What is a sinus infection?
Sinusitis is inflammation of the lining of the sinuses, usually after a viral cold, causing nasal blockage, facial pressure or pain, thick nasal discharge, reduced smell and sometimes fever and cough. Bacteria are involved in only a minority of cases (about 0.5–2% of viral colds develop bacterial sinusitis). For symptoms, see sinus pressure relief and sinus headache.
Saline rinses and sprays
Flushing the nose with a saline solution washes out mucus and irritants and helps the sinuses drain. Use distilled, sterile or boiled-and-cooled water. Rinse once or twice a day, using a squeeze bottle or neti pot, or use a saline spray several times a day. See how to use a neti pot safely.
Steam and warm compresses
- Take a hot shower and breathe in the steam, or lean over a bowl of hot (not boiling) water with a towel over your head for 5–10 minutes. Take care to avoid burns, especially with children.
- Place a warm, damp towel on the nose and cheeks for 10 minutes several times a day.
- Steam provides temporary comfort and thins mucus; it does not kill infection.
- Humidifiers help in dry air; clean them regularly.
Fluids, rest and sleep position
- Drink plenty of water, tea and broth to keep mucus thin.
- Rest, since your immune system works best when you sleep.
- Prop your head up with an extra pillow to help drainage.
- Avoid alcohol and smoking, which irritate the nasal lining.
- Avoid flying or diving while very congested.
Pain relief and medicines
Paracetamol (acetaminophen) or ibuprofen reduce pain and fever. Nasal steroid sprays (fluticasone, mometasone, budesonide) reduce swelling and may speed recovery, particularly in people with allergies. Decongestant sprays may be used for up to 3 days; oral decongestants should be avoided in high blood pressure, heart disease and glaucoma. Antihistamines help only if you have allergy, and some thicken the mucus. Check with a pharmacist for combined cold medicines.
Remedies to skip
- Essential oils, garlic, onion or hydrogen peroxide in the nose: not proven and can irritate or burn.
- Apple cider vinegar drinks or rinses: no evidence, can irritate.
- Echinacea, vitamin C or zinc to treat an established infection: little or no benefit.
- Leftover antibiotics: inappropriate and potentially harmful.
- Prolonged use of decongestant sprays (more than 3–5 days).
- Blowing the nose very hard: can push mucus into the ears and sinuses.
When antibiotics are considered
The AAO-HNSF guideline advises watchful waiting or antibiotics for adults with uncomplicated acute bacterial sinusitis. Antibiotics are considered for: symptoms lasting 10 days or more without improvement; severe symptoms (fever above 39 °C, purulent discharge and facial pain) for at least 3–4 consecutive days; or worsening after initial improvement (“double worsening”). Amoxicillin (with or without clavulanate) is the usual first choice for 5–10 days. Most people recover without antibiotics, and unnecessary use causes side effects and resistance.
When it is not just an infection
If you have nasal blockage, facial pressure, discharge and reduced smell for 12 weeks or more, or several infections a year, you may have chronic rhinosinusitis, allergy, polyps or a structural problem. An ENT assessment with nasal endoscopy and sometimes a CT scan can find the cause, and treatments such as nasal steroids, long-term rinses, allergy management, medicines for polyps or surgery may be appropriate.
When to see a doctor
- Symptoms last longer than 10 days, or worsen after improving.
- High fever, severe facial pain or swelling.
- Any eye swelling, double vision, severe headache or confusion (emergency).
- Recurrent infections or symptoms for 12 weeks or more.
- Immune problems, diabetes or other serious conditions.
- A child with persistent symptoms or who seems unwell.
Three common situations
Blocked nose and facial pressure five days after a cold started: likely viral; rinses, fluids, steam and pain relief.
Symptoms improved at day 6 but worsened again at day 8 with fever: consider bacterial sinusitis; see a doctor.
Four sinus infections this year: consult an ENT to look for allergy, polyps or an anatomical cause.
Sinus infections in children
Children get many colds, and a small share develop sinusitis. Persistent daytime cough or nasal discharge for more than 10 days without improvement, a high fever with thick discharge for three days or more, or worsening after a cold that was improving are the usual signs. Offer fluids, use saline drops or spray and manage fever with age-appropriate paracetamol or ibuprofen. Do not give over-the-counter cold medicines to young children, and seek advice for swelling around the eyes, severe headache or a child who looks very unwell.
Key points to remember
Most sinus infections get better without antibiotics. Use saline rinses, steam, fluids, rest and pain relief, and see a doctor if symptoms last more than 10 days, worsen or include warning signs.
This guide is for general information and does not replace an assessment by your own doctor or ENT specialist.
Questions about sinus infection home remedies
These answers are general information and do not replace an examination or individual medical advice.
What is the best home remedy for a sinus infection?
Saline nasal rinses, steam, fluids and rest are the best-supported measures.
How long does a sinus infection last?
Most viral sinus infections improve in 7–10 days.
Do I need antibiotics?
Usually not. They are considered if symptoms last more than 10 days, are severe or worsen after improving.
Does steam help a sinus infection?
It gives temporary comfort, but does not treat the infection.
Is it safe to use a neti pot?
Yes, with distilled, sterile or boiled-and-cooled water and a clean device.
When should I see a doctor?
If symptoms last more than 10 days, are severe, or you have eye swelling, a stiff neck or confusion.
Sources
- NHS · Sinusitis (sinus infection)
- AAO-HNSF · Clinical practice guideline: Adult sinusitis (Rosenfeld et al., 2015)
- US FDA · Is rinsing your sinuses with neti pots safe?
- NHS · Common cold
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.