Sinusitis: Symptoms, Home Care and When Antibiotics Are Needed

A nose that will not clear, a dull ache behind the eyes and cheeks that gets worse when you bend over, and thick mucus running down the back of your throat. If a cold seems to turn into a week or two of this, you may have sinusitis. It is one of the commonest reasons people visit a doctor in Pakistan, especially during the smog and dust of winter and the pollen season in spring. Many people take antibiotics for it, but most of the time they are not needed.

What is sinusitis?

The sinuses are air-filled spaces in the bones around your nose, cheeks and forehead. When their lining becomes inflamed and swollen, mucus cannot drain properly, and you get congestion and pressure. Sinusitis is called acute if it lasts under four weeks, and chronic if it lasts more than 12 weeks.

Sinusitis symptoms

• A blocked or stuffy nose
• Thick yellow or green mucus from the nose or down the throat
• Pain or pressure around the cheeks, eyes and forehead, often worse on bending forward
• Reduced sense of smell and taste
• Cough that is worse at night, bad breath and a sore throat
• Headache, tiredness and sometimes a mild fever
• Toothache in the upper jaw

What causes it?

• A viral cold, which is by far the commonest cause
• Allergies to dust, pollen, pets or mould (see allergy relief)
• Smoke, smog and air pollution, and cigarette or shisha smoke
• A deviated nasal septum or nasal polyps
• Infections in the upper teeth
• Overuse of nasal decongestant sprays

Does it need antibiotics?

Usually not. Most acute sinusitis is caused by a virus, and only a small fraction of cases are bacterial. The colour of the mucus does not tell you which it is, because green mucus is common in viral colds too. Doctors usually consider antibiotics only if symptoms last more than 10 days without improving, if they improve and then get worse again, or if there is high fever and severe facial pain from the start. Taking antibiotics when they are not needed brings side effects and contributes to antibiotic resistance.

Home care that helps

• Saline nasal rinse: flushes out mucus and allergens. Always use boiled and cooled or distilled water, never plain tap water, because it can contain germs.
• Steam or a warm shower to loosen mucus. Take care with hot water, particularly around children.
• Drink plenty of fluids, and rest.
• A warm cloth over the face for comfort
• Sleep with your head raised on an extra pillow
• Stay away from smoke and dust, and wear a mask during heavy smog

Medicines your doctor or pharmacist may suggest

• Pain and fever relief: paracetamol or ibuprofen, if suitable for you
• Steroid nasal sprays such as mometasone, which reduce swelling in allergic or chronic sinusitis. They work over days, not minutes.
• Antihistamines such as cetirizine, levocetirizine or fexofenadine, if allergy is behind it
• Montelukast, sometimes added when allergy and asthma are present
• Decongestant nasal drops and sprays give fast relief, but should not be used for more than about three days. Longer use causes rebound congestion that is worse than the original blockage. Decongestant tablets can raise blood pressure, so check with a doctor if you have high blood pressure.

When to see a doctor

• Symptoms for more than 10 days, or repeated attacks
• High fever or severe facial pain
• Swelling, redness or pain around the eye, double vision or trouble moving the eye. This needs urgent care.
• Severe headache, stiff neck, confusion or swelling of the forehead
• Blockage on one side only, or a nose that stays blocked for months, which may point to a polyp or deviated septum

Key takeaways

• Most sinusitis follows a cold and gets better without antibiotics.
• Saline rinses with clean water, fluids and rest help.
• Use decongestant sprays for three days at most.
• Eye swelling, high fever or a severe headache need urgent medical care.

Related medicines on Medimart

These are commonly used for sinusitis and allergy-related congestion:

• Mometasone: a steroid nasal spray that reduces swelling
• Cetirizine: an antihistamine for allergy symptoms
• Levocetirizine: an antihistamine for sneezing and a runny nose
• Fexofenadine: a non-drowsy antihistamine
• Montelukast: used in allergic conditions and asthma
• Paracetamol: for pain and fever

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse sinusitis medicines and allergy relief on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from a doctor. If symptoms are severe or last more than 10 days, please see a doctor.