Your head’s pounding. Your face feels puffy. Your nose is stuffy. You might be wondering: Are your allergies playing up, or is something wrong with your sinuses?
Both sinusitis and allergies can cause a glut of unpleasant symptoms, and it can be hard to tell these conditions apart. Although sinusitis and allergies have a similar symptom profile, they are caused by different things and may need to be managed differently.
The difference between allergies and sinusitis also extends to how they are managed, with intranasal corticosteroids and antihistamines forming the foundation of treatment for allergies, and steam inhalation, nasal irrigation and decongestants helping to relieve sinusitis. However, there are cross-overs for these two conditions, with some treatments being relevant to both.
This guide will equip you to understand the differences and help you navigate your path to relief.
What is sinusitis?
Your sinuses are hollow spaces inside your head, lined with mucus-producing membranes. The fluid made by your sinuses drains out via the nasal passages, which helps protect you from germs.
Sinusitis happens when these membranes become inflamed or swollen, often due to infections or blockages.
There are different types of sinusitis:
• Acute sinusitis: This is a short-term infection lasting up to 3 weeks, often triggered by a common cold virus or untreated allergies.
• Subacute sinusitis: Subacute sinusitis is the term used for sinusitis where the symptoms last between 4 and 12 weeks.
• Chronic sinusitis: When symptoms linger for more than 3 weeks, it might be chronic sinusitis. It can last for months, or even years, if not treated.
• Recurrent sinusitis: When you experience 4 or more episodes of sinusitis lasting less than 4 weeks, with complete resolution of symptoms in between each episode.
The usual suspects causing sinusitis include:
• Viral or bacterial infections: These can happen as a result of a cold or untreated allergies.
• Allergies: When allergens irritate your nasal passages, they can lead to inflammation and contribute to sinusitis.
• Structural issues: A crooked nasal wall between nostrils (deviated septum) or narrow sinus passages can make sinus drainage difficult. This can increase the risk of infection.
What causes sinusitis?
The inflammation in the sinuses in sinusitis is usually caused by either infections or allergy. Infections that may cause sinusitis include viral infections, such as the common cold or flu, bacterial infections, which are usually a complication of viral sinusitis, and fungal infections.
Other things that may increase the risk of sinusitis include untreated allergies, a crooked or bent nose, smoking, polyps, and overuse of decongestant nasal sprays.
What are allergies?
Allergies occur when your immune system overreacts to seemingly harmless substances like:
• Pollen
• Pet dander (such as pet fur and skin flakes)
This reaction triggers the release of chemicals, including histamine, which leads to inflammation in your nose, eyes, and sometimes sinuses.
Symptoms of an allergic reaction can mimic symptoms of sinusitis, making it tricky to work out what could be going on. To make matters more complicated, untreated allergies may result in a case of sinusitis.
What causes allergies?
Allergies occur when the immune system reacts to normally harmless substances in the environment, known as allergens.
When these allergens are inhaled, the immune system releases inflammatory chemicals such as histamine, causing the lining of the nose and sinuses to become swollen, inflamed, and produce more mucus. This can lead to symptoms such as sneezing, a blocked or runny nose, and sinus discomfort.
Learn more about navigating seasonal allergies or explore our guide to hay fever and allergies here.
What are the symptoms of allergies and sinusitis?
Both sinusitis and allergies can leave you feeling under the weather, and perhaps a bit confused. It’s important to understand the similarities and differences between allergies and sinusitis, as although allergies and sinusitis can both impact the sinuses and cause things like nasal congestion, the root causes and treatments can vary.
The table below shows that many of the symptoms are shared, but some are not.
| Symptom | Allergies | Sinusitis |
|---|---|---|
| Stuffy nose (congestion) | X | X |
| Headache | X* | X |
| Trouble breathing through the nose | X | |
| Trouble breathing through the nose | X | |
| Itchy, watery eyes | X | |
| Frequent sneezing | X | |
| Facial pain or tenderness | X | |
| Loss of sense of smell or taste | X* | X |
| Headache | X | X |
| Postnasal drip (feeling like mucus is dripping down the throat) | X | X |
| Cough or sore throat | X* | X |
| Fatigue or poor sleep | X* | X |
| Toothache or jaw pain | X | |
| Bad breath | X |
Here are some other clues to look out for:
• Fever and discharge: Sinusitis can come with fever (over 39ºC) and/or thick, green or yellow coloured mucus discharge (usually absent in allergies), as well as facial pain. These are severe symptoms that could indicate a more serious bacterial or viral infection. It’s vital that you see a doctor if you have these symptoms.
• Symptom duration: Allergies or sinus issues related to allergens tend to be seasonal or triggered by specific allergens, while sinusitis symptoms due to an infection typically last for weeks (for acute sinusitis) and don’t fluctuate as much. It is important to see a doctor if your symptoms last longer than 10 days, or if they worsen after initially improving, as this may indicate an acute bacterial rhinosinusitis.
If your symptoms seem worse after exposure to a known allergen, then allergies are more likely the culprit. However, allergies can also increase your risk of sinusitis, so it’s always best to consult your doctor for a proper diagnosis.
How are allergies and sinusitis diagnosed?
To work out the root cause of your symptoms, your doctor might use a combination of approaches:
• Physical examination: Your doctor will check your nose, ears, and throat for signs of inflammation or infection.
• Medical history review: Discussing your symptoms, allergies, and any recent illnesses can provide valuable clues.
• Imaging studies: In some cases, a sinus CT scan might be needed to visualise your sinuses and check for blockages.
• Allergy testing: Skin prick tests or blood tests can identify specific allergens you might be reacting to.
How do I know if I have allergies and sinusitis?
Sometimes the symptoms of allergies and sinusitis can feel similar. Asking a few simple questions about your symptoms may help you understand what might be causing them. Always see a medical professional for a diagnosis.
Do I have a fever?
A fever is more commonly associated with sinusitis caused by infection. Fever, particularly when combined with facial pain or thick nasal discharge, may indicate a sinus infection rather than allergies.
What colour is my mucus?
With allergies, mucus is usually clear and watery. In contrast, sinusitis caused by infection can produce thick yellow or green mucus, which may drain from the nose or down the back of the throat.
Are my eyes, ears or throat itchy?
Itching of the eyes, nose, ears or throat is a common sign of allergic reactions. When allergens are inhaled, the immune system releases histamine, which can trigger itching, sneezing and watery eyes.
Do I feel pressure or pain in my face?
Facial pain or pressure around the cheeks, eyes or forehead is more typical of sinusitis. This happens when inflamed sinuses become blocked and mucus cannot drain properly, causing pressure to build up.
How long have my symptoms lasted?
Allergy symptoms often continue as long as you are exposed to the trigger, such as pollen or dust mites. Sinusitis from infection usually develops after a cold and may improve within a few weeks, although symptoms that persist or worsen may require medical advice.
How to relieve sinusitis and allergy symptoms?
The good news is there are effective treatments for both sinusitis and allergies. Here’s a quick rundown:
Sinusitis:
• Antibiotics: Only used if your doctor thinks there is a bacterial infection.
• Corticosteroids nasal sprays or pain relieving medicines: To reduce inflammation and manage pain.
• Nasal irrigation and rinses: These help clear mucus buildup (think saline nasal sprays like FLO Nasal Mist or FLO Saline Plus Nasal Spray, or saline washes like FLO Sinus Care or FLO CRS).
• Selfcare tips: Take care of yourself by resting, drinking plenty of fluids, inhaling steam or applying a warm washcloth to your forehead.
Allergies:
• Antihistamines: These medications block the action of histamine, reducing allergy symptoms like congestion and runny nose. A locally acting product like EZE – ALLERGY Nasal Spray can provide fast-acting symptom relief.
• Corticosteroid nasal sprays: Reduce inflammation in the nasal passages.
• Allergy immunotherapy (desensitisation):This long-term treatment helps your body build tolerance to allergens over time.
• Saline sprays or washes: Non-medicated products such as FLO Saline Plus, FLO Nasal Mist and FLO Sinus Care can wash away allergens and provide relief from symptoms.
• Lifestyle modifications: Minimising exposure to allergens and maintaining a clean environment can help improve symptoms.
Note: This information is intended to improve your general knowledge of allergies and sinusitis. It does not replace professional medical advice. If you’re struggling with persistent sinus issues or allergy symptoms, visit your doctor for a diagnosis and a suitable treatment plan.
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