What do the common cold, flu and allergies have in common? They all can lead to a sinus infection, says board-certified otolaryngologist Jordan Josephson, MD. Here’s what you need to know to keep your sinuses healthy…
We each have four pairs of sinuses—hollow cavities located behind the bones around the eyes and nose. The sinuses filter the air that we breathe into our lungs…create mucus to keep nasal passages moist…and trap dust, dirt and infection-causing bacteria, fungus and the viruses that cause flu, COVID and the common cold.
As with other tissues in the body, the lining of your sinuses can become inflamed and swollen when infected That leads to congestion and malfunction of the filtering process. The infection can drip into the lungs, causing bronchitis or worsening asthma, leading to a cough or difficulty breathing. A sinus infection also can start due to inflammation caused by allergies, pollutants such as tobacco or marijuana smoke, or a physical obstruction including nasal polyps (benign growths in the sinuses) or a deviated septum.
When an infection invades your sinuses, normally imperceptible mucus becomes thick and possibly discolored (yellow, green, tan or brown). Congestion in the sinuses can lead to nasal obstruction, nasal discharge, headaches and/or facial pain, sore throat, postnasal drip, cough, mouth-breathing, chapped lips, snoring, sleep apnea, clogged ears, throat clearing, hoarseness and/or nose bleeds. You also might experience fatigue and difficulty sleeping.
If the underlying cause of a sinus infection is a virus or bacteria, the germs that caused the infection can spread to other people if they become airborne when you cough or sneeze. People also can come in contact with germs on surfaces or used tissues. Your hands also can carry the virus, and that is why it is so important to wash them frequently.
While the common cold may be gone in five days, an acute sinus infection can last two or three weeks (beyond that is considered chronic). A sinus infection caused by a virus often goes away on its own without medication. To feel better: Irrigate your sinuses with saline using a neti pot, a squeeze bottle or the SinuPulse Nasal Irrigation System (which looks like a Waterpik-style device) to wash out allergens and/or infection (virus, bacteria and/or fungus). If you have a lot of congestion or increased postnasal drip, you also may want to use a nasal steroid spray such as Flonase. Other things to do for a sinus infection: Get a lot of rest…drink lots of fluids…and eat nutritious foods. A steamy shower can help clear nasal passages, and a warm compress can ease sinus pressure.
Clearing the congestion can help prevent a viral infection from becoming bacterial. If severe congestion prevents mucus from draining, trapped bacteria and/or fungus can start to grow. One sign that a sinus infection has turned from viral to bacterial is when symptoms that had started to improve return with a vengeance.
See your doctor if any of the symptoms listed above, such as postnasal drip, coughing and/or congestion, last longer than a week…you have a fever…and/or the mucus changes color (usually to yellow or green). Most infections that clear in less than a week are not bacterial, so you shouldn’t start an antibiotic unless deemed necessary by your physician.
When you need medication: Various broad-spectrum antibiotics can be used initially to treat a bacterial sinus infection. Your physician may choose amoxicillin with clavulanate (Augmentin) in the penicillin family…a cephalosporin…or a Z-Pack (azithromycin) depending on your presentation and allergy profile. If those don’t work, your physician may take a culture to guide a further course of action.
Important: With a bacterial sinus infection, you should take the full course of the antibiotic—typically 10 to 14 days. Don’t stop taking the antibiotic when you feel better after just a few days. This is when resistant organisms can develop because the medication has killed only sensitive germs within those first few days, not the true culprits.
Avoiding sinus infections: Take all the steps you can to protect yourself from germs, including washing hands frequently…changing clothes and showering after exposure to pollen and other allergens if you’re allergic…getting your annual flu shot to avoid influenza…using a home dehumidifier if your home is very damp…using air filters to trap allergens and irritants because mold can lead to infections…and irrigating your nose and sinuses daily with a machine like the SinuPulse.
If you have sinus infections once a month or even every other month: See a board-certified ear, nose and throat (ENT) specialist or an allergist who specializes in sinus disease to determine if the inflammation you’re experiencing is viral, bacterial, fungal or allergic…and to learn how to stop them once and for all.
