Sinusitis (rhinosinusitis)

Sinusitis is when the hollow spaces behind the eyes, nose, forehead and cheeks become inflamed. Your body can most likely recover without the need for medical treatment. Sinusitis can sometimes be a chronic (long-term) condition, as a complication of allergies or structural problems in the nose.

Sinusitis is also called rhinosinusitis as it causes inflammation of both the nasal passages and sinuses.

Most cases of sinusitis are caused by an infection. If you have acute (short-term) sinusitis caused by a virus, you may have the following symptoms:

• discharge from your nose (a 'runny nose') and obstruction (feeling 'stuffy')
• changes in smell
• pain or pressure in your face (you may feel worse when you bend over, or you may feel pressure in your teeth)

Acute bacterial sinusitis has very similar symptoms to acute sinusitis caused by a virus.

If you have sinusitis caused by bacteria, you are more likely to have:

• fever
• pain in your face
• discoloured discharge from your nose
• symptoms that get worse after a mild illness ('double sickening')
• symptoms that last more than 10 days without getting better

If you have chronic or long-term (lasting more than 12 weeks) sinusitis, you may have:

• nasal congestion or obstruction (feeling stuffy or blocked)
• change in your ability to smell
• pain and pressure in the face

Sinusitis can also cause a cough and sore throat.

Sinusitis is usually caused by a viral infection, such as the common cold or COVID-19, or by a bacterial infection that develops after a viral infection.

Untreated allergies, having a crooked or bent nose, smoking, polyps in your nose and overuse of decongestant nose sprays can increase your chances of getting sinusitis.

You should see your doctor if you have symptoms of sinusitis and:

• your symptoms are severe or getting worse
• your symptoms haven't started to improve after around 7 to 10 days
• you have frequent episodes of sinusitis

Your doctor can usually diagnose sinusitis by talking to you about your symptoms and by examining you.

Your doctor may refer you for a CT scan or MRI of your sinuses. You will only need this if your doctor thinks you may have complications of sinusitis.

Sinusitis usually resolves on its own. Your doctor may prescribe or recommend the following treatments to help manage your symptoms:

• saline nasal sprays, rinses or drops
• nasal decongestants (do not use for more than 3 to 5 days)
• pain relief medicines such as paracetamol and ibuprofen
• steroid nasal spray
• steam inhalation

In some cases, your doctor may prescribe an antibiotic. This is only if your symptoms are severe, taking a long time to get better or if you have complications of sinusitis.

If you often get sinusitis it could be due to an allergy, so they may refer you to an ear, nose and throat (ENT) specialist.

Sinusitis can be difficult to prevent. You can reduce your chances of developing sinusitis by following good hand washing practices, avoiding cigarette smoke and treating existing problems such as allergies.

Complications of sinusitis can involve the eye or the brain. Eye complications include infections of the skin around the eye or the eye socket. These are both types of cellulitis.

Complications in the brain include infections such as meningitis or abscesses in different parts of the brain, but this is very rare.

The Australasian Society of Clinical Immunology and Allergy (ASCIA) has information about the symptoms and management of sinusitis — download the ASCIA sinusitis and allergy fact sheet (Opens in new tab).

Australian Commission on Safety and Quality in Health Care (Opens in new tab) has a decision aid you can use with your doctor to help you decide whether to use antibiotics when you or your child has sinusitis (acute rhinosinusitis).

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.