How to Tell If Your Cold is Actually a Sinus Infection

Camelia Davtyan, MD, clinical professor of general internal medicine, UCLA.

Is It a Cold or Sinus Infection?

Watery eyes, a stuffy nose, sneezing: How long these symptoms last can be a clue to what’s causing your congestion. Is it a cold or a sinus infection?

Cold

If it’s a cold virus, you may find yourself close to a tissue box for several days. Most of the time, colds get better on their own in 10 days or less.

Cold Symptoms

Colds bring on a nasty mix of symptoms that can really wear you down. They can include:

  • Sore throat
  • Cough
  • Headache
  • Stuffy nose
  • Mucus buildup
  • Sneezing
  • Fatigue
  • Swollen sinuses
  • Fever (usually low-grade in adults but higher in children)

Treating Your Cold

Because the common cold is a virus, antibiotics won’t help. But over-the-counter medications may make you feel better.

“The remedies you choose should be targeted at specific symptoms, so something for your headache, for your congestion, for your fever,” says Camelia Davtyan, MD, a professor of medicine at UCLA.

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Davtyan also stresses getting plenty of fluids and rest. The latter, she recognizes, is often hard.

“Getting enough rest can be a problem, because people don’t want to skip work and they have so many things to do,” she says. You may also have a hard time staying asleep at night because you can’t breathe through your nose.

Davtyan recommends sinus irrigation. A neti pot helps thin mucus and flush out your sinuses with a mix of distilled water and salt.

“People who irrigate when they have a cold usually do better,” says Davtyan.

Sinus Infection

When your nasal passages become infected, that’s a sinus infection. And they’re harder to get rid of. Viruses, bacteria, or even allergies can lead to sinus infections.

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Colds don’t usually cause sinus infections, says Davtyan, but they do offer a breeding ground for them.

“You touch your nose a lot when you’re sick, and each time you bring more bacteria to the sinuses,” she says. “Because your sinuses can’t drain, the bacteria stay there and grow.”

Sinus Infection Symptoms

Look for the following symptoms:

  • Sinus pressure behind the eyes and the cheeks
  • A runny, stuffy nose that lasts more than a week
  • A worsening headache
  • A fever
  • Cough
  • Bad breath
  • Thick yellow or green mucus draining from your nose or down the back of your throat (postnasal drip)
  • Fatigue
  • Decreased sense of smell

Treating Your Sinus Infection

If you think you have a sinus infection, you may need to see your doctor.

“Mostly, these acute infections go away on their own or after a simple course of antibiotics,” says ear, nose, and throat specialist Greg Davis, who practices at the University of Washington Medical Center in Seattle.

Davis recommends sinus irrigation for sinus infections. It can help ease your symptoms while you wait for the antibiotics to do their job. Steroids, decongestants, and over-the-counter mucus thinners can also ease your discomfort, he says.

See an ear, nose, and throat specialist if your sinus infection doesn’t go away after one or two courses of antibiotics, Davis says.

Some people have sinus infections over and over. The only known risk factors, Davis says, are allergies and smoking (another reason to quit!) In rare cases, an acute infection can become chronic if it’s not treated successfully.

If you have chronic infections, and antibiotics and other treatments don’t help, you may need sinus surgery, Davis says.

Your doctor will enlarge the small or inflamed and swollen openings of your sinuses, allowing them to drain, and letting you breathe more easily.

Show Sources

Greg Davis, MD, otolaryngologist, University of Washington Medical Center, Seattle.

Camelia Davtyan, MD, clinical professor of general internal medicine, UCLA.

National Institute of Allergy and Infectious Diseases: “Common Cold: Symptoms,” “What are the symptoms of sinusitis?”

How to Tell If Your Cold is Actually a Sinus Infection

woman with cold and sinus infection

Without fail, that pesky cold hits you out of nowhere again. You feel miserable but still have to go on with your daily responsibilities, even when you know the cold isn’t serious.

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But how do you know if your runny nose, headache and nagging cough are actually signs of a sinus infection? While it’s true that many of the symptoms of both illnesses overlap, there are clues to help you tell the difference.

Rhinologist Troy Woodard, MD, describes these illnesses and shares four questions you should ask yourself to decide which you have, plus tips for treating your symptoms.

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What does a cold look like?

A cold is a virus at work in your upper respiratory system (nose, mouth, throat and lungs). Typically, adults get between two and four colds per year with symptoms like:

  • Runny nose.
  • Stuffy nose.
  • Sneezing.
  • Cough.
  • Sore throat.
  • Chest congestion.
  • Watery eyes.

How a sinus infection happens

Colds can progress to become sinus infections, but not all sinus infections are viral. Bacteria and even allergies also can cause sinus infections.

“A sinus infection occurs when the sinus lining becomes inflamed, preventing the sinuses from draining,” he says. “The trapped mucous becomes a breeding ground for bacteria, which can lead to a sinus infection.”

Conditions that may make you more likely to get a sinus infection include:

  • Allergies.
  • Nasal polyps (small growths occurring in your nasal lining).
  • Immunodeficiencies (conditions that impact how well your immune system works).

Sinus infection versus cold: How to tell the difference

When it comes to the battle between a sinus infection vs. cold, knowing which one you have is tricky. Dr. Woodard suggests that you consider these questions to tell the difference between the two:

  1. How long have you had symptoms? Cold symptoms typically peak after three to five days and then improve over the next week. A sinus infection can stick around longer, though. If you have a runny nose, stuffy nose or sinus pressure that lasts for more than 10 days, suspect an infection.
  2. Do you have sinus pressure? If you have persistent facial pain, pressure or tenderness, you may have a sinus infection.
  3. What color is your discharge? If you have clear mucous, you probably have a cold. If you have yellow or green mucous, it’s probably a sinus infection.
  4. Do you have bad breath? If your breath has you reaching for a piece of gum, you could have a sinus infection.

Other symptoms of a sinus infection may include loss of smell and taste, cough, congestion, fever, headache, fatigue or aches in your upper jaw and teeth.

Start treating your symptoms right away

Since viruses can’t be cured, treating colds is primarily aimed at improving symptoms.

“It’s important to remember that with colds and other viruses, taking an antibiotic won’t help you feel better any faster,” says Dr. Woodard. “In fact, taking an antibiotic unnecessarily can do more harm than good.”

The overuse of antibiotics can lead to antibiotic resistance, which can make subsequent infections more difficult to treat.

“Get plenty of rest, stay hydrated and rinse out your sinuses with saline irrigation, which can help thin mucous and flush it from your nasal cavity,” he says.

When a sinus infection won’t go away

While it’s true that sinus infections sometimes clear on their own, antibiotics can sometimes shorten their duration.

Talk with your doctor if your symptoms don’t subside within 10 days or if you have persistent fevers, facial swelling or neck stiffness. As with colds, make sure you hit the sheets and get enough rest and drink your H2O. Proper hydration and nasal irrigation can ease sinus infection symptoms.

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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy