How to Treat a Sinus Infection

Acute rhinosinusitis, or a sinus infection, is the result of irritated mucosal tissue in the nasal and sinus cavities. This irritation may be traced back to a virus, allergy or irritant—or, in rarer cases, bacteria—which can trigger nasal congestion and discharge, toothache, facial pain or pressure, fever, fatigue, cough, ear discomfort, headache, a reduced sense of smell, and bad breath. The illness can last as long as a month, though most cases resolve within a week.

How it should be treated: Your doctor may prescribe a steroid nasal spray or recommend an over-the-counter steroid spray (Nasacort) to relieve nasal inflammation. A prescription mucolypic drug or an OTC version like Mucinex or Robitussin can help clear mucus from the airway. Antibiotics have no effect on acute viral sinus infections.

What you can do: OTC decongestants, antihistamines, and pain relievers can reduce symptoms. But follow the directions carefully: OTC decongestant nasal spray shouldn’t be used for more than three days in a row. Some people find nasal irrigation helpful. This process involves flushing the nose and sinuses with a saline solution. Placing a warm compress over the nose and forehead may help relieve pressure. Rest and drink plenty of fluids.

When to call your doctor: If your symptoms don’t improve after 10 days of treatment, are severe (such as a fever greater than 102.2° F) and persist for at least three days, or improve but then worsen again, your sinus infection may be bacterial, and your doctor may prescribe antibiotics. Even in cases eligible for antibiotics, an uncomplicated acute sinus infection may improve without treatment. See your doctor, too, if you get more than four sinus infections a year. This frequency could indicate chronic sinusitis.

If you use any prescription or OTC drugs, ask your doctor or pharmacist whether they’ll interact with any of the suggested treatments. Carefully read and follow the directions on drug labels and beware of a drug’s side effects. For example, certain antihistamines like Benadryl are not recommended for people over age 65 because they may cause drowsiness and dizziness.

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HealthAfter50 was published by the University of California, Berkeley, School of Public Health, providing up-to-date, evidence-based research and expert advice on the prevention, diagnosis, and treatment of a wide range of health conditions affecting adults in middle age and beyond. It was previously part of Remedy Health Media's network of digital and print publications, which also include HealthCentral; HIV/AIDS resources The Body and The Body Pro; the UC Berkeley Wellness Letter; and the Berkeley Wellness website. All content from HA50 merged into in 2018.