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To Your Health

How to identify, treat sinus infections

 Dr. Roger Hicks  


Many people with common colds mistakenly believe they have a sinus infection and need antibiotics. Most know colds are caused by viruses and antibiotics are of no help. But sinus infections are more serious and can be caused by bacteria, in which case antibiotics may be needed. So how do you tell the difference? 

Common colds are the most frequent illness in the U.S. and other industrialized nations, where most adults have a one once or twice a year. Sinus infections, or sinusitis, is also quite common, affecting one in eight adults every year. The symptoms overlap, with both causing a runny nose and nasal congestion. Thick colored nasal mucous, fever, cough and a scratchy throat can also occur with either condition. But facial pain or pressure is the hallmark of sinus infections and usually doesn’t occur with a cold. Sinus pain happens in the cheeks, forehead or around the eyes and typically gets worse with bending over. Other symptoms that can be present with a sinusitis but not a cold are pain in the upper molars and loss of sense of smell.

Most sinus infections result from colds, and the vast majority – 98 percent or more – are, like colds, caused by viruses. And like colds, the vast majority resolve on their own in 10 days or so with appropriate treatment at home.

So what can be done at home to treat sinusitis? With a cold, allergies, or sinus infection, we produce more and thicker mucous and can’t clear it out effectively. In addition, the mucous membranes lining the passageways connecting sinuses to nose can swell shut. This temporarily cuts off the sinuses’ connection with the outside, meaning any variation in air pressure – from changes in weather or elevation – can be painful. 

With that in mind, there are two parts to treatment: things to thin out mucous and things to open up the passageways between your sinuses and your nose. 

Drinking plenty of fluids and breathing in steam from the shower help thin out mucous. Irrigating the nasal passages using a saline rinse with a neti-pot or an over the counter saline nasal spray also help. You can open the passageways by using a decongestant to shrink the swollen mucous membranes. Herbal decongestants are helpful, both in steam and teas. 

If those aren’t enough, the most effective pharmaceutical is oxymetazoline nasal spray (over the counter Afrin and other brands). But be careful – use it no more than twice a day and no more than three days in a row, or six doses total, then skip a day. Otherwise, you risk having rebound congestion.

Many people will never experience sinusitis while others are especially susceptible. Allergies affect the sinuses and increase the likelihood of getting sinusitis. Other risk factors are smoking, changes in air pressure such as from diving or air travel and dental infections.

Of course, prevention is always better than any cure. Take steps to avoid people who have colds and wash your hands frequently with soap and water. If you have allergies, keep them under control or you set yourself up for sinusitis. If possible, avoid places with unhealthy air, such as areas where people smoke. Adding moisture to the air with the use of a humidifier can also reduce your risk for infected sinuses. 

Treating a sinus infection with home remedies will usually work, but if symptoms persist more than 10 days, a bacterial infection may have come in on top of the viral infection and medical treatment may be needed. One sign of that is if you improve but then get worse again. Other reasons to see a doctor or an urgent care facility such as Yubadocs are if there are signs the infection has spread beyond your sinuses, such fever, severe headache, swelling or redness around the eyes, visual changes, pain with eye movement, stiff neck or an altered mental state.

Once the pain from infected sinuses is gone, we tend to forget they are even there, but they are of immense value and literally help us put on a happy face. 

A director of the Urgent Care Association of America from 2011 to 2017, Dr. Roger Hicks served as the Association’s treasurer and then secretary. He is a founder and current board member of the Urgent Care Assurance Company, a malpractice company specializing in urgent care. He is the founding President of the California Urgent Care Association. He is also the founding president of the South Yuba River Citizens League and served on SYRCL’s Board of Directors for 30 years.