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Jonathan Hughes | Hemel Hempstead

What is Sinusitis?

Sinusitis is inflammation of the sinuses – small, air-filled spaces behind the forehead, cheeks, and around the eyes. When the lining of the sinuses becomes swollen, mucus cannot drain properly, leading to a blocked, heavy feeling in the face. Sinusitis may be acute, lasting a few days to several weeks, or chronic, where symptoms persist for more than twelve weeks and often recur.

Causes of Sinusitis

Acute sinusitis usually develops after a viral infection such as a cold or flu. In some cases, a bacterial infection follows, causing symptoms to last longer or worsen. Allergies, dental infections, or irritants like smoke and pollution can also trigger sinus inflammation. Chronic sinusitis is often linked to ongoing conditions such as nasal polyps, a deviated septum, or persistent allergies. These issues can block normal drainage and make the sinuses more prone to infection.

Symptoms of Sinusitis

Common symptoms include a blocked or stuffy nose, thick nasal discharge, pressure or pain in the face (particularly around the cheeks, eyes, or forehead), reduced sense of smell, and sometimes fever, cough, or tiredness. In chronic sinusitis, symptoms are often less severe but last much longer, with ongoing congestion, nasal discharge, and facial discomfort.

Treatment Options

Most cases of acute sinusitis improve within two to three weeks with simple self-care such as rest, fluids, steam inhalation, and saline rinses. Pain relief and short courses of decongestants may also help. If symptoms are severe or persistent, a doctor may prescribe antibiotics. Chronic sinusitis usually needs more targeted treatment, which may include steroid sprays or tablets to reduce inflammation, long-term management of allergies, or, in some cases, surgery to improve drainage and remove obstructions such as nasal polyps. An ENT specialist may carry out a nasal endoscopy or CT scan to assess the sinuses in more detail and recommend the best treatment plan.

If you think you’re having sinusitis problems, get in touch with your ENT specialist in London to book a consultation today!
020 3897 0667

What is the difference between acute and chronic sinusitis?
Acute sinusitis comes on suddenly, usually after a cold or flu, and typically clears within a few weeks, generally up to about four. Chronic sinusitis is defined as symptoms lasting twelve weeks or more, and it tends to grumble on or keep returning. The symptoms overlap, but acute sinusitis is usually sharper and more infection-like, while chronic sinusitis is lower grade yet persistent, with ongoing congestion, reduced sense of smell, and facial pressure. The distinction matters because the two are treated quite differently.

Do I always need antibiotics for sinusitis?
No, and most people do not. The large majority of acute sinus infections are viral, so they settle on their own within two to three weeks with self-care such as rest, fluids, saline rinses, and pain relief, and antibiotics make little difference. A bacterial cause becomes more likely, and antibiotics more worth considering, if symptoms last beyond about ten days without improving, are severe, or get better and then clearly worse again. Chronic sinusitis is driven by inflammation rather than infection, so it usually needs anti-inflammatory treatment like steroid sprays rather than repeated courses of antibiotics.

Can allergies cause sinusitis?
Yes, and they are a common underlying factor, especially in chronic sinusitis. Allergies such as hay fever or dust mite allergy inflame and swell the lining of the nose, which narrows the drainage channels the sinuses depend on and lets mucus and infection build up. Getting the allergy under control, with antihistamines, steroid sprays, or avoiding your triggers, often reduces how often sinusitis flares.

When should I see a specialist?
It is worth seeing an ENT specialist if sinus symptoms last more than about twelve weeks, keep coming back, or are severe enough to affect your sleep, work, or quality of life, particularly when standard treatments have not helped. Some symptoms need urgent, same-day attention rather than a routine appointment: swelling or redness around the eye, double or reduced vision, a severe headache, or confusion, as these can point to a rare but serious complication.

What treatments are available if medication doesn’t work?
For chronic sinusitis that does not respond to sprays or tablets, surgery may be recommended. This usually involves a minimally invasive procedure called endoscopic sinus surgery, which opens the natural drainage pathways of the sinuses and helps prevent further infections.