Is that spring in the air? Or do I have a sinus infection?

Updated: May 31, 2016 - 10:27 am

Q: I’ve been miserable for a week, both indoors and out, with congestion and a headache. How do I know if I’m developing allergies or a sinus infection?


It can be tricky to distinguish between an allergic reaction and sinus infection, especially this time of year. The two conditions have overlapping symptoms and are extremely common.

Michelle Napral
Michelle Napral, nurse practitioner at the University of Minnesota Health Nurse Practitioners Clinic

Seasonal allergies, also called hay fever, affect up to 30 percent of people in the United States. Beyond their burden on the body, allergies also burden the economy. The financial burden for allergy treatment has nearly doubled from 2000 to 2005, increasing from $6.1 to $11.2 billion annually.

Before you’re able to determine whether you’re ailing from a sinus infection or hay fever, it’s important to know more about why allergies occur. Most people breathe in substances like pollens, pet dander and mold spores without a problem. But, for the people with some type of allergy, the immune system treats these substances as if they’re harmful to the body, causing allergic reactions. The body then increases mucus production in the nose, which causes the nasal passages to swell and narrow.

What do allergies feel like?

Symptoms include sneezing, a stuffy or runny nose with clear discharge, headache, nasal itching, postnasal drip, cough, itchy eyes or ears, sore throat, trouble sleeping, headache and fatigue.

If you have seasonal allergies, keep your car and home windows closed when pollen counts are high. If possible, use an air conditioner. In severe cases, you might even consider wearing a filter mask when doing yard work, and showering before bed to decrease contact with allergens.

It’s impossible to avoid triggers all the time and symptoms are bound to occur. When this happens, most people respond well to nose rinses, steroid and non-steroidal nasal spray, antihistamine medication and decongestants. Certain cases may require immune therapy or allergy shots.

How is a sinus infection different?

Sinus infections, on the other hand, occur when the body has foreign bacteria in the sinus cavity. They sometimes stem from poorly managed allergies, when fluid is trapped in swollen sinuses and bacteria is allowed to accumulate. Unlike allergies, sinus infections are accompanied by yellow or green discharge from the nose, pain in the teeth and pressure in the face that often feels worse when a person bends forward. Some people may also have a fever and aches, which are not typically associated with allergies.

Sinus infection symptoms usually improve in seven to 10 days. For patients who visit our clinic, we recommend taking over-the-counter pain relievers, rinsing the nose and sinuses with salt water a few times a day, and drinking plenty of liquids to promote sinus drainage. Nasal sprays also help, as do vaporizers. To ease congestion, patients can use an expectorant containing guaifenesin during the day, which will help loosen mucus. These measures not only relieve symptoms, but can dislodge the bacteria-causing infection. For painful areas of the face, it’s helpful to apply heat.

Most of the time, these infections do not need to be treated with antibiotics, but some people with sinusitis will need to be treated with antibiotics, especially if symptoms do not improve after 10 days. If your symptoms last more than 10 days, or if your symptoms get better at first but then get worse, consider seeing your health care provider.

By identifying which condition is troubling you, you’ll be able to address symptoms faster and, with any luck, get back to normal activities.

Michelle Napral is a nurse practitioner at the University of Minnesota Health Nurse Practitioners Clinic, 3rd Street & Chicago. Send questions to