Are Chronic Allergies to Blame for Your Sinusitis?

By Dianne Lange. Medically reviewed by Tom Iarocci, MD. May 7th 2016

Few symptoms of disease or illness are so discrete that they point directly at a single condition.

Take allergy and sinus inflammation, or sinusitis, for instance. Your congestion and facial pain can indicate one and not the other or may actually mean you have both, says Dean C. Mitchell, M.D., author of Dr. Dean Mitchell's Allergy and Asthma Solution (Marlowe & Co.).

Allergies occur when the immune system mistakenly identifies a substance such as pollen or mold as harmful and launches an attack on the invader. The cascade of chemical events that occurs as the body defends itself ultimately leads to inflammation.

The inflammation caused by an allergy affects the nasal passages first. If it extends deeper into the sinuses -- the air-filled areas behind the forehead, cheeks, eyes and nasal bones -- it's called sinusitis.

The sinuses are lined with thin, mucous-producing tissue that swells when inflamed, preventing mucous from flowing freely into the nose. Air and mucous may become trapped in the sinuses, causing pressure and pain, and setting the stage for infection. Studies show that sinusitis rarely occurs without inflammation of the nasal mucous membranes, or rhinitis, whether it's caused by an allergy or not.

Comparing allergy and sinusitis 

An allergic reaction to something you've breathed and the more serious condition of sinusitis have these symptoms in common:

  • nasal congestion
  • sore throat
  • feeling of fullness in the cheeks, forehead and brow
  • decreased sense of smell
  • sneezing

Here’s how the two conditions tend to differ:

  • Nasal discharge from an allergy is clear; mucous discharge from inflamed sinuses is thick and green.
  • Pain in the cheeks, forehead and brow and headache are more common with sinusitis than an allergy.
  • Watery eyes and conjunctivitis are more common with an allergy than sinusitis.  However, severe swelling around the eyes is a serious but rare sign of sinusitis.
  • Fever, although rare, may indicate a sinus infection.

Sidestep seasonal and pet allergies

Allergies can't be prevented, but you can take action to keep your runny nose and congestion from progressing to acute sinusitis. Limit your exposure to pets, pollen, mold or whatever makes you sneeze, says the Asthma and Allergy Foundation of America.

Take medication before trouble starts. If you're prone to seasonal allergies, talk to your health-care provider about medications like nasal sprays that you take even before the pollen count rises. 

Patients who suffer from recurring bouts of allergic rhinitis should observe their symptoms on a continual basis. If facial pain or a greenish-yellow nasal discharge occurs, a qualified ear, nose and throat specialist can provide appropriate treatment.

Once nasal passages start to swell, take steps to remedy the discomfort and prevent the inflammation from worsening, whether it's in your nasal passages (allergic rhinitis) or has traveled deeper into your sinuses (sinusitis).

Take the next steps

Severe symptoms, like a fever over 100.5 F or sinus discomfort that lasts for more than 10 days, require medical attention. Don't be tempted to self-diagnose or self-medicate with those antibiotics left over from your last sinus infection, either. According to the Infectious Diseases Society of America, bacteria causes only 10 percent or fewer cases of sinusitis, and inappropriate antibiotic use can lead to problems, including antibiotic resistance.

  • Intervene early. Irrigation with nasal saline is helpful for many people. Oral decongestants, nasal sprays and drops are available that may help to reduce swelling so that sinus passages don't become blocked. However, don’t use any decongestant for more than a few days without talking to your doctor. Be sure there are no contraindications to specific OTC medications.
  • Combine sprays.  Talk to your health-care professional about short-term use of both an intranasal corticosteroid spray along with the decongestant. The intranasal corticosteroid treats the inflammation causing the swelling. 
  • Use an over-the-counter pain reliever such as acetaminophen or ibuprofen for short-term relief of headache and facial pain. 

Here are some additional things you can do at home to ease minor symptoms:

  • Steam from the shower may be helpful for decongesting.   
  • Sip on hot green tea several times a day for an immune boost; tea also improves efficacy of antibiotics if they become necessary.
  • Continue drinking water to maintain good hydration and lubricate mucous membranes.
  • Use nasal saline to provide moisture when nasal passages are likely to become dry and irritated, such as during air travel.

In short, there are many different strategies that can be used to relieve symptoms. And while the first instinct shouldn’t always be to rush in to the doctor’s office for an antibiotic, don’t hesitate to work with your health care provider when you need help managing the symptoms or the optimal treatment of allergies, sinusitis or other illnesses.

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