Sinusitis treatment involves saline solutions, anti-inflammatories, nasal decongestants, and antibiotics that can help relieve symptoms and fight bacteria. Surgery may be indicated in some cases.

Sinusitis is an inflammation of the nasal sinuses, which are small cavities in the skull surrounding the nose and eyes. Symptoms of sinusitis include a stuffy or runny nose and facial pressure.

Sinusitis requires individualized treatment by an otolaryngologist (ENT) or primary care provider based on the cause and severity of symptoms. Causes of sinusitis include allergies, viruses, bacterial infections, and fungal infections.

female patient and female provider pinching noses to demonstrate sinus symptoms

Main treatments

The most common sinusitis treatments recommended by a healthcare provider are:

1. Saline solutions

Saline solutions, like sodium chloride 0.9% or salt water nasal spray, help irrigate and clean out the nasal sinuses, as well as reduce symptoms like a stuffy or runny nose caused by viral or bacterial sinusitis.

These solutions also help eliminate irritants and allergens that can cause allergic sinusitis.

Saline solutions can be found in pharmacies or drugstores and are sold under a variety of brand names.

2. Analgesics and anti-inflammatories

Analgesics and anti-inflammatories, like acetaminophen (Tylenol) and ibuprofen (Advil), may be indicated by your provider to relieve headache and facial pain.

These medications also decrease inflammation of the nasal sinuses, helping to relieve sinus infection symptoms.

3. Nasal sprays

Nasal sprays containing corticosteroids, such as fluticasone, budesonide, or mometasone, help reduce inflammation and swelling in the sinuses to relieve symptoms like nasal congestion, runny nose, itchiness, and sneezing.

4. Oral corticosteroids

Oral corticosteroids, such as prednisone or prednisolone, help reduce swelling and inflammation of the sinuses to relieve symptoms of sinusitis.

It is important to take these medications only as prescribed by your healthcare provider, at the correct dose for the duration indicated.

5. Nasal decongestants

Nasal decongestants, such as naphazoline, oxymetazoline, and tetrahydrozoline, cause vasoconstriction that rapidly clears out the sinuses, helping improve symptoms of sinusitis like runny or stuffy nose.

These medications should only be used for a short time (maximum 10 to 14 days), as they can lead to dependence and cause a rebound effect, which is when the nasal mucosa starts producing more mucus in response to a decrease in secretions.

Decongestants also come in pill form, in formulations that combine decongestants and analgesics to treat symptoms like runny and stuffy nose as well as pain.

6. Antihistamines

In the case of allergic sinusitis, your provider may recommend the use of antihistamines like cetirizine or loratadine to treat inflammation of the sinuses triggered by allergies.

7. Expectorants

In some cases, a provider may recommend the use of expectorants like guaifenesin that work by thinning out phlegm to make it easier to eliminate.

8. Antibiotics

Antibiotics for a sinus infection include amoxicillin, amoxicillin + clavulanate (Augmentin), azithromycin, cefuroxime axetil, and levofloxacin are only indicated for the treatment of acute or chronic bacterial sinusitis.

Antibiotics should only be used for sinusitis when prescribed by a doctor or other healthcare provider for that specific purpose. Duration of treatment is typically 5 to 14 days, depending on the severity of symptoms and response to the antibiotics.

9. Antifungals

In the case of fungal sinusitis (sinusitis caused by fungi), your provider may recommend antifungal medications like amphotericin B to help eliminate the fungus.

These medications should only be taken after testing is done to identify the type of fungus causing the infection.

10. Surgery

Surgery may be recommended by your doctor in cases of recurrent or chronic sinusitis, in which symptoms last more than 12 weeks.

Surgery is typically indicated when sinusitis is caused by a deviated septum, nasal polyps, narrowing of the orofacial cavities, or fungal infections, or when a sinus infection does not respond to other treatments.

Surgery can also improve symptoms of sinusitis by correcting any nasal abnormalities and opening up the sinuses to allow for mucus to drain out.

Chronic sinusitis

The treatment for chronic sinusitis is prolonged, typically lasting 3 to 4 weeks, and may involve antibiotics, corticosteroids in the form of pills or nasal sprays, nebulizer treatments with filtered water or normal saline, or even surgery.

Chronic sinusitis is sinusitis that lasts for more than 12 weeks. It is typically caused by bacteria that are resistant to antibiotics, allergies that are difficult to control, fungal infections, or blockages that prevent normal drainage of the sinuses.

Home remedies

Home remedies can be used to complement treatments prescribed by your provider but should not be used in place of these treatments.

One good option is to perform nasal irrigation with normal saline, which helps to clear secretions out of the nasal passages and reduce sinus pain and congestion.

Another natural remedy for a sinus infection is herbal steam inhalation, using medicinal plants that contain expectorant properties, such as eucalyptus or orange peels.

To do this at home, add one drop of eucalyptus essential oil or one orange peel to 1 L of water and bring it to a boil on the stove. Remove from the heat and inhale the steam, making sure to let the water cool for a minute or two to avoid burns.

Pediatric sinusitis

Treatment of pediatric sinusitis, or sinusitis in children, will depend on the cause of the sinusitis as well as the symptoms and may include anti-inflammatories, antihistamines, and, if necessary, antibiotics, which should be prescribed by a pediatrician based on the age and weight of the child.

In addition to medications, performing nasal irrigation with normal saline or a salt water spray or using a nebulizer with a saline solution can help drain secretions, reduce inflammation of the sinuses, and relieve symptoms like runny nose and nasal congestion.

Self-care measures

It is important to adopt the following self-care measures while being treated for sinusitis:

Drink about 1.5 to 2 L (six to eight 8-oz glasses) of water a day;
Avoid smoky areas and air conditioning;
Avoid cleaning the house until sinusitis has resolved;
Avoid handling objects or being in areas with a lot of dust.

It is also recommended to protect your nose and mouth with a scarf if you are out in the cold.

Signs of improvement

Resolution of symptoms like runny nose, nasal congestion, headache, and facial pain is a good sign that the infection is improving.

Signs of worsening infection

Signs of a worsening infection include worsening symptoms like runny nose, nasal congestion, headache, and facial pain. In this case, it is important to go back to the doctor for a follow-up appointment to reevaluate your symptoms and consider switching to a different medication.