In brief
- The sinuses are located to the left and right of your nose in the bone of your upper jaw and forehead.
- You could have a sinus infection when you have a cold (runny or blocked nose) and additional symptoms, such as pain in your face or loss of smell.
- Sometimes, cold symptoms or loss of sense of smell can be caused by coronavirus.
- Chewing or leaning forward can be painful or make the pain worse.
- A sinus infection usually clears up on its own in 1 to 3 weeks.
- Nasal spray or drops and paracetamol can help relieve the symptoms.
- Antibiotics do not affect the symptoms or the recovery.
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What is a sinus infection?
The paranasal sinuses are located to the left and right of your nose in the bone of your upper jaw (maxillary sinus) and forehead (frontal sinus).
The top of the maxillary sinuses borders the eye socket. The roots of the upper teeth begin just under the maxillary sinuses.
All sinuses are connected to the nasopharynx through a small opening. The nasopharynx is where the back of the nose meets the throat. The sinuses and the nasopharynx are covered with a mucous membrane.
Whenever you have a cold, the mucous membranes of the sinuses and the nasopharynx are inflamed. You could have a sinus infection when, in addition to cold symptoms (runny, snotty or blocked nose) you also lose your sense of smell and feel pain/pressure in your face.
Sometimes, cold symptoms or loss of sense of smell can be caused by coronavirus.
What are the symptoms of a sinus infection?
A sinus infection usually starts with a common cold: a runny, snotty or blocked nose and sneezing. The snot can be watery, yellow or green, sometimes with some traces of blood. Snot that leaks into the back of your throat sometimes leads to coughing (especially at night).
A sinus infection is when you develop any of the following symptoms in addition to a common cold:
- You feel pressure or pain in your upper jaw, face or forehead.
- You lose your sense of smell.
- The roots of your upper teeth and molars can be painful.
- Chewing or leaning forward can be painful or make the pain worse.
- Usually the infection is on one side (left or right), sometimes with some swelling of the cheek.
- If you have a sinus infection, you may have a fever.
How does a sinus infection develop?
Colds are usually caused by a virus, sometimes by bacteria. They cause the mucous membranes to become inflamed, making the mucous membranes swell up and produce a lot of mucus (snot).
The swollen mucous membrane and the snot can block the opening between the sinuses and the nasopharynx. The snot becomes thicker and can no longer drain away properly. Basically, the sinus gets too full. This can cause you to feel pressure or pain.
Advice for a sinus infection
- Quit smoking. Smoking irritates the mucous membranes and delays healing.
- Inhaling steam can help ease the symptoms. For example, lean your face over a bowl of hot water for 15 minutes 3 times a day. Be careful not to burn yourself with hot steam or by knocking over a bowl of hot water.
- Don’t let the temperature of the water get above 60 degrees Celsius.
- Young children should not inhale steam, because they have a greater risk of getting burnt.
- Adding something to the water (such as salt or menthol) is not useful. Children younger than 2 years old may not use menthol anyway.
- You can also inhale steam in the bathroom or shower by running the hot water and carefully inhaling the steam in the room. Do not inhale steam from a special kitchen tap with boiling water. The risk of burns is then very high.
- Using a saline nasal spray or drops can help ease the symptoms.
- You can buy the saline solution ready-made (as drops or a spray) from the chemist’s/drugstore or pharmacy. This is convenient and this way you also get a dropper (pipette) or spray cap. You may also give the ready-made saline solution to young children (including babies and children younger than 2 years old, although they usually find the drops or spray unpleasant).
- You can also make the saline solution yourself, for adults and children 6 years old and older. To do this, sprinkle 9 grams of table salt into 1 litre of lukewarm water. Use clean scales and a clean bottle that has been boiled to sterilise it. You can use the drops or spray a few times a day (or as often as needed). The home-made saline solution should not be given to children younger than 6 years old.
Inhaling steam or using saline solution does not make you recover any faster.
It is unclear whether it is better to blow your nose or to sniff. If you blow your nose too hard, you also blow the snot towards the sinuses.
Medication for a sinus infection
Medication is not necessary. A sinus infection clears up on its own.
If you like, you can use the following:
- Some people use xylometazoline spray or drops. This reduces swelling of the mucous membrane in the nasopharynx and eases the symptoms of a blocked nose. Xylometazoline can be purchased from the chemist’s/drugstore or pharmacy. You can use it 3 times a day, but not longer than 1 week.
Xylometazoline should not be given to children between 2 and 6 years old. If necessary, only if the blocked nose causes much discomfort and saline solution does not help enough. In that case, use xylometazoline 0.05% for children between 2 and 6 years old.
Do not give xylometazoline to children younger than 2 years old. They could have rare but serious side effects from it. - If necessary, you can use a painkiller. Preferably use paracetamol (acetaminophen) because it works well and has little chance of side effects. Adults can take 1 or 2 tablets (500 mg each) 2 to 4 times a day. If that does not help, adults can try a different painkiller, such as ibuprofen or naproxen . These 2 painkillers can cause side effects, such as stomach problems or sometimes severe allergic reactions.
Antibiotics are usually not necessary for a sinus infection. They do not affect the symptoms or the recovery from a normal sinus infection. Antibiotics can often cause side effects, especially gastrointestinal and vaginal problems. You could also become allergic to the antibiotic, after which you will never be able to use it again.
If you have a weakened immune system (for example, due to an illness or because you are taking certain medication), antibiotics may sometimes be necessary for a sinus infection.
What happens next if you have a sinus infection?
A sinus infection usually clears up on its own in 1 to 3 weeks. 1 in 10 people still have symptoms after 3 weeks.
When should I call my doctor for a sinus infection?
Call your GP’s office if you have a sinus infection and any of the following symptoms:
- You are very ill (fever and not able to do anything).
- You have a fever for more than 5 days.
- You have a fever again after a few fever-free days.
- The symptoms of the sinus infection have not improved after 2 weeks.
- You get a very bad headache.
- You are nauseous and vomiting.
- You become very drowsy.
- You develop symptoms in 1 eye:
- The eyelids are swollen or red.
- Your eye hurts, is swollen and bulges out.
- You suddenly have poorer or double vision.
- You have a swelling on your forehead.
Antibiotics may sometimes be necessary if you have these additional symptoms.
More information about sinus infection
The information about sinus infection is based on:
- the GPs’ guideline on ‘Acute rhinosinusitis’.