Sinusitis: symptoms, treatment, how long it lasts and when to see a GP

The NHS says sinusitis is common after a cold or flu. The main symptoms are pain, swelling and tenderness around your cheeks, eyes or forehead; a blocked or runny nose; a reduced sense of smell; green or yellow mucus from your nose; and a high temperature. NHS inform defines a high temperature as 38C or more.

Other symptoms include a headache, toothache, bad breath, a cough and a feeling of pressure in the ears. You may also snore at night and sound nasal when you speak.

Young children may be irritable, have difficulty feeding and breathe through their mouth, according to both the NHS and NHS inform.

The NHS says you can usually treat mild sinusitis yourself. NHS inform says it usually gets better on its own within 2 or 3 weeks, and lists nasal decongestants (which should not be used for more than a week, as this might make things worse) and warm packs held to the face among the things you can do.

A pharmacist can give the same treatments as a GP for sinusitis, and the NHS says to see one if you think you have sinusitis or your child is 12 or older and you think they have it.

If your sinusitis needs treatment, the NHS says a pharmacist or GP may prescribe steroid nasal sprays or drops to reduce the swelling (you might need to take these for a few months), or antihistamines if an allergy is causing symptoms. Rarely you may need antibiotics. NHS inform says that if symptoms are not improving or are getting worse, your GP may prescribe antibiotic tablets or a corticosteroid spray or drops.

The NHS describes a homemade salt water solution. Boil around 570ml (1 pint) of water and leave it to cool. Mix in 1 teaspoon of salt and 1 teaspoon of bicarbonate of soda. Wash your hands, stand over a sink, cup the palm of one hand and pour in a small amount of the solution. Sniff the water into one nostril at a time, breathing through your mouth and letting the water pour back into the sink, and try not to let it go down the back of your throat.

Repeat up to 3 times a day, making a new solution each time, until your nose feels more comfortable. NHS inform says you can also buy salt water sachets from a pharmacy.

The NHS says sinusitis usually clears up on its own within 4 weeks. NHS inform says it usually gets better within 2 to 3 weeks and NICE says acute sinusitis lasts about 2 to 3 weeks and most people get better without antibiotics.

NHS inform says the symptoms often clear up within a few weeks (acute sinusitis) but occasionally can last 3 months or more (chronic sinusitis). It says to speak to your GP practice if symptoms are severe or getting worse, have not started to improve after around 7 to 10 days, or you keep getting sinusitis.

The NHS says to see a GP if you do not get better after 7 days of treatment from a pharmacy or GP, or after 3 weeks of treating symptoms yourself.

Sinusitis is usually caused by a cold or flu virus spreading to the sinuses, according to NHS inform, so the underlying cold or flu virus can pass to other people even though the swelling in your sinuses is not itself something you give someone. Only a few cases are caused by bacteria infecting the sinuses.

The NHS advice is that if you have a high temperature or you do not feel well enough to do your normal activities, try to stay at home and avoid contact with other people until you feel better.

NHS inform says sinusitis is usually caused by a cold or flu virus spreading to the sinuses from the upper airways. An infected tooth or fungal infection can also occasionally cause the sinuses to become inflamed.

It is not clear exactly what causes sinusitis to become chronic, but NHS inform says it may be related to allergies and related conditions including allergic rhinitis, asthma and hay fever, nasal polyps (benign growths inside the nose), smoking and a weakened immune system. Controlling underlying conditions like allergies may improve chronic symptoms.

The NHS says to see a GP if a child has sinusitis symptoms and is aged 11 years or younger, or does not get better after 7 days of treatment from a pharmacy or GP. It says to call 111 for advice about a child under 5 years old if they are very unwell, painkillers do not help or symptoms get worse.

Young children with sinusitis may be irritable, have difficulty feeding, breathe through their mouth and sound nasal. Do not give aspirin to children under 16.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you or a child has sinusitis symptoms and are very unwell, painkillers do not help or symptoms get worse, or you have a weakened immune system, for example because you are having chemotherapy.

A GP may refer you to an ear, nose and throat (ENT) specialist if you still have sinusitis after 3 months of treatment, keep getting sinusitis or only have symptoms on one side of your face. An ENT specialist may recommend surgery for some people. If swelling or redness develops around an eye, or you have a severe headache with a stiff neck or new confusion, get urgent medical help through 999 or 111.

The NHS says surgery for chronic sinusitis is called functional endoscopic sinus surgery (FESS). It is carried out under general anaesthetic and the surgeon can widen the sinuses either by removing some of the blocked tissue or by inflating a tiny balloon in the blocked sinuses and then removing it. NHS inform links to NICE guidance on balloon catheter dilation for chronic sinusitis.

Most care takes place through a pharmacist or GP. The NHS says a pharmacist can give the same treatments as a GP, and an ENT referral is considered if sinusitis lasts 3 months despite treatment, keeps coming back or affects only one side.

Private ENT consultations are available if you want a quicker specialist opinion, including nasal endoscopy and scans. The tests and operations are the same as on the NHS. Ask what the evidence for any procedure is and whether medical treatment has been tried first.