Sinus Infection Treatments and Medications

Everyone knows what to expect when cold and allergy season rolls around—you expect a stuffy nose, itchy throat, and frequent sneezing. But if your sinus symptoms worsen, and you experience long-term facial pain, runny nose, headache, and nasal congestion, you there could be a more serious problem.

When cold or allergy symptoms just won't going away, they could be caused by a sinus infection. Use this guide to what a sinus infection is and how you can treat one with medications and alternative treatments at home.

Simply explained, a sinus infection occurs when there is an infection in the sinuses, a connected system of air-filled spaces in the skull. Under normal conditions, mucus drains out so that air can pass through sinus cavities. When fluid builds up in the sinuses, germs grow and an infection can occur.

Sinus infections can cause facial discomfort because of nasal congestion. You may experience a headache, pain behind the eyes, and facial tenderness or swelling. Other sinus infection symptoms are similar to having a bad cold or intense allergies including nasal discharge, postnasal drip, fatigue, sinus pressure, loss of sense of smell, throat irritation, and even a fever.

Typically triggered by allergies or a cold, a sinus infection can take many forms. Acute sinusitis may cause mild symptoms and go away quickly without antibiotics. These cases are often caused by a viral infection like the common cold and do not require anything more than symptomatic treatment for your comfort.

Chronic sinusitis, on the other hand, can stick around for several months and be much more troublesome. Depending on the severity of the infection, you may be able to treat it yourself with home remedies, but it's likely that you will need antibiotic treatment.

Certain groups of people are more likely to get sinus infections. If you smoke, travel to a different altitude, have a weakened immune system, allergic rhinitis, or cystic fibrosis, you are more at risk for developing sinus infections.

“A sinus infection is usually diagnosed empirically without need for imaging or cultures,” explains Lindsey Elmore, Pharm.D., BCPS. A simple medical exam and review of your symptoms should be enough for your doctor to identify a sinus infection. Your doctor will likely check your nose with a light to look for inflammation. He or she also may ask you about any pain you’re feeling to see if it traces back to the sinus cavities.

In rare cases, or if you get frequent infections, your doctor may perform other tests to rule out other conditions like a fungal infection. This may include allergy testing, a nasal endoscopy to visually inspect the sinuses, swabbing your nose for a culture of nasal drainage, or lab imagery to scan for abnormalities.

“Symptoms may be acute (short term) or chronic (long term), and you should seek a doctor’s help if you have symptoms that last more than 10 days, or are unresolved with over the counter agents as this may be an indication that you have a bacterial sinus infection,” says Dr. Elmore.

The standard treatment healthcare providers prescribe for a presumed bacterial sinus infection is an antibiotic. However, if you have a sinus infection caused by a viral infection such as the common cold, your doctor will not prescribe antibiotics as these medications only treat bacterial infections. Instead, you can treat the sinus infection symptomatically until it resolves, with nasal decongestants and antihistamines.

There are plenty of ways to treat symptoms of a sinus infection at home with over-the-counter (OTC) medications and home remedies. OTC antihistamines block the effects of histamine, helping symptoms like sneezing and runny nose. Simple treatments like drinking water, keeping your sinuses hydrated (with a nasal rinse product), and using warm compresses, can also help treat symptoms of a sinus infection.

Keeping your nasal passages clean can help you prevent future sinus infections. If you anticipate having sinus issues during allergy or cold season, flushing out your nasal passages with a saltwater solution can help you avoid the pains of a sinus infection.

Recurrent and chronic sinus infections could be a sign of a more serious problem with the physical structure of the sinuses, such as a deviated septum or nasal polyps. These issues may require specialized treatment from an allergist, otolaryngologist, or another doctor to avoid continuous sinus infections in the future.

These medications can quickly help to relieve sinus pressure, but should not be taken for a long time. Overusing decongestant nasal sprays can actually make congestion worse, so you should take each of these medications as directed by your doctor. Decongestant nasal sprays should only be used for a maximum of three days. Common side effects of these nasal sprays include irritation, dryness, burning, stinging, and sneezing.

If the decongestant nasal spray dries you out, you can add a saline nasal spray or drops to moisturize the nasal passages—saline products can be used as needed with no limitations on duration. Nasal decongestant oral tablets can raise your blood pressure, so if you have high blood pressure, ask your healthcare provider before using it.

Other popular antibiotics prescribed for sinus infections include Zithromax (azithromycin) or Augmentin. Common side effects of antibiotics include nausea, vomiting, and diarrhea.

Fluticasone nasal spray is a steroid drug that can be purchased over-the-counter (or by prescription) for relieving symptoms of sinusitis. Flonase is a popular nasal spray that you can spray in each nostril daily for relief of sneezing, runny nose, and congestion. Prolonged use of steroids can cause disruptions in the body’s hormone levels, so they should only be taken as advised.

Newer antihistamines such as Claritin, Allegra, Zyrtec, and Xyzal, treat the same symptoms but cause less drowsiness. Some antihistamines also contain a decongestant. Ask your pharmacist for assistance in picking an appropriate product that will help your symptoms and is safe and appropriate to take, considering your medical condition(s) and the medications you take.

NSAIDs help with symptoms of pain and fever, as well as swelling/inflammation. NSAIDs can interact with other drugs, so ask your healthcare provider if you can take an NSAID with the other drugs you take. Also, NSAIDs should not be taken for a prolonged period of time, so consult with your doctor if this treatment method does not resolve your sinusitis within 7-10 days.

Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.

This is not an exhaustive list of sinus infection medication side effects. If you experience any adverse reactions from a medication or treatment, it’s always best to consult with your healthcare provider.

A homemade solution for nasal irrigation is one of the best home treatments for a sinus infection. You can use a syringe or a neti pot to stream a solution of non-iodized salt, baking soda, and lukewarm distilled (or previously boiled) water through the nostrils to help keep your nasal passages clean. Or, you can choose a product at your pharmacy that is already prepared and ready to mix packets.

Other home remedies for sinus infections include staying hydrated by drinking a lot of water, using decongestant nasal sprays, and inhaling steam over the stove or in the shower. Certain lifestyle adjustments may also promote nasal drainage such as sleeping with your head elevated at night or keeping a humidifier running in your home to avoid an arid environment.

To relieve pain at home, you can use a warm compress or take over-the-counter pain medications to reduce headaches and facial pain from congestion.

Frequently asked questions about sinus infections