Sinusitis: symptoms, treatment and which doctor to see

What sinusitis is, how to tell it from a cold, why antibiotics are often not needed, how chronic sinusitis is treated, and when to see an ENT.

Also known as: Sinus Infection

What sinusitis is

The sinuses are air-filled spaces in the bones of the face — behind the cheeks, between the eyes and above the eyebrows — that open into the nose through small channels. Their lining makes mucus that normally drains away unnoticed. When the lining swells, these channels block, mucus collects and the area becomes inflamed. This is sinusitis, also called rhinosinusitis because the nose is always involved too.

Acute sinusitis lasts up to about four weeks and usually follows a cold. Most cases are caused by viruses and settle by themselves. A smaller number become bacterial infections. Chronic sinusitis lasts twelve weeks or more, despite treatment. It is a long-term inflammatory condition rather than a simple infection, and is often linked to allergies, asthma or nasal polyps — soft, painless swellings of the nasal lining.

Symptoms

• Blocked nose, often on one or both sides
• Thick nasal discharge, yellow or green, from the front of the nose
• Postnasal drip — mucus running down the back of the throat, causing throat clearing or cough
• Facial pain or pressure around the cheeks, eyes or forehead, often worse bending forward
• Reduced sense of smell
• Fever, tiredness, toothache in the upper jaw, or bad breath

Coloured mucus by itself does not mean a bacterial infection. Signs that a bacterial infection may have developed include symptoms lasting more than about ten days without improvement, severe symptoms with a high fever, or getting better and then suddenly worse. Headache without nasal symptoms is rarely due to sinusitis, and is often a migraine or tension-type headache.

Causes and who is at risk in India

Anything that swells the nasal lining or blocks drainage can lead to sinusitis:

• Colds and other viral infections
• Allergic rhinitis — to dust mites, pollen, mould or pets — which is very common
• Air pollution, road and construction dust, and smoke from tobacco, cooking fuel or incense
• A deviated nasal septum or nasal polyps
• Asthma, which often coexists with chronic sinusitis
• Dental infections in the upper teeth
• Weakened immunity, including poorly controlled diabetes and long-term steroid use

In people with uncontrolled diabetes, or whose immunity is suppressed, fungal infections of the sinuses can occur and spread quickly. India saw many cases of one such infection, mucormycosis ('black fungus'), during the COVID-19 pandemic. This is rare but is an emergency, and its signs are listed below.

How it is diagnosed

Acute sinusitis is diagnosed from your symptoms and a look inside the nose; tests are usually not needed. For chronic or repeated sinusitis, or when a complication is suspected, an ENT surgeon may use:

• Nasal endoscopy — a thin camera passed into the nose in the clinic, after a numbing spray, to look at the drainage channels, polyps and pus.
• CT scan of the sinuses — shows the anatomy of the sinuses and how blocked they are. It is mainly used for chronic sinusitis, before surgery, or when a complication is suspected, not for a routine cold.

Allergy tests may help if allergic rhinitis is suspected, and an MRI is sometimes used if infection may have spread around the eye or brain. Plain X-rays of the sinuses are now rarely helpful.

Which doctor to see

Most acute sinusitis can be managed by a general physician. See an ENT surgeon if:

• Symptoms last more than twelve weeks, or keep coming back
• One side of the nose is always blocked, bleeds, or has a foul-smelling discharge
• Your sense of smell has gone and does not return
• Treatment has not helped and surgery may be an option

You can find ENT surgeons in Bengaluru or general physicians in Bengaluru on The Doctor Index, each with a registration you can check.

Treatment

Acute sinusitis

Most acute sinusitis gets better within a week or two with simple measures: rest, fluids, a painkiller suitable for you, and saline nasal irrigation — rinsing the nose with salt water using a bottle or pot, made with boiled and cooled or sterile water. Steroid nasal sprays can reduce swelling. Decongestant sprays may help for a few days but cause rebound blockage if used longer.

Antibiotics do not help viral sinusitis, and using them when they are not needed adds side effects and contributes to antibiotic resistance. A doctor may prescribe them when bacterial infection is likely. Do not take leftover antibiotics or buy them without a prescription, and if you are prescribed a course, take it as directed.

Steam inhalation is widely used in Indian homes and some people find it soothing, but take care: bowls of boiling water cause serious scalds, particularly in children.

Chronic sinusitis

Daily saline nasal irrigation and steroid nasal sprays are the mainstay, used regularly for weeks to months. Treating allergies and asthma helps. A short course of oral steroids or antibiotics is sometimes added for flare-ups or large polyps. For severe polyps that keep returning, newer biological injections are an option at specialist centres.

If medicines do not control symptoms, endoscopic sinus surgery widens the natural drainage channels and removes polyps, working through the nostrils without external cuts. A deviated septum may be corrected at the same time. Surgery helps many people, but chronic sinusitis can return, so sprays and rinses usually continue afterwards. Do not stop your prescribed sprays without talking to your doctor.

Living with chronic sinusitis

• Make nasal rinsing part of your daily routine, and clean the bottle regularly
• Learn the right technique for nasal sprays — aim away from the middle of the nose
• Reduce dust and smoke at home, and wear a mask in heavy dust or pollution
• Keep diabetes well controlled
• Stop smoking

When it is an emergency

Rarely, sinus infection spreads to the eye, bone or brain. Call 112 or 108, or go to the nearest emergency department, for:

• Swelling or redness around the eye, a bulging eye, double vision or reduced vision
• Severe headache, a stiff neck, confusion or drowsiness
• Swelling of the forehead or face, or numbness of the face
• Black crusts in the nose or on the palate, especially with diabetes or after steroid treatment
• High fever with a person who seems very unwell

Questions to ask at your appointment

• Is this sinusitis, a cold or an allergy?
• Do I need antibiotics, and why?
• How should I rinse my nose and use my spray?
• Do I need a nasal endoscopy or CT scan?
• Could allergies, asthma or a deviated septum be part of the problem?
• Would surgery help me, and what are the chances of it coming back?

Common questions

All ent conditions →

Sources

• MedlinePlus, US National Library of Medicine — Sinusitis
• American Academy of Otolaryngology–Head and Neck Surgery (ENT Health) — Sinusitis
• MedlinePlus, National Library of Medicine — Sinusitis — Public-domain health-topic summary
• Human Phenotype Ontology Consortium — terminology definitions — HPO licence; definitions reproduced without alteration

Sinusitis: symptoms, treatment and which doctor to see is original text by The Doctor Index; the compiled source draft was used for research. Source: MedlinePlus, National Library of Medicine. Orphadata Science: Free access data from Orphanet. © INSERM 1999; July 2026 data, CC BY 4.0. This product uses the Human Phenotype Ontology (hp/releases/2026-09-01). Only sources listed for this article apply. Source material has been selected and arranged; HPO definitions are reproduced without alteration. No source organisation endorses this compilation. Köhler S et al. The Human Phenotype Ontology project: linking molecular biology and disease through phenotype data. Nucleic Acids Research 2014;42(D1):D966–D974. doi:10.1093/nar/gkt1026.

General information, not advice about your situation. Errors can be reported through the corrections process. Reference TDI-C-2160.