Sinusitis: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Sinusitis?
An ear, nose, and throat doctor, called an ENT or otolaryngologist, treats sinusitis. A primary care doctor can also help sort out what type of sinusitis you have. Some people are also referred to an allergy specialist, a doctor who treats allergies. 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 sinusitis?
Sinusitis means the tissue lining the sinuses is swollen or inflamed. The sinuses are air-filled spaces in the skull, behind the forehead, nasal bones, cheeks, and eyes. An infection from a virus, bacteria, or fungus can cause it. An inflammatory reaction can also cause it. Sinusitis is also called rhinosinusitis, and it affects about one in eight adults each year.
Acute sinusitis lasts 4 weeks or less. Chronic sinusitis lasts longer than 12 weeks.
Symptoms
Common symptoms of acute sinusitis include:
- Nasal stuffiness and discharge.
- Pressure-like pain, pain behind the eyes, toothache, or tenderness of the face.
- Headache, fever, and fatigue.
- Cough, often worse at night.
- Bad breath or loss of smell.
- Sore throat and postnasal drip, which is mucus draining down the back of the throat.
In adults, these symptoms very often follow a cold that does not get better, or that gets worse after 7 to 10 days. Chronic sinusitis has the same symptoms, but they tend to be milder and last longer than 12 weeks.
In children, watch for a cold that gets better and then worse. A high fever with dark nasal discharge for at least 3 days is another sign.
Causes and who gets it
If the openings get blocked or mucus builds up, bacteria and other germs can grow more easily. Colds and allergies can cause extra mucus or block the openings. A deviated septum (a bent wall inside the nose), a nasal bone spur, or nasal polyps can also block the openings.
Viruses or bacteria usually cause acute sinusitis. About 98 percent of acute cases are caused by a virus, not bacteria. Chronic sinusitis is usually caused by long-lasting inflammation instead of a long infection.
Risk factors include cystic fibrosis, day care, large adenoids, smoking, and flying or scuba diving. A weakened immune system from HIV or chemotherapy also raises the risk.
To lower your risk, avoid colds and flu and wash your hands often. Get a flu shot each year and control any allergies.
How doctors diagnose it
A provider looks in your nose for polyps. They may also shine a light on the sinus and tap over it to find tenderness. A provider may look inside with a scope, which is a tube with a light. This test is called nasal endoscopy. You do not need X-rays or CT scans to diagnose uncomplicated sinusitis if you have discharge plus pressure or blockage.
A CT scan may be needed if your doctor suspects a complication. It may also be needed for repeated or long-lasting sinus symptoms.
Treatment
Treatment depends on the cause. To ease stuffiness, put a warm, moist washcloth on your face. Drink plenty of fluids. Saline nasal spray and a humidifier can also help. Acetaminophen, ibuprofen, or naproxen can ease sinus pain or pressure.
Be careful with over-the-counter decongestant nasal sprays. Using them for more than 3 to 5 days can make stuffiness worse and lead to dependence.
Most of the time, acute sinusitis does not need antibiotics. Most of these infections go away on their own. Some people with acute bacterial sinusitis may get better faster with an antibiotic.
For chronic sinusitis, the main treatments are salt water nasal irrigation, which rinses the nose, and nasal steroid sprays. Nasal steroid sprays and antihistamines can also reduce swelling, especially with nasal polyps or allergies.
For chronic sinusitis, surgery is an option when medicines and other treatments cannot control the symptoms. The most common type is endoscopic sinus surgery. It widens the natural drainage pathways between the sinuses and the nose.
When to see a doctor
Contact your health care provider if:
- Your symptoms last longer than 10 to 14 days, or a cold gets worse after 7 days.
- You have a severe headache that over-the-counter pain medicine does not relieve.
- You have a fever.
- You still have symptoms after taking all of your antibiotics properly.
- You notice any change in your vision during a sinus infection.
A sinus infection that spreads to the eye, face, or brain is an emergency. Call 911 or go to the emergency room if you think this is happening.
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. These doctors can examine you and treat common cases. They can also follow long-lasting symptoms and refer you to an ENT or allergy specialist when needed.
Common questions
How long does sinusitis last?
Acute sinusitis lasts 4 weeks or less, and chronic sinusitis lasts longer than 12 weeks. Most acute sinus infections go away on their own.
Do I need antibiotics for sinusitis?
Most of the time, no. Most acute sinusitis is caused by a virus, so it should not be treated with antibiotics.
Does green or yellow mucus mean I have a sinus infection?
Not always. Green or yellow mucus does not mean you definitely have a sinus infection or need antibiotics. Many people with this symptom recover fully without taking antibiotics.
Can a headache be mistaken for sinusitis?
Yes, migraine or tension headaches can cause sinus pain or pressure.
Sources
- MedlinePlus - Sinusitis (Medical Encyclopedia)
- ENT Health (American Academy of Otolaryngology-Head and Neck Surgery) - Sinusitis
- MedlinePlus - Sinusitis
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.
