Sinusitis: Symptoms, How Long It Lasts and What Actually Helps

Sinusitis is inflammation of the sinuses, the air-filled spaces in the bones around the nose, cheeks and forehead. It often follows a cold and can make your face feel heavy, painful and blocked for weeks. Many people assume a thick green discharge means they need antibiotics, but most sinusitis is viral and improves by itself. Understanding the usual timeline and the signs that something more serious is happening can save both discomfort and unnecessary medicine.

Symptoms

Common symptoms include pain, tenderness or pressure around the cheeks, eyes or forehead, a blocked or runny nose, reduced sense of smell, thick yellow or green mucus, mucus dripping down the back of the throat, headache, toothache, bad breath and sometimes a mild fever. Pain often worsens when bending forward. Children may have a persistent cough, nasal discharge and bad breath rather than obvious facial pain.

Sinusitis or a cold?

Colds and sinusitis overlap. A cold can lead to sinus inflammation. A typical cold peaks within a few days and improves over about a week, which our guide to how long a cold lasts describes. Sinusitis is more likely when facial pressure, congestion and discoloured mucus persist beyond ten days or when symptoms improve then suddenly get worse again. Mucus colour alone does not tell you whether an infection is viral or bacterial.

How long it lasts

Acute sinusitis usually improves within two to three weeks. Symptoms lasting more than 12 weeks are called chronic sinusitis, which has different causes and management, including allergies, nasal polyps and ongoing inflammation.

What helps

Most people can manage sinusitis at home. Rest, drink fluids and take paracetamol or ibuprofen for pain or fever. Saline nasal sprays or rinses can help clear mucus and are safe for repeated use. Some people find holding a warm flannel over the face or breathing in steam from a shower helps with pressure. Avoid bowls of boiling water, which cause scalds.

Decongestant sprays may briefly relieve a blocked nose, but should not usually be used for more than about a week because they can cause rebound congestion. A pharmacist can advise whether a decongestant or steroid nasal spray is suitable, particularly if you have high blood pressure, glaucoma, a heart condition or are pregnant.

Do you need antibiotics?

Usually not. Antibiotics make little difference for most people with acute sinusitis and can cause side effects. They may be considered when symptoms have lasted more than ten days without improvement, symptoms improve then worsen, there is severe facial pain and high fever, or someone has a condition that increases the risk of complications. Even then, a delayed prescription, used only if symptoms do not improve, is sometimes suggested.

Pharmacy First for sinusitis

In England, pharmacists can assess acute sinusitis in people aged 12 and over under Pharmacy First. They can recommend symptom relief, supply a nasal spray or antibiotics when clinical criteria are met and refer onwards when needed. Our guide to NHS 111, Pharmacy First and A&E explains the options.

Chronic and recurrent sinusitis

If sinus symptoms keep returning or last more than 12 weeks, see a GP. Treatment may include regular saline rinses, steroid nasal sprays, managing hay fever or other allergies and, occasionally, referral to an ear, nose and throat specialist. Nasal polyps, dental infections and smoking can all contribute. Loss of smell that lasts weeks has several possible causes, including viral infections. Our guide to smell loss after infection covers recovery options.

Preventing sinusitis

You cannot prevent every case, but reducing colds helps. Wash hands frequently, avoid smoking and second-hand smoke, manage allergies and keep indoor air reasonably fresh. Saline rinses may help people who get frequent sinus problems.

Sinusitis in children

Children have sinuses that are still developing. The forehead sinuses are not fully formed until the teenage years, so sinusitis in young children tends to look different. Rather than facial pain, a child may have a runny or blocked nose that lasts longer than ten days, thick discharge, a night-time cough, bad breath and tiredness. Most of these children have a lingering cold rather than a bacterial infection and improve with time, fluids and saline drops or sprays suitable for their age. Decongestant medicines are not recommended for young children. See a GP if a child has a high fever with facial swelling, symptoms that keep getting worse or any swelling or redness around the eye, which needs same-day assessment.

Sinusitis, allergies or a dental problem?

Hay fever and other allergies can cause blocked noses and facial pressure too, but they usually come with itchy eyes, sneezing and clear watery mucus and follow a seasonal or trigger-related pattern rather than starting with a cold. Pain in one cheek with toothache can occasionally come from an infected upper tooth rather than the sinus itself, particularly if the tooth is sensitive to biting or temperature, so a dentist is worth seeing if pain centres on a tooth. A persistent one-sided blocked nose with bleeding, particularly in someone who smokes, should also be checked by a GP rather than assumed to be sinusitis.

Air travel and swimming

Flying with sinusitis can be painful because pressure changes are harder to equalise through inflamed sinuses. If you must travel, a pharmacist may suggest a decongestant spray used shortly before take-off and landing. Chewing or swallowing during descent can also help. Diving should be avoided until symptoms settle. Swimming in chlorinated water can irritate the nose for some people but is not harmful in itself.

When to get help

See a pharmacist or GP if symptoms are severe, have not improved after about ten days, keep coming back or are worsening after an initial improvement. Seek urgent medical help the same day or call 999 for swelling or redness around the eye, double vision, reduced vision, difficulty moving the eye, severe headache, confusion, a stiff neck, high fever with feeling very unwell or swelling of the forehead. These can indicate rare but serious spread of infection to the eye socket, brain or surrounding bone.

A quick recap

Sinusitis causes facial pain or pressure, congestion and discoloured mucus, often after a cold. Most acute sinusitis clears within two to three weeks without antibiotics. Pain relief, fluids and saline rinses help, while decongestant sprays should only be used briefly. In England pharmacists can assess acute sinusitis in anyone aged 12 and over. Seek urgent help for eye swelling, vision changes, severe headache or confusion.

Frequently asked questions

Does green mucus mean sinusitis is bacterial?

No. Mucus colour can change with viral infections too, so it is not a reliable sign that antibiotics are needed.

How long does sinusitis last?

Acute sinusitis usually improves within two to three weeks. Chronic sinusitis lasts more than 12 weeks.

Is sinusitis contagious?

Sinusitis itself is not usually passed on, but the colds that trigger it can be.

Can a pharmacist treat sinusitis?

In England, pharmacists can assess acute sinusitis in people aged 12 and over and supply treatment when criteria are met.

Are saline nasal rinses safe?

Yes, for most people, when made or used according to instructions. Use sterile, boiled and cooled or purpose-made solutions.

Can sinusitis cause toothache?

Yes. Inflammation in the cheek sinuses can cause pain in the upper teeth.

When should I worry about sinusitis?

Get urgent help for swelling around the eye, vision changes, severe headache, confusion, stiff neck or feeling severely unwell.