Is It a Sinus Infection or Allergies?

By Terez Malka, MD
Medically reviewed checkmarkMedically reviewed
December 13, 2021

Each year, almost 12% of all Americans will be diagnosed with a sinus infection. And more than 50 million people in the U.S. every year experience allergy symptoms.

Nasal and sinus congestion are among the most common reasons for visiting a healthcare provider—for conditions like sinus infections, allergies, and viral illnesses like colds. 

These conditions share common symptoms, and you can have more than one of them at once—so it can be tough to know what’s causing your suffering.

In fact, a viral illness or long-standing allergies can actually lead to a sinus infection.

The number of common symptoms shared between allergies and sinus infections means that identifying one or the other can often be difficult and confusing, especially if you’re trying to diagnose yourself at home.

So how can you tell the difference?

In this article, I’ll explore the difference between sinus infections and allergies, including their individual and shared symptoms.

I’ll talk about some home remedies and other treatment options, as well as ways to prevent sinus infections and the symptoms of allergies. Finally, I’ll help you know when it’s best to talk to a healthcare provider. 

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What Are the Differences Between Sinus Infections and Allergies? 

There are two different kinds of sinus infections, viral and bacterial.

Viral infections are far more common—they cause nearly all sinus infections. These types of infections can be uncomfortable, but do get better on their own.

Bacterial sinusitis is less common, and generally starts as a viral infection (or sometimes allergies).

Once the sinuses and nasal passages are swollen and inflamed, bacteria can grow and gradually infect the lining of the facial and nasal cavities, leading to more severe and long-standing symptoms. 

Allergies can cause a wide spectrum of symptoms.

They occur as a result of the immune system reacting to allergens like pollen, pet dander, dust, and other triggers.

Once the body has a negative reaction, the immune system responds by releasing a chemical called histamine, which causes an allergic reaction. 

What causes allergies are specific to the patient, and each allergy sufferer may have slightly different symptoms in response.

While most allergies appear during childhood and adolescence, they can also develop in response to new triggers as an adult.

Indoor and outdoor causes for allergic reactions can include: 

  • Pollen from trees, grass, plants, and weeds
  • Pet hair or dander 
  • Dust and dust mites 
  • Mold 
  • Cockroaches 
  • Rodent dander 

Symptoms

Compare the following common ailments to see if you are dealing with allergy symptoms or have a possible sinus infection.

Keep in mind that it’s possible to have both conditions at the same time, particularly in peak allergy seasons. 

Symptom

Nasal congestion

Headache

Difficulty breathing through nose

Facial pain centered around the cheeks and eyes

Thick, yellow/green discharge

Unable to blow nose

Tooth pain

Bad or stale breath

Fever

Watery, itchy eyes

Allergies

Sinus Infection

If severe enough, chronic allergies can lead to allergic rhinitis, which is often confused with the common cold.

Symptoms for allergic rhinitis include headaches, sneezing, congestion, fogginess, skin rash, and itchy eyes.

If you share several symptoms of sinus infections and allergies and can’t tell which one you’re dealing with, consider that eye itchiness and redness, or symptoms that always occur at certain times of year or in certain environments, often point to an allergic reaction.

Treatment

In the majority of cases, both allergic reactions and sinus infections can be treated at home without prescription medications. 

The most important step when dealing with an allergic reaction is to identify the allergens causing the reaction and avoid them.

When it is impossible to avoid an allergen, there are many effective over-the-counter medications that can help:

  • Daily antihistamine medications: Cetirizine (Zyrtec), loratadine (Claritin), and levocetirizine (Xyzal) can be helpful and safe options for reducing allergy symptoms.
  • As-needed antihistamines: These medications, like diphenhydramine (Benadryl) can be taken as needed for acute allergic symptoms.
  • Corticosteroids: Nasal sprays like fluticasone (Flonase) or Nasocort used twice a day can be effective for nasal congestion and overall allergic symptoms.
  • Allergy eye drops: These can be effective for eye redness, tearing, and itching.

Sinus infections don’t necessarily clear up with allergy medications.

The good news is that most sinus infections respond well to over-the-counter treatments and time.

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

There are several ways to help speed up this process with home remedies, as well as relieve pressure and pain from the sinuses, including:

  • Warm compress: Apply over the nose and forehead.
  • Decongestant nasal sprays: Nasal sprays like oxymetazoline (Afrin, twice a day for three days only, unless you have high blood pressure) or fluticasone (Flonase, twice a day for as long as symptoms last) can help drain and dry pooled mucus. 
  • Saline nasal sprays: Use several times per day to help clear and thin pooled mucus.
  • Steam: Inhale either from a bowl or in a warm shower.
  • Humidifier: Use one to add moisture to the air.
  • Water and rest: Get plenty of both. 
  • Over-the-counter medications: Take acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for pain and discomfort, and Robitussin or Mucinex (guaifenesin) to thin mucus and decrease coughing and congestion.

Prevention 

Because it’s impossible to fully prevent allergies, identifying and avoiding the cause of your allergies is by far the most important step in preventing future reactions.

Beyond just avoiding allergens, there are specific strategies depending on what is causing the allergy—if it’s a pollen allergy, wash your hair before bed after a day outside.

If you have a dust allergy, wash your sheets weekly and clean your living space regularly.

If you’re allergic to an animal, abstain from touching your face after contact with animal hair and dander. 

To prevent sinus infections, use the same tactics and behaviors that work for avoiding colds and the flu, including: 

  • Frequently wash your hands with soap and water 
  • Cover your mouth when you cough or sneeze 
  • Avoid close contact with infected people
  • Get plenty of rest and exercise
  • Avoid nasal irritants like smoke or other pollution
  • Stay hydrated 

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When to See a Healthcare Provider

There are cases in which both allergic reactions and sinus infections will require the attention of a medical professional.

If you experience symptoms for several days and cannot identify the ailment, a medical provider will be able to diagnose you properly.

But even if you know what you have, you should seek medical care after experiencing any of the following:

  • Severe headaches or intense facial pain that do not improve with appropriate doses of Ibuprofen, acetaminophen, and decongestants
  • Symptoms that get worse after initial improvement
  • Symptoms that persist 10 or more days without improvement, or worsen after 10 days
  • Fever over 100.4° F lasting longer than three days, or any fever above 102° F (38.8° C)
  • Problems seeing, double vision, or severe swelling and redness around the eyes
  • Multiple cases over the course of a year
  • Issues with balance or dizziness
  • Discolored nasal discharge
  • Hearing loss or ringing in the ears (tinnitus) 
  • Recurring adenoid, ear, or tonsil infections
  • Persistent trouble swallowing or talking

A specialist also might have recommendations for preventive measures like allergy shots, which can lessen the way your body reacts to allergens over time. Did you know you can get affordable primary care with the K Health app?

Download K to check your symptoms, explore conditions and treatments, and if needed text with a provider in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

How can you avoid sinus infections due to cold or allergies?
You can avoid sinus infections due to viruses with practices like frequent hand washing with soap, avoiding close contact with sick people, and covering your mouth when you cough or sneeze. Avoiding a sinus infection due to allergies includes avoiding the causes of your allergies, taking over-the-counter allergy medications when needed, and staying hydrated, well-rested, and active.
Is fluticasone used for sinus infections or allergies?
Commonly known as Flonase, fluticasone is used for allergies, but will also help with congestion due to sinus infections and common colds. It should be used twice each day for as long as symptoms last to help drain and dry pooled mucus.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Terez Malka, MD

Dr. Terez Malka is a board-certified pediatrician and emergency medicine physician.