It starts as a stuffy nose. A week later you still feel pressure behind your eyes, your head aches when you bend over, and you wonder: is this still a cold, or has it turned into a sinus infection? As New England heads into late fall, both are common. Here is how to tell them apart, what helps at home, and when it is time to get checked.
What is a sinus infection?
Your sinuses are small air spaces behind your cheeks, forehead and nose. When a cold or allergies make the lining swell, mucus can get trapped. That trapped mucus causes pressure and pain. Doctors call this sinusitis.
Here is the part that surprises many people: according to the CDC, most sinus infections are caused by viruses, the same kind of germs behind the common cold. That means many of them get better on their own, without antibiotics.
Cold or sinus infection? Common signs
A cold and a sinus infection share a lot of symptoms, and one can lead to the other. Signs that point toward a sinus infection include:
- Pain or pressure in your face, especially around the eyes, cheeks or forehead
- A stuffy or runny nose that is not easing up
- Mucus dripping down the back of your throat (post-nasal drip)
- Headache, sore throat or cough
- Bad breath or a reduced sense of smell
- Feeling better for a few days, then suddenly worse again
A typical cold slowly improves over about a week to 10 days. A sinus problem often lingers longer or comes back stronger. If your symptoms seem more like itchy eyes and sneezing that show up at the same time each year, allergies may be the cause. Our allergy and asthma care page has more on that.
What helps at home
For mild symptoms, simple comfort care can make a real difference while your body fights the infection:
- Rest and drink plenty of fluids to keep mucus thin.
- Hold a warm, damp washcloth over your nose and forehead.
- Breathe in steam from a hot shower or a bowl of hot water (carefully, to avoid burns).
- Try a saline (salt water) nasal spray or rinse. If you use a rinse bottle or neti pot, use distilled, sterile or boiled-and-cooled water only.
- Run a clean cool-mist humidifier, and clean it often.
- Ask a pharmacist or provider which over-the-counter medicines are right for you, and follow the label.
For children, read labels carefully and check with your child’s doctor before giving any cold medicine. The CDC advises never giving aspirin to children and avoiding over-the-counter cough and cold medicines in children under 4 unless a provider says otherwise.
When to see a provider
The CDC recommends seeing a healthcare provider if you have:
- Severe symptoms, such as a severe headache or bad facial pain
- Symptoms that get worse after starting to get better
- Symptoms lasting more than 10 days without improving
- A fever lasting longer than 3 to 4 days
- Several sinus infections in the past year
At a visit, a provider will ask about your symptoms, look in your nose and throat, and check for other causes like strep throat, flu or an ear infection. If you have been around flu or COVID, a rapid test can help sort things out. Many people need only comfort care. If your provider thinks a bacterial infection is likely, they will talk with you about whether an antibiotic makes sense. Taking antibiotics when they are not needed will not help you feel better and can cause side effects, so it is worth getting the right answer.
Call 911 or go to the emergency room if…
Rarely, a sinus infection can spread to nearby areas like the eye or brain. Get emergency care right away for:
- Swelling, redness or pain around one or both eyes, or an eye that is pushed forward
- Double vision, blurry vision or trouble moving the eyes
- A severe headache with a stiff neck
- Confusion, unusual sleepiness or trouble waking up
- Trouble breathing
- A very high fever with any of the signs above
Get checked without the wait
If your sinus symptoms are dragging on or getting worse, our Acton and Canton clinics can help seven days a week, and no appointment is needed. Walk in, or reserve your spot online to save time. We see both children and adults, and we have rapid tests and a lab on site. Learn more about the illnesses and infections we treat.