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Usually viral and self-healing — antibiotics only help with a longer or severe course.
Also known as: sinusitis · frontal sinusitis · maxillary sinusitis
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Usually the continuation of a cold: the linings swell, drainage from the sinuses is blocked, and a dull pressure builds over the forehead, cheeks or teeth, worsening when bending forward. Plus a blocked nose, reduced sense of smell and sometimes headache. In the vast majority of cases the cause is viral, not bacterial — antibiotics then do not help. What helps: saline nasal rinses, decongestant sprays for a few days, inhalation, patience. See a doctor if symptoms last more than ten days, worsen again after improving, with high fever — or if swelling or redness appears around the eye, which is urgent.
The most effective single measure and the only one that can be used as often as wanted. It washes secretions out and keeps the openings clear — with body-warm water, prepared from boiled or sterile water.
Almost all sinus infections are viral and need no antibiotic. It becomes different when the complaints last more than ten days, when things get worse again after an initial improvement, or with a high fever and severe one-sided pain.
They help noticeably in the first days. From about a week a dependence develops: the nose blocks up more on stopping than before, and it becomes hard to get off them.
Inhaling makes the secretions thinner, a warm cloth on forehead and cheeks eases the pressure. Neither heals faster, but it makes the days bearable.
Swelling or redness around the eye, double vision, a stiff neck or severe pain in the forehead with a high fever are the rare but serious courses. That belongs in the emergency department, not in tomorrow’s consultation.
Most sinus infections are viral — antibiotics change nothing about that. Steroid nasal sprays reduce the swelling at the openings, salt rinses clear what would otherwise sit. Both need days, and both act on drainage, not on the organism.
Nine out of ten sinus infections are viral and last about seven to ten days. Only when symptoms go beyond ten days, or worsen again after improving, does bacterial involvement become likely — that is the rule by which antibiotics are decided.
A dull pain over cheek, forehead or behind the eye that grows on bending, climbing stairs or coughing — usually worse on one side.
One side is blocked, the sense of smell is gone, secretion runs down the back of the throat and irritates a cough there at night.
A course that was better after five to seven days and then clearly gets worse again speaks for a bacterial share. That says more than the colour of the secretion.
Swelling or redness around the eye, double vision, a bulging eye, a stiff neck, severe headache with confusion: that belongs in hospital at once.
The roots of the upper back teeth reach the maxillary sinus. If it is inflamed, several upper teeth hurt together — especially when bending forward.
Normal or slightly raised with the usual form — it is mostly viral and needs no antibiotic. Clearly raised together with a high fever and one-sided pain changes the picture.
With a nose that keeps blocking, allergy belongs considered — it is the commonest cause behind the chronic picture.
Belongs alongside with repeated infections in quick succession, because a weakness of the defences is then asked about.
Fever, sweating and faster breathing clearly raise the need. Drinking enough keeps the mucus thin and the circulation steady — in children and older people it is the most important point of all.
With low levels airway infections occur somewhat more often; correcting a deficiency makes sense, a high single dose during the infection does not act on it.
Needed by the defence cells. For lozenges at the start of a cold there are hints of a slightly shortened duration; at a high dose over months zinc lowers copper.
Antibodies and defence cells are protein. After several days with little appetite it is worth at least keeping the protein up — soup with egg, quark, yoghurt, lentils.
Studied for swelling of the lining — 500–1000 mg a day between meals over 1–2 weeks; the studies are small. Together with blood thinners it raises the tendency to bleed.
600 mg a day thins tough mucus; in chronic sinus inflammation that is the studied approach. Saline nasal rinsing has better numbers for these complaints.
The menthol in it creates a feeling of a clear nose without changing the swelling — measured, the airflow stays the same. In babies and small children menthol does not belong on the face.
Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.
Cortisone as a nasal spray is the treatment with the best numbers in the chronic form with polyps — it acts locally and is barely absorbed. Cortisone as a tablet is a different matter and stays reserved for short bursts.
Decongestant nasal sprays work by narrowing the vessels. Beyond a week that reverses — the lining swells more than before, and getting off them is hard.
Enough fluid keeps mucus thin. Spicy food briefly gets the flow going — that is relief for minutes to hours, not treatment of the inflammation.
The classic sweating tea: 2 tsp flowers to 250 ml, 10 minutes, two to three cups a day. It dissolves nothing — it thins the secretions, as long as enough is drunk.
As a steam inhalation over a bowl, 10 minutes, eyes closed. The warmth and the steam do the larger part of the work here, the herb the smaller.
Also common for inhaling. Anyone allergic to daisy-family plants leaves it out — chamomile, yarrow, arnica and marigold belong to the same family.