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  • Thomas Jacques

How to deal with sinusitis

Most of us have had an episode of sinusitis: they usually start with a common cold, but after a few days, the symptoms develop into a miserable combination of blocked nose, fever and facial pain.


If you suffer from sinusitis (properly known as acute rhinosinusitis) frequently, you'll be familiar with the dozens of pharmacy medications and remedies that are advertised to help with your symptoms. It can be hard to know which products are worth using, and which are a waste of money! Read on for a myth-busting guide to managing your sinusitis.


Remember that this article isn't a personalised guide suitable for everyone, and if in doubt, you should consult a doctor or pharmacist.





Painkillers?

Absolutely. Simple, chief painkillers like paracetamol and ibuprofen are excellent for relieving the headache, facial pain and fever of sinusitis. They are safe for the vast majority of people (ensure you read the packet and don't take more than the maximum dose).


Nasal sprays?

Yes. Decongestant sprays such as oxymetazoline and xylometazoline rapidly relieve your blocked nose by constricting the blood vessels in the nasal lining. Although they are good for acute (short-term) illnesses like sinusitis, they should never be used for longer than 1-2 weeks, and are unsuitable for long-term nasal conditions such as rhinitis (hay fever) or chronic rhinosinusitis.


In addition to decongestant sprays, nasal steroid sprays can also shorten the duration of acute sinusitis, especially if the symptoms have been going on for ten or more days. These can be purchased over the counter or prescribed by your doctor. Seek advice from your pharmacist or doctor if you are starting these for the first time.


Decongestant tablets?

Probably not. Although these pills (such as pseudoephedrine) are marketed heavily as sinusitis remedies, the evidence does not suggest that they give significant improvement in sinusitis symptoms. They also cause side effects for quite a large proportion of people.


Saline (salt water) spray?

Yes! Saline sprays and irrigation systems are helpful for the symptoms of almost all nasal conditions. Although they may not alter the overall length of the illness, there is evidence that they improve symptoms, and they are extremely safe.


Aromatic ointments?

Strong-smelling ointments containing menthol and eucalyptus have been used for centuries to improve cold and sinusitis symptoms. They are simple and safe remedies, and subjectively make people feel less congested. Interestingly, they do not actually improve the nasal airway directly, but work by stimulating cold temperature receptors in your nose, making you feel as if there is more airflow.


Antibiotics?

When we are feeling unwell, feverish and congested it can be very tempting to assume that we need antibiotics. However, the scientific evidence suggests that for most patients with acute sinusitis, taking antibiotics makes no significant difference to their symptoms, or the overall length of the illness. Whatever small benefits there are have be balanced against the risks of side effects (stomach disturbance, diarrhoea, allergies) and bacterial resistance to antibiotics.


If you speak to your GP about an episode of sinusitis, please be understanding if they ask you to persist with treatments like painkillers, nasal sprays and irrigations. A smaller group of patients with very persistent or worsening symptoms, high fever, severe pain or other health conditions may require antibiotics. For more information, visit NICE for their summary of the evidence on antibiotics in sinusitis.

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