How to identify and prevent a sinus infection

The start of fall means back-to-school, football and pumpkin-flavored everything. It also brings a higher occurrence of sinus infections.

Sinus infections are very common; they affect an estimated one in eight adults each year, and Americans spend more than $1 billion annually on over-the-counter-medications to treat them, according to the American College of Allergy, Asthma and Immunology. It can be tricky to identify them, though, because many sinus infection symptoms are also associated with the common cold.

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If symptoms like congestion or post-nasal drip last more than 10 days, it's likely a sign you have a bacterial sinus infection and need to see a doctor, said Dr. Tran Locke, an ear, nose and throat (ENT) specialist at Baylor College of Medicine. Those longer-lasting symptoms can be frustrating to deal with until they clear up, she said.

"They will eventually resolve," Locke said. "It's just that you're going to be miserable for longer."

The sinuses are cavities in the bones of the face, connected by small channels. They produce a thin mucus that keeps the nose moist, and air passes through them as you breathe.

If they become inflamed — a condition known as sinusitis —  mucus may become trapped and build up, creating a breeding ground for bacteria.

"The mucus just gets stuck. It stays in your sinuses and becomes stagnant," Locke said. "And bacteria just love to grow there."

Sinus inflammation may be caused by several things, including allergies, the common cold and exposure to an irritant such as smoke. Some people may also be predisposed to inflammation due to a condition like a deviated septum, or because they have weaker immune systems.

Because allergies and colds are more common in the fall and winter, there is also a higher occurrence of sinus infections during those seasons, Locke said.

"Everyone's a little bit different. It kind of depends on your triggers," she said. "But I see it more in the wintertime because of the [upper-respiratory infections] that become sinus infections."

Typical symptoms of a sinus infection include congestion; facial or sinus pressure; thick, discolored mucus; and decreased smell. Less common symptoms include upper tooth pain; ear pressure; headaches and fever.

Sinus infections are typically caused by a virus or bacteria, Locke said. They can also be caused by fungus, though that is less common.

Viral sinus infections are basically indecipherable from the common cold because symptoms last only a few days, Locke said. In those cases, over-the-counter medications like decongestants, nasal sprays or rinses and pain relievers can alleviate symptoms. Rest and hydration also help you recover, she said. Sinus infections may require a prescription for antibiotics.

Some people may experience chronic sinusitis, with symptoms lasting at least 12 weeks. Those people should see an ENT, because they may require additional treatment, Locke said. Specialists can perform a nasal endoscopy to check for something like nasal polyps, painless and benign growths on the lining of the patient's nasal passages or sinuses.

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Many patients can be treated with medication such as antibiotics and steroids, but others may need a minimally-invasive surgery to correct an underlying issue, Locke said.

The good news is that there are ways to prevent sinus infections, and that starts with good hygiene, Locke said. You can use a nasal irrigation devices, such as a neti pot, to clean out your nose on a regular basis. But use distilled water; tap water may contain bacteria. Tap water is safe to drink because stomach acids will kill those bacteria, but they can stay alive in the nose, according to the U.S. Food and Drug Administration.

You should also wash your hands to limit your exposure to germs, keep up-to-date on any allergy medications that you take, and avoid being exposed to irritants such as smoke, Locke said.

"The main thing is good nasal hygiene and hand hygiene to prevent these infections," she said.

evan.macdonald@chron.com

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