Sinus Infection: Symptoms, Treatment, and When You Need Antibiotics
Most sinus infections are viral and clear on their own in a week to 10 days. The symptoms, what helps at home, when antibiotics make sense, and when to see a clinician.
A sinus infection causes pressure in your face, a stuffy nose and thick drainage, and most of the time it's caused by a virus that clears on its own within about a week to 10 days. Antibiotics only help when bacteria are the cause, which is more likely if symptoms last longer than 10 days, start strong with a high fever, or get worse after you'd started to improve. Here's how to tell the difference and when to have someone take a look.
What is a sinus infection?
Your sinuses are air-filled spaces in the bones around your nose, cheeks and forehead. When their lining swells, usually after a cold or during allergy season, mucus can't drain and pressure builds. That's sinusitis. Most cases are viral. A smaller share turn into a bacterial infection, often when mucus has been trapped for a while.
Sinus infection symptoms
- Pressure or pain in the face, around the eyes, cheeks or forehead
- A stuffy nose
- Thick yellow or green drainage from the nose or down the back of the throat
- A reduced sense of smell or taste
- A headache that's worse when you bend forward
- Pain in the upper teeth
- Cough, bad breath, tiredness or a low fever
Sinus infection or allergies?
Allergies tend to cause itchy eyes, sneezing and clear, watery drainage, and they come back in the same season each year. A sinus infection is more likely to bring facial pain, thick colored drainage and sometimes a fever. The two overlap, because allergies can swell the sinuses and set the stage for an infection. If it's allergies, our seasonal allergies page covers what can help.
Viral or bacterial: when do antibiotics help?
Antibiotics don't work on viruses, and taking them when you don't need them brings side effects without making you better faster. A bacterial sinus infection is more likely if:
- Symptoms last more than 10 days without improving
- You start to get better, then get worse again
- It starts severe, with a high fever and thick drainage for several days in a row
A clinician can examine you, sort out which pattern you're in, and discuss whether an antibiotic makes sense.
Sinus infection treatment at home
For a viral sinus infection, and alongside any prescription, these help with symptoms:
- Saline nasal rinses or sprays. If you use a rinse bottle or neti pot, use distilled, sterile or boiled-then-cooled water, never straight from the tap.
- Steam from a shower or a bowl of hot water, and a humidifier, which matter in Denver's dry air
- Warm compresses over the face
- Plenty of fluids and rest
- Over-the-counter pain relievers, if they're safe for you
- A steroid nasal spray, which can ease swelling
Decongestant nasal sprays can help briefly, but using them for more than a few days can make congestion worse once you stop. Check with a pharmacist or clinician before using decongestants if you have high blood pressure, are pregnant, or are treating a child.
When to see a clinician
Get seen if symptoms last more than 10 days, get worse after improving, come with a high fever, or keep coming back several times a year. Repeated or long-lasting sinus problems may need a specialist, and a clinician can tell you if that's the next step.
Sinus infections are often a good fit for telehealth. A video visit with an AfterOurs clinician is $75 self-pay, available 8 AM to 11 PM daily, and if the clinician needs to examine you in person, they'll tell you. In the clinic, a standard self-pay visit is $175, and a self-pay in-clinic visit never costs more than $330. We contract with all major commercial and government plans, including Colorado Medicaid and Medicare. We can't guarantee a particular commercial plan has us in network; if it's out of network or denies the visit, we drop you to the self-pay rates. More on our cost and insurance page and our sinus infection page.
Call 911 or go to the ER if you have swelling or redness around one or both eyes, changes in your vision or double vision, a severe headache with a stiff neck, confusion, swelling of the forehead, or a high fever that won't come down. These can mean an infection is spreading beyond the sinuses.
Where to find us
Four clinics across metro Denver, all ages welcome, se habla español:
- Hampden (Southeast Denver): 8 AM–11 PM daily
- Littleton: 8 AM–11 PM daily
- Thornton: 8 AM–11 PM daily
- Highlands: Mon–Fri 5–11 PM, Sat–Sun 8 AM–11 PM
Walk in, or book online.
Medically reviewed by Peter Martinuzzi, MD
This article is general health information, not medical advice for your situation. If you are worried, come in or book a telehealth visit — and if it is an emergency, call 911.