Acute Sinusitis: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Acute Sinusitis?
A primary care doctor treats acute sinusitis. An ear, nose, and throat doctor (an ENT) may help when it keeps coming back or will not go away. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is acute sinusitis?
Acute sinusitis is swelling or inflammation of the tissue lining the sinuses. The sinuses are air-filled pockets in the face. They sit behind the forehead, nasal bones, cheeks, and eyes. Most of the time, mucus drains out and air flows through the sinuses.
Sinus infections happen when fluid builds up in the sinuses. This fluid buildup allows germs to grow. Acute sinusitis is when symptoms are present for 4 weeks or less. It is caused by viruses or bacteria growing in the sinuses.
Symptoms
The symptoms of acute sinusitis in adults very often follow a cold that does not get better or that gets worse after 7 to 10 days. Symptoms include:
- Bad breath or loss of smell.
- Cough, often worse at night.
- Fatigue and a general feeling of being ill.
- Fever.
- Headache.
- Pressure-like pain, pain behind the eyes, toothache, or tenderness of the face.
- Nasal stuffiness and discharge.
- Sore throat and postnasal drip (mucus dripping down the throat).
Causes and who gets it
Viruses cause most sinus infections, but bacteria can cause some sinus infections. Colds and allergies may cause too much mucus to be made, or swelling may block the opening of the sinuses. When the sinus openings become blocked or too much mucus builds up, bacteria and other germs can grow more easily.
A deviated nasal septum (a bent wall between the nostrils), nasal bone spurs, or nasal polyps (growths in the nose) may block the opening of the sinuses. Risk factors include a previous cold, seasonal allergies, smoking and exposure to secondhand smoke, and a weak immune system.
How doctors diagnose it
Your healthcare provider will determine if you have a sinus infection by asking about symptoms and examining you. The provider may look in the nose for polyps or tap over a sinus area to find tenderness. The provider may view the sinuses through a fiberoptic scope (nasal endoscopy, a thin tube with a light). A CT (computed tomography) scan of the sinuses can also help diagnose sinusitis.
Treatment
Most sinus infections usually get better on their own without antibiotics. You do not need antibiotics for many sinus infections. Even when antibiotics do help, they may only slightly reduce the time it takes for the infection to go away. Your healthcare provider can decide if you need an antibiotic. For some sinus infections, the provider may suggest watchful waiting, which means watching for 2 to 3 days to see if antibiotics are needed.
When antibiotics are not needed, their side effects could still cause harm. They can range from mild reactions, like a rash, to more serious health problems. Antibiotics are more likely to be prescribed sooner for severe symptoms, such as severe swelling around the eyes.
Some steps can help you feel better. Put a warm compress over the nose and forehead. Use a decongestant or saline nasal spray. Breathe in steam from a bowl of hot water or a shower. Drink plenty of fluids to thin the mucus. Be careful with spray nasal decongestants. They may help at first, but using them for more than 3 to 5 days can make nasal stuffiness worse.
When to see a doctor
See a healthcare provider if you have severe symptoms, such as severe headache or facial pain. Contact your provider if your symptoms last longer than 10 to 14 days, or you have a cold that gets worse after 7 days. Call 911 or go to the emergency room if you have vision changes, severe swelling around the eyes, confusion, trouble waking up, or a stiff neck with fever. In very rare cases, sinusitis can cause a skin infection around the eye or meningitis (an infection around the brain).
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. This kind of doctor can examine your sinuses, decide if antibiotics are needed, and watch how the illness goes. Follow-up visits can happen right in the office.
Common questions
Do I need antibiotics?
Most sinus infections usually get better on their own without antibiotics. You do not need antibiotics for many sinus infections. Your healthcare provider can decide if you need an antibiotic.
How long does acute sinusitis last?
Acute sinusitis is when symptoms are present for 4 weeks or less. In adults, the symptoms very often follow a cold that does not get better or that gets worse after 7 to 10 days.
Is green or yellow mucus a sign that I need antibiotics?
A green or yellow discharge does not mean that you definitely have a sinus infection or need antibiotics. Many people with this symptom recover fully without taking antibiotics.
How can I feel better at home?
Put a warm compress over the nose and forehead to help relieve sinus pressure. Use a decongestant or saline nasal spray. Breathe in steam from a bowl of hot water or shower. Ask your healthcare provider about over-the-counter medicines that can help you feel better.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
