Diagnosis

Your doctor will feel for tenderness in your nose and face and look inside your nose.

Other methods that might be used to diagnose acute sinusitis and rule out other conditions include:

  • Nasal endoscopy. A thin, flexible tube (endoscope) with a fiber-optic light inserted through your nose allows your doctor to visually inspect the inside of your sinuses.
  • Imaging studies. A CT scan or MRI can show details of your sinuses and nasal area. While not recommended for uncomplicated acute sinusitis, imaging studies might help identify abnormalities or suspected complications.
  • Nasal and sinus cultures. Laboratory tests are generally unnecessary for diagnosing acute sinusitis. However, when the condition fails to respond to treatment or is worsening, tissue cultures might help determine the cause, such as a bacterial infection.
  • Allergy testing. If your doctor suspects that allergies have triggered your acute sinusitis, he or she will recommend an allergy skin test. A skin test is safe and quick, and can help pinpoint the allergen that's responsible for your nasal flare-ups.

Treatment

Most cases of acute sinusitis, those caused by a viral infection, resolve on their own. Self-care techniques are usually all you need to ease symptoms.

Treatments to relieve symptoms

Your doctor may recommend treatments to help relieve sinusitis symptoms, including:

  • Saline nasal spray, which you spray into your nose several times a day to rinse your nasal passages.
  • Nasal corticosteroids. These nasal sprays help prevent and treat inflammation. Examples include fluticasone (Flonase, Veramyst), budesonide (Rhinocort), mometasone (Nasonex) and beclomethasone (Beconase AQ, Qnasl, others).
  • Decongestants. These medications are available in over-the-counter (OTC) and prescription liquids, tablets and nasal sprays. Use nasal decongestants for only a few days. Otherwise they may cause the return of more severe congestion (rebound congestion).
  • OTC pain relievers, such as aspirin, acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).

    Use caution when giving aspirin to children or teenagers. Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition, in such children.

Antibiotics

Antibiotics usually aren't needed to treat acute sinusitis. Even if your acute sinusitis is bacterial, it may clear up without treatment.

Your doctor might wait and watch to see if your bacterial acute sinusitis worsens. However, severe, progressive or persistent symptoms might require antibiotics. If your doctor prescribes an antibiotic, be sure to take the whole course, even after your symptoms get better. If you stop taking them early, your symptoms may recur.

Immunotherapy

If allergies are contributing to your sinusitis, allergy shots (immunotherapy) that help reduce the body's reaction to specific allergens may help treat your symptoms.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Lifestyle and home remedies

These self-help steps can help relieve sinusitis symptoms:

  • Rest. This will help your body fight infection and speed recovery.
  • Drink fluids, such as water or juice. This will help dilute mucous secretions and promote drainage. Avoid beverages that contain caffeine or alcohol, as they can be dehydrating. Drinking alcohol can also worsen the swelling of the lining of the sinuses and nose.
  • Moisten your sinus cavities. Drape a towel over your head as you breathe in the vapor from a bowl of hot water. Keep the vapor directed toward your face. Or take a hot shower, breathing in the warm, moist air. This will help ease pain and help mucus drain.
  • Apply warm compresses to your face. Place warm, damp towels around your nose, cheeks and eyes to ease facial pain.
  • Rinse your nasal passages. Use a specially designed squeeze bottle (Sinus Rinse, others) or neti pot. This home remedy, called nasal lavage, can help clear your sinuses.

    If you make your own rinse, use water that's contaminant-free — distilled, sterile, previously boiled and cooled, or filtered using a filter with an absolute pore size of 1 micron or smaller — to make up the irrigation solution. Also be sure to rinse the irrigation device after each use with contaminant-free water and leave open to air-dry.

  • Sleep with your head elevated. This will help your sinuses drain, reducing congestion.

Alternative medicine

No alternative therapies have been proved to ease the symptoms of acute sinusitis, but products containing certain combinations of herbs may help. These combination therapies, sold under brand names such as Sinupret and SinuGuard, contain cowslip, gentian root, elderflower, verbena and sorrel.

Possible side effects include stomach upset, diarrhea and allergic skin reactions.

Preparing for your appointment

When you see your doctor, expect a thorough examination of your sinuses. Here's information to help you get ready for your appointment.

What you can do

Make a list of:

  • Your symptoms, including any that seem unrelated to the reason for your appointment
  • Key personal information, including whether you have allergies or asthma and family medical history
  • All medications, vitamins or other supplements you take, including the doses
  • Questions to ask your doctor

Take a family member or friend along, if possible, to help you remember the information you're given.

For acute sinusitis, questions to ask your doctor include:

  • What's likely causing my symptoms?
  • What are other possible causes for my symptoms?
  • What tests do I need?
  • Is my condition likely temporary or chronic?
  • What's the best course of action?
  • What are the alternatives to the primary approach you're suggesting?
  • I have these other health conditions. How can I best manage them together?
  • Are there restrictions I need to follow?
  • Should I see a specialist?
  • Are there brochures or other printed material I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you questions, such as:

  • When did your symptoms begin?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Do you smoke or are you around smoke or other pollutants?
July 29, 2017
References
  1. Sinusitis. American Academy of Allergy, Asthma & Immunology. http://www.aaaai.org/conditions-and-treatments/allergies/sinusitis.aspx. Accessed Jan. 11, 2016.
  2. Hwang PH, et al. Acute sinusitis and rhinosinusitis in adults: Clinical manifestations and diagnosis. http://www.uptodate.com/home. Accessed Jan. 14, 2016.
  3. Hwang PH, et al. Acute sinusitis and rhinosinusitis in adults: Treatment. http://www.uptodate.com/home. Accessed Jan. 14, 2016.
  4. Sinusitis (sinus infection). National Institute of Allergy and Infectious Disease. www.niaid.nih.gov/topics/sinusitis/pages/index.aspx. Accessed Jan. 14, 2016.
  5. Adult sinusitis. American Rhinologic Association. http://care.american-rhinologic.org/adult_sinusitis. Accessed Jan. 15, 2016.
  6. Complications of sinusitis. American Rhinologic Association. http://care.american-rhinologic.org/complications_sinusitis. Accessed Jan. 14, 2016.
  7. Meltzer EO, et al. Rhinosinusitis diagnosis and management for the clinician: A synopsis of recent consensus guidelines. Mayo Clinic Proceedings. 2011;86:427.
  8. Sinupret+. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Jan. 15, 2016.
  9. SinuGuard. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Jan. 15, 2016.