Patient information · ENT
Sinusitis
why it takes longer than you expect
Sinusitis is inflammation of the air spaces around the nose, usually following a cold. It causes facial pressure, blockage and a thick discharge, and it typically takes two to three weeks to resolve — considerably longer than most people anticipate. Almost all of it is viral.
Go to an emergency department immediately if there is
- swelling or redness around the eye, or the eyelid becoming puffy
- double vision, reduced vision, or an eye that will not move normally
- severe headache with a stiff neck, or dislike of bright light
- confusion, drowsiness, or a seizure
- swelling over the forehead, or a soft boggy swelling of the scalp
Infection spreading from the sinuses into the eye socket or the skull is rare but serious and needs immediate hospital assessment. Swelling around the eye is the sign to act on. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
What to expect
Symptoms are facial pain or pressure, particularly on bending forward, a blocked nose, thick discoloured discharge, reduced sense of smell, and sometimes upper toothache. Discoloured mucus does not indicate bacterial infection and is not by itself a reason for antibiotics.
Treatment that works
- Saline nasal rinsing — using a sachet and a squeeze bottle or neti pot, once or twice daily — is the most useful self-treatment there is. Use cooled boiled or distilled water, never straight from the tap.
- A steroid nasal spray reduces the inflammation causing the blockage. It takes several days to work.
- Paracetamol or ibuprofen for the pain and pressure.
- Steam inhalation may ease congestion, though evidence is limited. Take care to avoid scalds.
- Plenty of fluids, and sleeping propped up.
- Decongestant sprays may be used for no more than five to seven days — longer causes rebound congestion that is worse than the original problem.
When antibiotics are considered
Antibiotics make little difference to most sinusitis. They are appropriate where symptoms have lasted more than ten days without improvement, where there is a clear pattern of getting better then markedly worse, where there is a high fever with severe pain, or where someone is at particular risk. Sometimes a delayed prescription is offered to hold and use only if things have not turned around in a few days.
When it keeps coming back
Sinusitis lasting more than twelve weeks, or recurring several times a year, is a different problem from an acute infection and needs assessing rather than repeatedly treating. Underlying causes include allergy, nasal polyps, a deviated septum and dental infection. Investigation may involve nasal endoscopy, allergy testing or a CT scan.
- Treat allergic rhinitis properly — untreated allergy is the commonest driver of recurrent sinusitis.
- Stop smoking; smoke paralyses the clearance mechanism in the nose.
- Continue saline rinsing daily as prevention, not only during infections.
Book an appointment if symptoms have lasted more than ten days without improvement, sinusitis keeps returning, you have facial pain with a fever, or you want nasal endoscopy or a CT scan. Our ENT team sees patients seven days a week without a referral, and we arrange CT quickly through our CQC-registered imaging partners.
ENT assessment and fast CT access
Same-day appointments most days, seven days a week, 9am–7pm, on Whitechapel Road.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.