Dealing with chronic sinusitis, also known as a chronic sinus infection, can be a miserable experience and, quite frankly, a little gross.
No one who has ever had a sinus infection would compare it to having a stuffy nose — because when you have a sinus infection, your nose feels like it's completely blocked, and no amount of nose-blowing brings relief. Thick yellowish-green mucus fills your nasal and sinus cavities, and drains out of your nose, or worse, down the back of your throat — causing bad breath and sometimes even an upset stomach.
Intense pressure builds up in your head and ears and behind your eyes. Your face, especially around the eyes and nose, feels tender. And, you're tired — tired of coughing, having a fever and a sore throat, feeling fatigued, and suffering from an onslaught of headaches.
Now imagine dealing with the symptoms of a chronic sinus infection for 12 weeks or longer. Sufferers of chronic sinusitis don't have to imagine it.
What are the different types of sinus infections?
Sinusitis is categorized based on how long the condition lasts as well as its frequency:
- Acute sinusitis usually lasts a few weeks, but less than a month. There is a subcategory of acute sinusitis, called recurrent acute sinusitis, which occurs when someone gets four or more sinus infections in a year, with symptoms resolving after each one.
- Subacute sinusitis lasts one to three months.
- Chronic sinusitis lasts three months or more.
How do sinus infections start?
Sinusitis occurs when the lining of the sinus or nasal cavity becomes inflamed. What can start as inflammation in your sinuses from a respiratory infection, allergies or environmental pollutants can spark a sinus infection when the lining of the sinuses becomes inflamed and swollen, causing mucus to become trapped and germs to grow.
"Once you have a cold or upper respiratory tract infection, that virus can then settle into the sinuses and cause inflammation as well," says Dr. Mas Takashima, an otolaryngologist (ear, nose and throat specialist) and chair of Houston Methodist ENT Specialists. "About 95% of sinusitis is caused by a virus — making it much more common than bacterial sinusitis. Viral sinusitis is also much more infectious as well."
Certain conditions, such as having allergies, asthma or a respiratory infection, can make people more susceptible to getting chronic sinus infections, and it is important that these patients be evaluated to address the cause and not just the sinusitis symptoms.
"There are many causes of chronic sinusitis. Patients with a weakened immune system are more prone to getting recurrent acute sinusitis," explains Dr. Takashima. "Sometimes, however, the issue may be anatomy, such as a deviated septum (the wall between the nostrils), scarring from previous sinus surgery, or nasal polyps, which result from chronic inflammation in the nose. Once the polyps get to a certain size, they rarely regress on their own and they narrow the sinus drainage pathways."
"In some of these cases, a surgical solution may be appropriate to open the sinuses, allowing them to aerate and drain better," adds Dr. Takashima.
This procedure may be performed in your doctor's office via a balloon dilation of the sinuses, or in the operating room with traditional endoscopic sinus surgery.
How do you treat a sinus infection?
Treatment for acute and chronic sinus infections include self-care, over-the-counter and prescription medications, and sinus surgery, if necessary, to enlarge the opening to the sinuses or address other anatomical issues.
Your doctor may also recommend a combination of over-the-counter and prescription medications, including:
- Antibiotics
- Decongestants
- Over-the-counter pain relievers, such as acetaminophen (Tylenol) or ibuprofen (Advil or Motrin)
- Steroid nasal sprays
- Saline nasal irrigations
Patients with sinusitis often go to the doctor expecting to get a prescription for an antibiotic. If you have signs of a sinus infection, talk to your doctor about whether an antibiotic is appropriate to treat the type of infection that you have. Dr. Takashima warns that we must be vigilant about not treating viral infections with antibiotics, which only work on bacterial infections, to prevent creating superbugs — antibiotic-resistant bacteria.
What can I do to find relief from a sinus infection?
- Place a warm compress over your face to help relieve sinus pressure
- Breathe in steam by placing a towel over your head and leaning over a bowl or sink full of hot water to allow the steam to relieve congestion. WARNING: Make sure that the water is not too hot because steam can cause burns
- Rinse the sinuses. Dr. Takashima recommends using a squeeze bottle for effective nasal irrigation
- Keep the nasal passages moist by using a saline nasal spray
- Rest
- Stay hydrated
- Use a humidifier to add moisture to the air
What should I do when a sinus infection won't go away?
If symptoms don't improve after 10 days or if you have a persistent fever for more than three or four days, seek medical attention. Also, if you have a history of recurrent acute sinusitis or chronic sinusitis, consider seeing an ear, nose and throat specialist for evaluation and treatment.
How can I prevent a sinus infection?
One of the best ways to prevent chronic sinusitis is to avoid the initial infection. Follow these tips:
- Wash your hands often with soap and water for a least 20 seconds, especially when coming into contact with commonly used surfaces. If soap and water are not available, use a hand sanitizer
- Avoid anyone with a cold, flu or other respiratory illness
- Stop smoking or avoid secondhand smoke
If you have a sinus infection, stay home, if you can. Remember to wash your hands, cough or sneeze into a tissue and keep your distance from others so that you avoid making others sick.
"Or, as COVID-19 has taught us, wear a mask," says Dr. Takashima.
Need care now?
Houston Methodist Virtual Urgent Care offers on-demand video visits from wherever you are, no appointment needed. Our board-certified providers are available 24/7 to address many common health issues.
