Acute Sinusitis: Treatment, Symptoms, Causes

Acute sinusitis refers to an inflammation of the sinuses, often accompanied by an infection.

This condition affects millions of Americans each year. Sinusitis, sometimes called rhinosinusitis or simply a sinus infection, can cause mucus to build up, causing the familiar symptoms of nasal congestion, or feeling “stuffed up.”

Most cases of acute sinusitis go away within 10 days. But if a bacterial infection develops, it can take longer to treat the infection. 

In this article, I’ll describe the difference between acute and chronic sinusitis, and the common symptoms and causes of acute sinusitis.

I’ll also cover how acute sinusitis is diagnosed and treated, and who is more at risk for developing acute sinusitis. Finally, I’ll offer some preventative tips and describe when you should reach out to your doctor for care.

What is Acute Sinusitis?

Acute sinusitis is a short-term inflammation of the sinuses.

Most cases of acute sinusitis go away by themselves and the symptoms can be managed with at-home remedies.

However, if your symptoms persist, that may indicate a bacterial infection, in which case you should speak to your doctor about the right course of treatment.

In the case of a bacterial sinus infection, it may take up to a month for your symptoms to resolve.

Acute vs. Chronic Sinusitis

Acute sinusitis is a short-term inflammation that generally lasts 10 days or less and can be treated easily at home.

Chronic sinusitis refers to inflammation or infection of the sinuses that lasts more than 12 weeks, despite medication or medical intervention.

What is Acute Maxillary Sinusitis?

Acute maxillary sinusitis refers to an inflammation or infection of the maxillary sinuses, located beneath each eye, which can cause facial pain, particularly in the cheek, jawbone, or frontal area of the teeth.

You can feel pain on one side of the face or both, and you may have tenderness in the area as well.

Acute Sinusitis Causes

The most common cause of acute sinusitis is the common cold, which is a viral infection.

But there are additional possible causes, including: 

• Allergies
• Bacterial infection
• Fungus
• Nasal polyps or nasal obstruction
• Deviated nasal septum
• Infected adenoids
• Cystic fibrosis
• Infected tooth

Who is At Risk?

According to the American Academy of Otolaryngology and the Center for Disease Control and Prevention (CDC), acute sinusitis is fairly common and affects millions of adults per year.

But there are some risk factors which can increase the likelihood of getting acute sinusitis: 

• Allergies
• Structural problems with your nose or sinus cavities
• Working or spending time in places where a higher rate of infections take place, like preschools or daycare
• An immune system disorder, like HIV/AIDS or cystic fibrosis
• Smoke exposure
• Poor air quality 
• Activities that cause significant pressure changes, including flying and scuba diving

Acute Sinusitis Symptoms

The main symptoms of sinusitis are:

• Facial pain that worsens when you bend over
• Pressure or tenderness in the face
• Stuffy nose
• Thick nasal discharge, sometimes yellow or green in color
• Congestion or difficulty breathing through the nose
• Cough

Other symptoms include:

• Fever
• Ear pain or pressure
• Headache
• Tiredness or fatigue
• Toothache
• Altered sense of smell
• Bad breath
• Sore throat

Acute Sinusitis Diagnosis

Not all cases of acute sinusitis require medical attention. In fact, in most cases, symptoms will resolve on their own within 10 days.

However, if you’re unsure whether your symptoms are acute sinusitis, or if you experience symptoms that last longer than 10 days—or symptoms that get worse—speak to your doctor or healthcare provider as soon as possible.

Many providers will diagnose acute sinusitis simply by reviewing your symptoms and medical history.

If seeing your doctor in person, they may perform a physical exam and examine your ears, nose, and throat to check for blockage, drainage, or swelling.

When looking into your nose, your doctor may use a nasal endoscope, a thin, flexible, fiber-optic scope that helps to identify inflammation or other abnormalities.

In some cases, your doctor may also order an imaging test, such as a CT scan or MRI, to look for other causes of inflammation or sinus abnormalities. 

Potential Complications

Complications of acute sinusitis are very uncommon, and serious complications even more rare.

In those cases, complications can include: 

• Chronic sinusitis: An infection or inflammation that persists beyond 12 weeks.

• Meningitis: Inflammation in the membranes and fluid that surround the brain and spine (known as the meninges). 

• Infections: An infection that spreads to the bones (osteomyelitis) or skin (cellulitis).

• Vision problems: If the infection spreads to your eye, it can cause impaired vision, or in rare cases, permanent blindness.

Acute Sinusitis Treatment 

Without the use of antibiotics or other prescription treatments, close to 50% of all sinus infections improve within a week, and 70% resolve within two weeks.

Because most cases of acute sinusitis are caused by viruses, supportive home care is generally enough to help ease your symptoms in the meantime.

However, if you have a chronic or more complicated case of sinusitis, your doctor may recommend one of the following treatment options.

Antibiotics

In the case of a suspected bacterial infection, your doctor may prescribe antibiotics to help clear the infection.

Keep in mind that antibiotics aren’t always needed to treat acute bacterial sinusitis. It’s possible that your doctor may recommend waiting to see if the infection clears on its own before prescribing medication. 

More severe or persistent cases of acute sinusitis may require antibiotics.

In those instances, be sure to follow the recommended dosage and complete the entire course as directed by your provider.

Amoxicillin-clavulanate is often the first-line antibiotic prescribed by doctors for acute bacterial sinusitis.

However, if you’re allergic to penicillin, your doctor can prescribe an alternative, like trimethoprim and sulfamethoxazole (Bactrim, Septra). 

Surgery

In rare cases of sinus abnormality or blockage, your doctor or otolaryngologist (commonly called an ear, nose and throat doctor, or ENT) may recommend surgery to treat the root cause of your acute sinusitis.

Depending on the state of your sinuses, you may undergo surgery to remove polyps or tumors, correct a deviated septum, or clean and drain your sinuses.

Immunotherapy

If allergies are the main cause of your sinusitis, your doctor may recommend allergy shots, also called immunotherapy, to help manage and limit your body’s reaction to triggering allergens.

Acute Sinusitis Home Remedies

Most cases of acute sinusitis can be managed at home.

Lifestyle and at-home remedies that can help to soothe your symptoms include:

• Rest: As with many infections, getting adequate rest will help your body to fight the infection and speed up recovery. Be sure to drink ample fluids, too.

• Over-the-counter (OTC) pain relievers: Some OTC pain relievers, including acetaminophen or ibuprofen, may help if you’re experiencing significant pain.

• Nasal sprays (corticosteroids) and decongestants: Some nasal sprays, including nasal steroids and decongestants, can help to relieve nasal congestion. Talk to your doctor about which products may help; many are available over the counter.

• Vapor bath: Moistening your sinus cavities with a vapor bath may help to ease pain and help mucus drain your cavities. To do so, fill a bowl with hot water and place your head over the bowl while draping a cloth or towel over your head to keep the vapor directed toward your face. Taking a hot shower or bath may help, too.

• Nasal lavage: Rinsing your nasal passages with a neti pot or designated squeeze bottle can help to clear your sinuses and relieve your symptoms. Doctors recommend only using distilled or sterile water for these procedures.

• Acupuncture: No alternative therapies or herbal remedies have been proven to ease or treat the symptoms of acute sinusitis. In fact, some herbs and herbal products can cause unwanted side effects, including upset stomach, diarrhea, and allergic skin reactions. However, some people report that some pressure points activated during acupuncture or acupressure help provide relief from acute sinusitis symptoms. In particular, some studies show that acupuncture may be beneficial for people with chronic acute sinusitis, chronic acute sinusitis that doesn’t respond well to treatment, and acute sinusitis caused by allergies.  

While treating and managing your acute sinusitis at home, if you notice persistent or severe symptoms that don’t resolve on their own, reach out to your provider or healthcare professional immediately.

When to See a Doctor

If you experience persistent or severe symptoms that don’t go away after 10 days with at-home treatment or antibiotic therapy, reach out to your doctor. 

In rare cases, it’s possible that your symptoms could be a sign of a more serious infection. If you experience any of the below symptoms, reach out to your provider immediately:

• Severe eye pain, swelling, or redness
• High fever
• Confusion
• Double vision or other vision changes
• Stiff neck

Finally, if your symptoms worsen after initially improving, it’s important to reach out to your provider as soon as you can.

Prevention Tips

Not all cases of acute sinusitis are preventable.

Still, there are some things you can do at home to help reduce your risk of getting acute sinusitis:

• Daily hygiene and risk mitigation: Help keep your upper respiratory system healthy by avoiding infections as much as possible. Stay away from others when they’re sick, and wash your hands thoroughly with soap and water often, especially before mealtime.  

• Allergy management: If you have allergies, talk with your provider about the best way to keep your symptoms under control, including nasal sprays and antihistamines.  

• Don’t smoke: Avoiding firsthand or secondhand tobacco smoke and other pollutants will help to keep your lungs and nasal passages healthy.

• Humidifier or air purifier: Using a humidifier will help add moisture to your at-home air, which can help to prevent sinusitis. If using a humidifier regularly, be sure to clean the humidifier as directed to keep it free of mold. Or, if the air quality in your home is poor, using an air purifier can also help keep your lungs and nasal passages healthy.

• Eat well and stay hydrated: Keeping your body in overall good health can help prevent acute sinusitis. This includes eating a diet full of whole foods, fruits, and vegetables, and staying hydrated throughout the day.

• Regular nasal lavage: Rinsing your nasal cavities regularly with a neti pot or designated squeeze bottle can help to keep your sinuses clear and healthy.

If you notice persistent symptoms that don’t resolve on their own, reach out to your healthcare professional immediately.

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