NEW YORK, NY, UNITED STATES, August 1, 2023/ — Sinus infections are as common as they are unpleasant, affecting tens-of-millions Americans each year. Often times they clear up on their own within days to weeks, but sometimes they can be more serious. Knowing when to see a doctor about a sinus infection can help bring both relief and curative care before further complications set in. So, when is a sinus infection serious enough to seek help? Dr. Paunel Vukasinov, Board-Certified Internist with Medical Offices of Manhattan has the details.
“Sinuses are empty cavities in the bones of the face and skull. They can be thought of as being similar to an interconnected cavern system that extends from the bridge of the nose up to the lower forehead, between the eyes, either side of the nose nearly to the cheekbones, and further back into the skull behind the nose. During normal breathing through the nose, the air passes through the sinuses on the way in and out,” said Dr. Vukasinov.

The sinuses contain tiny hairs called cilia as well as mucus that help to filter the air of unwanted particles and germs before entering the lungs.

A sinus infection—also called sinusitis—happens when bacteria, viruses, or fungi are able to multiply in the sinuses, which causes inflammation. People with allergies, asthma, or compromised immune systems can be at greater risk for these infections.

“Diagnostic tests for sinusitis can include x-ray imaging, CT (computed tomography) scans, cultures, or biopsies, but these tests are typically reserved for special cases. Sinusitis can usually be diagnosed based on the clinical symptoms,” said Dr. Vukasinov.

So what are the symptoms of sinus infections?

Having a runny nose or postnasal drip with a sinus infection is common, with opaque mucus that might be yellow or green. Other common symptoms include congestion, sore throat, coughing, and headache. However, these symptoms can all overlap with the common cold, too. Other symptoms can be more emblematic of a sinus infection.

In addition to the symptoms above, sinus infections can cause pain, tenderness, or pressure in the areas around the sinuses, including around the eyes, around the nose, the forehead, and even the upper jaw. Coughing, hoarseness, and a tickling feeling in the throat may all be present and are especially noticeable after going to bed and when waking in the morning. Because the passageways within the head are interconnected, a sinus infection can also lead to earaches.

“There are many over-the-counter (OTC) options available for treating acute sinusitis. For mild cases and people without a history of severe sinusitis, this is usually a good place to start,” said Dr. Vukasinov.

Nasal irrigation methods—such as a neti pot—are a medication-free way to treat a sinus infection. There are many methods, but they’re all attempts to remove mucus and germs by flushing out the sinuses. Never use water from the tap for nasal irrigation, as contamination in the water can not only make a sinus infection worse but can also cause additional and more severe issues. Instead, use distilled water or water that has been boiled for 5 minutes and then allowed to cool to a safe temperature.

Decongestant nasal sprays (oxymetazoline) can help alleviate symptoms for a short period of time, but after a couple days of use they can actually cause symptoms to worsen. For prolonged use, a steroid nasal spray (fluticasone or triamcinolone) could be considered.

Oral antihistamines and decongestants can be effective. These include medications like Sudafed, Zyrtec, Claritin, and Allegra.

“Decongestants, whether they be nasal sprays or oral tablets, should be avoided for people with high blood pressure, glaucoma, difficulty sleeping, or any history of prostate issues,” said Dr. Vukasinov.

For bacterial sinus infections, a doctor may prescribe antibiotics such as amoxicillin. This will not help viral or fungal sinusitis.

When then is it time to see a doctor about a sinus infection?

“People should seek medical attention for sinusitis if it’s not getting better after 10 days, if the infection keeps clearing up only to return again, or if the symptoms are especially severe. Every individual is the best authority on their own body—if it feels like a serious problem, see a doctor,” said Dr. Vukasinov.

“A sinus infection that includes uncommon symptoms is also a reason to seek help. These symptoms might include a high fever, changes in vision, or cognitive issues like confusion or lethargy,” Dr. Vukasinov added.

An otolaryngologist—also called an ear, nose, and throat specialist, or ENT—is an excellent resource if one is readily available. But for people who don’t have easy access to an otolaryngologist, a visit with a physician or even to an emergency room is appropriate.

“The key is to prevent it from becoming something more serious, and the best way to do that is to listen to your own body,” said Dr. Vukasinov.

Medical Offices of Manhattan offers comprehensive health care at four locations in New York

Paunel Vukasinov, MD, is a board-certified internal medicine specialist at
Medical Offices of Manhattan.