Girl sneezing outside
June 23, 2017 | by Stephanie P. Rezendes PA-C

Sinusitis, colds and allergies can be confusing because the symptoms can appear similar. Below are some tips to help you understand the differences in symptoms and treatment.

When does sinusitis become chronic?

Chronic sinusitis is a long-lasting form of sinusitis. Sinusitis is a condition that causes a stuffy nose, pain in the face, and discharge (mucus) from the nose.

The sinuses are hollow areas in the bones of the face. They have a thin lining that normally make a small amount of mucus. When this lining gets inflamed, it swells and makes extra mucus.

The most common type of sinusitis often happens after you catch a cold, otherwise known as acute sinusitis, and usually gets better in one to three weeks.

Chronic sinusitis lasts for at least three months. People with this condition often have very swollen sinuses. One or more sinus might fill with infected mucus.

Who is likely to get chronic sinusitis?

You may be more likely to get chronic sinusitis if you have:

  • Allergies. Allergies to molds, cockroaches, dust mites and animal dander are most likely to cause sinus problems.
  • Compromised immune system.
  • Frequent colds.
  • An injury or deformity of the nose that makes it hard to drain mucus normally.
  • Breathing cigarette smoke might also make you more likely to get chronic sinusitis.

What treatments are available?

Treatment options can include lifestyle changes, home care, medications and surgery.

  • Lifestyle changes.
    • If you smoke, quit. Also avoid second-hand smoke.
    • If you have allergies, talk to your doctor about how to better control your allergy symptoms.
    • Nasal irrigation: Rinse out your nose with salt water. This cleans the inside of your nose and washes allergens and mucus from the nose. Different devices can be used to rinse the nose.
  • Steroids. Prescription medications such as Flonase can help reduce swelling and mucus, and shrink polyps, if you have them. Steroids can be taken as sprays or drops that you put in your nose. You can also add steroid medicines to the salt water you use for rinsing out your nose. Your doctor also might prescribe steroid pills.
  • Antibiotics. These may be used to treat sinus infections, which sometimes occur when you have chronic sinusitis.
  • Surgery. Some people with chronic sinusitis may benefit from surgery to reopen blocked nasal passages and remove polyps or mucus trapped in the nose. This may be considered if medications don’t provide long-lasting relief.

When should an ENT be consulted?

If your symptoms don’t improve after trying medications and conservative measures for three months, or if you’ve tried multiple rounds of antibiotics, you may want to consider seeing an otolaryngologist, also called an ENT. It’s important to share any prior diagnostic imaging studies with your ENT’s office before your appointment.

Use this chart below to help identify what illness your symptoms may be suggesting. It’s usually best to seek initial treatment from your primary care provider. If symptoms persist, your primary care provider may refer you to an allergist or ENT doctor.

SIGN/SYMPTOM SINUSITIS ALLERGY COLD
Facial Pressure /Pain Yes Sometimes Sometimes
Duration of illness Over 10-14 days Varies Under 10 days
Nasal Discharge Whitish or colored Clear, thin, watery Thick, whitish or thin
Fever Sometimes No Sometimes
Headache Sometimes Sometimes Sometimes
Pain in upper teeth Sometimes No No
Bad breath Sometimes Sometimes Yes
Coughing Sometimes Sometimes Yes
Nasal Congestion Yes Sometimes Yes
Sneezing No Sometimes Yes

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