Sinusitis (sinus infection)Overview

Sinusitis is swelling of the sinuses, usually caused by an infection. It's common and usually clears up on its own within 2 to 3 weeks. But medicines can help if it's taking a long time to go away.

Sinusitis is common after a cold or flu.

Symptoms of sinusitis include:

• pain, swelling and tenderness around your cheeks, eyes or forehead
• a blocked nose
• a reduced sense of smell
• green or yellow mucus from your nose
• a sinus headache
• a high temperature of 38C or above
• toothache
• bad breath

Signs of sinusitis in young children may also include irritability, difficulty feeding, and breathing through their mouth.

What are the sinuses?

The sinuses are small, empty spaces behind your cheekbones and forehead that connect to the inside of the nose.

Sinusitis causes the lining of the sinuses to swell up.

This stops mucus draining into your nose and throat properly, making you feel blocked up.

You can often treat mild sinusitis without seeing a GP by:

• getting plenty of rest
• drinking plenty of fluids
• taking painkillers, such as paracetamol or ibuprofen (do not give aspirin to children under 16)
• avoiding allergic triggers and not smoking
• cleaning your nose with a salt water solution to ease congestion

How to clean your nose with a salt water solution

1. Boil a pint of water, then leave it to cool.
2. Mix a teaspoon of salt and a teaspoon of bicarbonate of soda into the water.
3. Wash your hands.
4. Stand over a sink, cup the palm of 1 hand and pour a small amount of the solution into it.
5. Sniff the water into 1 nostril at a time.
6. Repeat these steps until your nose feels more comfortable.

You do not need to use all of the solution, but use a fresh one each day.

You might also want to try:

• holding a warm clean flannel over your face for a few minutes several times a day
• inhaling steam from a bowl of hot water (do not let children do this because of the risk of scalding)

But there's no evidence that warm face packs or steam will help your symptoms, so there's no guarantee these will work.

A pharmacist can help with sinusitis

A pharmacist can advise you about medicines that can help, such as:

• decongestant nasal sprays or drops to unblock your nose (decongestants should not be taken by children under 6)
• salt water nasal sprays or solutions to rinse out the inside of your nose

You can buy nasal sprays without a prescription, but they should not be used for more than a week.

Find a pharmacy

See a GP if:

• your symptoms are severe
• painkillers do not help or your symptoms get worse
• your symptoms do not improve after a week
• you keep getting sinusitis

If you have sinusitis, a GP may be able to recommend other medicines to help with your symptoms, such as:

• steroid nasal sprays or drops – to reduce the swelling in your sinuses
• antihistamines – if an allergy is causing your symptoms
• antibiotics – if a bacterial infection is causing your symptoms and you're very unwell or at risk of complications (but antibiotics are often not needed, as sinusitis is usually caused by a virus)

You might need to take steroid nasal sprays or drops for a few months. They sometimes cause irritation, sore throats or nosebleeds.

Your GP may refer you to an ear, nose and throat (ENT) specialist if, for example, you:

• still have sinusitis after 3 months of treatment
• keep getting sinusitis
• only have symptoms on 1 side of your face

They may also recommend surgery in some cases.

Surgery for sinusitis

Surgery to treat chronic sinusitis is called functional endoscopic sinus surgery (FESS).

FESS is carried out under general anaesthetic (where you're asleep).

The surgeon can widen your sinuses by either:

• removing some of the blocked skin tissue
• inflating a tiny balloon in the blocked sinuses, then removing it

You should be able to have FESS within 18 weeks of your GP appointment.

The ENT UK website has more information about FESS (PDF, 506kb).