Acute sinusitis is something none of us want, but which we all experience on occasion. The stuffy nose, the headache, sore throat, cough, earache… Many of us choose to power through, and the treatments for sinusitis are most often home remedies. So, it can be tempting not to have yourself checked out at all. Most cases of acute sinusitis resolve within seven to ten days, with the majority being caused by the common cold. If you do treat acute sinusitis at home, you should use topical or oral decongestants, fluids, and if needed a mild painkiller like motrin or advil.
It’s when an infection lasts longer than that that it becomes a problem. If your acute sinusitis lasts more than a week then it might be a bacterial infection and you may need antibiotics. A doctor may also prescribe a nasal sprays (i.e. Flonase or Nasacort) as well as sinus rinses to relieve symptoms. Even then, most cases of acute sinusitis resolve quickly, and easily, with no or minimal treatment. In fact, many doctors are slower than they used to be to prescribe antibiotics for sinusitis, due to resistance problems. Only five to ten percent of acute sinusitis cases are caused by bacteria.
Does Acute Sinusitis Become Chronic If Not Treated?
The answer to this is: Sometimes. It used to be believed that acute sinusitis would inevitably become chronic if not treated, but most medical professionals now agree that this is pretty rare.
If your sinusitis is the result of a cold then it will likely go away once your body fights off the virus. Even many cases of bacterial sinusitis resolve on their own without treatment. Some people may experience recurring sinus infections that might need attention. The risk factors include:
- Deviated septum, meaning that the tissue between your nostrils is crooked. This can be congenital or caused by an injury.
- Medication that suppresses the immune system.
- Cystic fibrosis.
- Flying frequently
- Scuba diving
- Narrow sinus pathways, which can be corrected with balloon sinuplasty.
- GERD (Gastroesophageal reflux disease)
In some cases, chronic sinusitis is diagnosed as acute until it lasts longer than twelve weeks or an underlying cause is discovered. Nasal polyps, for example, are a common cause of chronic sinusitis which may not be immediately noticed. Risk factors for chronic sinusitis include those above as well as asthma, aspirin sensitivity or a dental infection. However, the following symptoms can indicate that you have chronic sinusitis:
- Yellow or green mucus
- Hardened mucus blocking nasal passages
- Post nasal drip
- Trouble with smelling or tasting
- Discomfort in the area of your eyes, forehead, and cheeks
Rarely, a stubborn infection can become chronic. This can happen even with treatment, but is obviously more common without. If you have sinusitis symptoms that last for more than a week, again, you should contact your doctor. If your sinusitis is not clearing up then your doctor may perform a sinus culture to establish what is responsible for the infection and target treatment appropriately. In most cases, though, an infection causing acute sinusitis will not become chronic, but rather chronic sinusitis is caused by some significant underlying condition or risk factor. For example, allergies are a common cause of chronic sinusitis. (And obviously if you develop acute sinusitis at the same time every year then it’s probably related to the pollen count). An allergist can often help with this problem.
Can Sinusitis Become Something More Serious?
Yes, but it’s very rare. Sinus infections can sometimes spread to other parts of your head. This can cause:
- Vision problems, which may become permanent.
- Meningitis, or inflammation of the membranes and fluid around the brain and spinal cord.
- Bone infection.
- Skin infection.
Meningitis from sinus infections have been known to be fatal but is, again, extremely rare. These complications can usually be prevented with antibiotics. If your doctor does give you antibiotics for acute sinusitis, it is very important to take the entire course and not stop, even if you are feeling better. Thus, in rare cases, untreated acute sinusitis can lead to serious complications. Again, it’s worth stressing that these complications are extremely rare. They are more common if you have an underlying health problem, and people with cystic fibrosis or a compromised immune system should be particularly careful and make sure to see their doctor for sinusitis.
How Can I Prevent Sinusitis From Becoming Chronic?
You can start by reducing the risk of getting acute sinusitis in the first place:
- Quit smoking and avoid being around people who smoke. Ask smokers to go outside.
- Wash your hands before eating and after visiting the bathroom.
- Wash your hands or use hand sanitizer when arriving or leaving a school, daycare, nursing home, or hospital.
- If you live in a dry environment, run a humidifier and consider a hydrating nasal spray. Sinusitis can be caused by your nasal passages drying out, and this type is likely to recur. It may become chronic if you are still in the dry environment.
- Drink plenty of water and stay hydrated.
- Use steam. A hot shower is very good for your nasal passages.
- Sleep with your head elevated.
- Try not to blow your nose until you need to, and then do it as gently as possible.
- Don’t use topical nasal decongestants (nasal sprays) unless you absolutely have to and never for more than a day or two. Use shorter-acting sprays.
You prevent acute sinusitis from becoming chronic by:
- Talking to your doctor about sinusitis that lasts for more than a week.
- Taking any prescribed antibiotics as directed and finishing the course even if you think you are better.
- Talking to your doctor about underlying problems that might cause chronic or recurring sinusitis.
If you have a deviated septum, it can be corrected surgically. Nasal polyps can be treated with nasal corticosteroids, usually in a spray form, but it may require other medications including injected corticosteroids or medication for the underlying condition. In extreme cases, simple endoscopic surgery can be performed in the office in combination with Balloon Sinuplasty to remove polyps or in more advanced cases in the operating room. Correcting these problems can also improve your breathing, decrease sinus infections and headaches, improve your sense of smell and taste and reduce snoring, thus improving sleep quality.
If you have chronic or recurring sinusitis, your doctor may also perform allergy tests. There are also other minor surgical options available. All of these can treat chronic sinusitis by dealing with the underlying condition causing it.
What is the Primary Consequence of Not Treating Acute Sinusitis?
As mentioned, most cases of acute sinusitis resolve quickly on their own, and you should only be concerned if the infection is lingering for more than 1-2 weeks. The only real consequence of not treating sinusitis is that your symptoms may last longer and you may develop chronic sinusitis on rare occasion if symptoms last for more than 12 weeks.
However, you should be alert for signs that your acute sinusitis may be turning into something else, and you should track your symptoms to establish whether your sinusitis is recurring, especially on a pattern. This may be a sign of an underlying condition that does require medical attention.
If in doubt, you should absolutely check with your doctor, but he may or may not recommend treatment or antibiotics. Most likely, he will give you advice on how to treat your sinusitis and when you should come back if it has not cleared up.
However, you should get medical help immediately if:
- Your vision changes
- You notice redness or swelling around your eyes
- You have a very high fever above 101.5
- You have a severe headache, and painkillers don’t seem to be working.
All of these can indicate that you have serious complications that may require more advanced treatment. (As already mentioned, these are rare).
Otherwise, the best thing to do is nurse yourself carefully and keep an eye on things.
If you have a sinusitis bout that looks like it might become chronic, or have been experiencing acute sinusitis regularly, you should get yourself checked out to eliminate underlying causes. To find out more and talk about your symptoms and options, contact SoCal Sinus today.