • Fever
  • Bad breath
  • Sore throat
  • Pain in teeth 

Sinus infections can be classified based on their duration and underlying cause. Duration is based on how long the symptoms last. The categories are:

  • Acute sinusitis3 – A short-term infection, usually caused by a virus, that lasts up to 4 weeks
  • Subacute sinusitis – An infection that lasts longer than 4 weeks but less than 12 weeks
  • Chronic sinusitis4 – A long-term infection that persists for 12 weeks or longer and may be caused by a bacterial, fungal, or viral infection
  • Recurrent sinusitis – Repeated acute or chronic sinusitis, with episodes lasting less than 12 weeks

Causes and Risk Factors of Sinus Infections

While viruses most typically bring on sinus infections, in some situations, bacteria, fungi, and allergens may also be to blame. All can cause inflammation in the sinus cavity for various reasons. Several factors can contribute to the development of a sinus infection:

Environmental Factors

Environmental conditions that can cause sinus infections include:

  • Pollen, dust mites, pet dander, mold, other allergens, and air pollution – These can aggravate the sinuses and nasal passages.
  • Smoke – Cigarette smoke can harm the sinus lining and weaken the immune system, making you more prone to infections, whether it is inhaled directly or as secondhand smoke.
  • A change in the weather or barometric pressure – If the air in the sinuses has difficulty circulating freely, change in the atmosphere’s pressure can cause sinus pain as the air in the sinuses struggles to equalize with the air outside.
  • Swimming in chlorinated pools or other water sources – Bacteria love to live in damp environments that may not be cleaned enough, like outdoor swimming pools, but even if pools are treated and cleaned, the chlorine itself can irritate the sinuses enough to cause sinusitis.
  • Dry air – This results in dryness and inflammation of the nasal passages.
  • Certain occupations or environments – Spending much time in an environment, such as at work, that exposes you to airborne irritants or pollutants such as cigarette smoke, air pollution, and chemicals can increase the risk of sinus infections
Environmental causes of sinusitis

Pre-Existing Medical Conditions

Additionally, several pre-existing medical conditions may increase the risk of developing a sinus infection. These include:

  • Allergies5 – When encountering something it is allergic to, like pollen, one of the bodies’ responses is inflammation, which at high levels in the sinuses can result in sinusitis
  • Asthma6 – This can cause inflammation in the sinuses and nasal passages
  • Cystic fibrosis – This is a genetic disorder that can cause thick mucus to accumulate in the sinuses and lungs
  • Structural abnormalities7 in the nasal passages or sinuses – These include; a deviated septum or narrow sinus openings, and can make it more difficult for mucus to drain properly, increasing the risk of infections
  • Gastroesophageal reflux disease (GERD) – If stomach acid flows back into the throat, it can irritate the sinuses.
  • Nasal polyps – Small, noncancerous growths that can block the sinuses and lead to infections8
  • Immune system disorders – Including HIV/AIDS or autoimmune diseases, such disorders weaken the body's ability to fight off infections.

Other Risk Factors

Other factors that increase your likelihood of developing a sinus infection include:

  • Being young –Children9 are more likely to develop sinus infections than adults, as their immune systems are still developing and may be more prone to viral infections.
  • Infections in the teeth or gums can spread to the sinuses and increase the risk of sinus infections10

Sinus Infection Complications

Some sinus infections clear up on their own. Viral infections cannot be treated with antibiotics and all treatment involves is symptom relief. According to the American Academy of Allergy, Asthma, and Immunology, around 70% of individuals with acute sinusitis recover without taking antibiotics11. According to the CDC, taking antibiotics when they are not needed can be harmful due to potential side effects12.

However, treating them is generally the best way to speed this up, as untreated sinus infections can develop complications. These include:

  • Chronic sinusitis – If sinusitis is left untreated, it can develop into a chronic condition that may require long-term management
  • Asthma attacks or other exacerbations of the condition
  • Spread of infection – Sinus infections can spread to other areas of the body, including the eyes, brain, and bones of the face
  • Vision problems – Sinus infections that affect the eye area can cause vision problems and even blindness if left untreated, and even normal sinus infections can cause you to squint or want to close your eyes a lot, making it more difficult to function
  • Meningitis (inflammation of the protective membranes surrounding the brain and spinal cord) – In rare cases, sinus infections can lead to meningitis, a serious and potentially life-threatening condition
  • Osteomyelitis – Infection and inflammation of the bones
  • Cavernous sinus thrombosis – Blood clots in the veins beneath the brain ()
  • Abscesses or pus pockets in the brain (brain abscess)

Treatment of Sinus Infection 

Treatment of a sinus infection depends on its underlying cause13. It's important to consult a healthcare provider to determine the appropriate treatment. If it's an acute infection, treatment may involve managing symptoms with medications such as;

  • Over-the-counter pain relievers – Drugs such as acetaminophen, ibuprofen, or naproxen can help relieve sinus pain and headaches
  • Decongestants – To help reduce swelling in the nasal passages, making it easier to breathe
  • Antibiotics – If the sinus infection is bacterial, antibiotics may be prescribed to help clear the infection. However, antibiotics are not effective for viral sinus infections.
    • In certain instances, a doctor may recommend watchful waiting or delayed antibiotic prescribing. Watchful waiting involves monitoring the symptoms for a few days to see if the infection resolves on its own before considering antibiotics. Delayed prescribing involves prescribing antibiotics but advising the patient to wait a few days before taking them, as there is a possibility that the symptoms may improve without medication.

If the sinus infection is chronic or severe, other treatments may be recommended by your physician and may include:

  • Nasal corticosteroids – These sprays help reduce inflammation and swelling in the nasal passages, allowing for better drainage and less congestion
  • Allergy shots
  • Surgery  

It's important to consult with a healthcare provider to determine the best course of treatment for your specific case.

Home Remedies for Sinus Infection

The primary objective of treating acute sinus infections is alleviating symptoms14. Below is how to get rid of a sinus infection:

  • Consuming plenty of fluids and getting adequate rest
  • Inhaling steam from a hot water bowl or shower on multiple occasions throughout the day
  • Utilizing a humidifier
  • Placing a warm, moist washcloth or compress over the nose, cheeks and forehead alleviates discomfort.
  • Saline nasal rinses15 – These are a natural way to flush out mucus and improve breathing. They can be used as a standalone treatment or in combination with other medications. You can use a saline nasal spray or nasal wash like a Neti Pot to flush out the sinuses. To safeguard yourself against a life-threatening brain infection16, make sure to use safe water.
  • Lifestyle changes that may help alleviate symptoms such as:
    • Quitting smoking 
    • Changing home or work conditions to reduce exposure to environmental toxins and allergens, such as dust mites, pet dander, or cockroaches
Treatments for sinusitis

Prevention of Sinus Infections

To reduce the risk of developing sinus infections, it is important to maintain good health and prevent the spread of illness. CDC highlights some measures and precautions to prevent the spreading of the infection, which may include:

  • Practicing good hygiene by washing your hands regularly with soap and water17
  • Getting vaccinated as recommended, such as for the flu and pneumonia
  • Avoiding close contact with individuals who have colds or other respiratory infections
  • Refraining from smoking and avoiding exposure to secondhand smoke
  • Using a clean humidifier to add moisture to the air in your home

Frequently Asked Questions

How long does a sinus infection last?

Acute sinusitis is characterized by symptoms that persist for less than four weeks. Chronic sinusitis is characterized by symptoms that last for more than 12 weeks. However, several factors can contribute to the prolongation of a sinus infection, including bacterial infection, allergies, weak immune system, structural problems, or chronic sinusitis.

How long is a sinus infection contagious?

A sinus infection caused by a virus is typically contagious as long as the symptoms last, which means it lasts 7–10 days. However, it is important to note that not everyone with a sinus infection is contagious. Unlike viral infections, sinus infections caused by bacteria cannot be transmitted from one person to another.

Conclusion

While sinus infections can be bothersome and interfere with daily activities, there are a number of approaches to treat them and speed up recovery. 

Antibiotics can be helpful in some circumstances, but it's important to be aware that they aren't always necessary or useful (such as for a viral sinus infection) and may have unwanted effects. Instead, you can effectively manage sinus infections by maintaining proper hygiene, utilizing over-the-counter medicines, and talking to your doctor about treatment options. Proper diagnosis and treatment of sinus infections are important to prevent complications and improve quality of life.

Remember that prevention is important; therefore, adopting measures to maintain healthy sinuses and avoid potential irritants can significantly lower your risk of getting sinus infections.

References
  1. Battisti, A. S. (2023, March 2). Sinusitis. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK470383/[]
  2. CDC (2022, August 24). Suffering from a sinus infection? Centers for Disease Control and Prevention. Retrieved 23rd May from https://www.cdc.gov/antibiotic-use/sinus-infection.html[]
  3. DeBoer, D. L., Kwon, E. (2022, August 8). Acute Sinusitis. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK547701/[]
  4. Kwon, E., O’Rourke, M. C. (2022, August 8). Chronic Sinusitis. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK441934/[]
  5. WHO Team. (2019, September 18). Noncommunicable diseases: Allergic rhinitis and sinusitis. World Health Organization. https://www.who.int/news-room/questions-and-answers/item/noncommunicable-diseases-allergic-rhinitis-and-sinusitis[]
  6. Staudacher, A. G., & Stevens, W. W. (2019). Sinus Infections, Inflammation, and Asthma. Immunology and allergy clinics of North America, 39(3), 403–415. https://doi.org/10.1016/j.iac.2019.03.008[]
  7. Naclerio, R. M., Bachert, C., & Baraniuk, J. N. (2010). Pathophysiology of nasal congestion. International journal of general medicine, 3, 47–57. https://doi.org/10.2147/ijgm.s8088[]
  8. Mayo Clinic Staff (2021, Feb 11). Nasal polyps. Mayo Clinic. Retrieved 23rd May 2023 from https://www.mayoclinic.org/diseases-conditions/nasal-polyps/symptoms-causes/syc-20351888#[]
  9. Cao, Z. Z., Xiang, H. J., Gao, J. J., Huang, S. Y., Zheng, B., Zhan, X., Chen, R. R., & Chen, B. B. (2018). Lin Chuanc er bi yan hou tou jing wai ke za zhi [Prevalence of allergy in children with acute rhinosinusitis] [Article in Chinese] Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery, 32(18), 1377–1382. https://doi.org/10.13201/j.issn.1001-1781.2018.18.004[]
  10. Mayo Clinic Staff. (2022, June 29). Tooth Abscess - Symptoms and causes. Mayo Clinic. Retrieved 23rd May 2023 from https://www.mayoclinic.org/diseases-conditions/tooth-abscess/symptoms-causes/syc-20350901[]
  11. Sinusitis. (n.d.). American Academy of Allergy, Asthma & Immunology. Retrieved 23rd May from https://www.aaaai.org/Conditions-Treatments/allergies/sinusitis[]
  12. Centers for Disease Control and Prevention. (2019, August 27). Sinus Infection (Sinusitis). CDC. Retrieved 23rd May 2023 from https://www.mayoclinic.org/diseases-conditions/tooth-abscess/symptoms-causes/syc-20350901[]
  13. Centers for Disease Control and Prevention. (2019, August 27). Sinus Infection (Sinusitis). CDC. Retrieved 23rd May 2023 from https://www.mayoclinic.org/diseases-conditions/tooth-abscess/symptoms-causes/syc-20350901[]
  14. Centers for Disease Control and Prevention. (2019, August 27). Sinus Infection (Sinusitis). CDC. Retrieved 23rd May 2023 from https://www.mayoclinic.org/diseases-conditions/tooth-abscess/symptoms-causes/syc-20350901[]
  15. Tomooka, L. T., Murphy, C., & Davidson, T. M. (2000). Clinical Study and Literature Review of Nasal Irrigation. The Laryngoscope, 110(7), 1189–1193). Wiley. https://doi.org/10.1097/00005537-200007000-00023[]
  16. Centers for Disease Control and Prevention. (2023, May 3). Ritual Nasal Rinsing & Ablution. CDC. Retrieved 23rd May 2023 from https://www.cdc.gov/parasites/naegleria/ritual-ablution.html[]
  17. Centers for Disease Control and Prevention. (2022, November 15). When and How to Wash Your Hands. CDC. Retrieved 23rd May 2023 from https://www.cdc.gov/handwashing/when-how-handwashing.html[]

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