Each year, nearly 30 million Americans are diagnosed with a sinus infection. Commonly referred to as “acute sinusitis,” sinus infections occur when inflammation of the lining of the nose and sinus cavities develop. As one of the most common illness in the country, they are a very frequent reason for patients to seek urgent medical care. In this Q & A, Catherine Spaulding, MD, a physician at Mount Sinai Urgent Care, explains how to identify a sinus infection and how best to treat your symptoms.  

How do I know if I have a sinus infection?

Look for the common symptoms such as a runny or congested nose, headaches, as well as pain and pressure in the sinuses — which are located above and below the eyes and on either side of the nose.

Frequently, sinus infections also cause a sore throat and coughing that is worse at night or the first thing in the morning. This is caused by post nasal drip and occurs when mucus drains down the back of the throat—most common when lying flat—resulting in  irritation of the throat, a scratchy or hoarse voice, and/or a cough.

Symptoms of a sinus infection typically last between three to ten days.

How do I tell the difference between COVID-19 and a sinus infection?

Distinguishing between COVID-19 and a sinus infection can be difficult since both can cause nasal congestion, a sore throat, headaches and sinus pain or pressure.  However, COVID-19 is more commonly associated with a fever, cough, body aches, chills, chest tightness, shortness of breath and occasionally with diarrhea. It is best to share all of your symptoms with your doctor to help determine if you should be tested for COVID-19.

Do I need to take antibiotics to get rid of my sinus infection?

Typically, no. While antibiotics are useful in treating bacterial infections, they are powerless against viruses. Taking antibiotics when they are not necessary or indicated can lead to resistant bacterial infections and unwanted medication side effects. Because of this, it is important to discuss whether an antibiotic is really needed when treating any infection.

Only around two percent of sinus infections are caused by bacteria. However, there are several instances in which your doctor might recommend antibiotics for treatment. This includes:

• If your symptoms persist beyond 10 days without any improvement
• If your illness worsens after day seven
• If you have fevers with a temperature greater than 102 F at the start of symptoms
• If you have a history of immunocompromising conditions—such as cancer, a history of an organ transplant, poorly controlled HIV or an immunodeficiency —or use of immunosuppressant medications—such as high doses of corticosteroids or  chemotherapy
• If you have undergone sinus surgery

What should I take to treat my symptoms?

Like the common cold, most sinus infections will go away on their own. Treatment  should be aimed at relieving congestion in the nose and sinus passages. Doing so not only improves symptoms of the infection but reduces the possibility of developing a secondary bacterial infection. Here are some things to try at home:

• Rinse your nasal passages with saline. Use a nasal saline rinse or spray twice daily to remove the mucus from the sinus cavities. This will allow you to breathe much easier.
• Use a nasal steroid spray. After rinsing out your nose with saline, use a nasal steroid spray such as Fluticasone—one spray in each nostril twice daily— to reduce post nasal drip and congestion.
• Try an over the counter decongestant. Medications such as pseudoephedrine provide additional help in relieving your stuffy, runny nose. But keep in mind that pseudoephedrine is a mild stimulant that can cause insomnia, so avoid taking right before bedtime. Additionally, it can raise your blood pressure so those with hypertension should not take this and should try Coricidin instead.
• Use a bedside humidifier. Running a humidifier while you sleep can help to moisten the nasal passages and throat which will improve the flow of mucus by thinning it . If you do not have a humidifier, try taking a steam shower before bed for the same effect.
• Take preventative measures. If you have a history of seasonal allergies, consider starting a daily antihistamine to prevent inflammation and mucus production.