Introduction: When a Cold Starts to Feel Different
A blocked nose, thick mucus, and pressure around the cheeks or forehead often begin during a common cold. When swelling prevents mucus from draining normally, these symptoms may develop into acute sinusitis.
Most cases improve with supportive care. Severe, persistent or worsening symptoms may need medical assessment based on their pattern, duration and the person’s medical history.
Sudden hearing loss can be frightening, especially when it happens without warning. Many people assume it is caused by earwax, water trapped in the ear, or a blocked ear after a cold. While these are common reasons for temporary hearing changes, a rapid loss of hearing may also be a sign of a more serious condition that requires urgent medical attention.
One important cause is sudden sensorineural hearing loss (SSNHL), where hearing decreases rapidly over a few hours or within 72 hours. Because the symptoms can resemble less serious ear problems, some people delay seeking help, hoping their hearing will return on its own. Unfortunately, waiting may reduce the chances of successful treatment.
Recognising the warning signs and seeing an ENT specialist promptly can make a significant difference. Early assessment helps identify the cause and allows appropriate treatment to begin as soon as possible.
What Is Acute Sinusitis?
The sinuses are air-filled spaces behind the forehead, cheeks, nose and eyes. Their mucus normally drains into the nasal passages.
Acute sinusitis occurs when the sinus lining becomes inflamed, and drainage pathways become blocked, causing congestion, facial pressure and nasal discharge.
It lasts for less than four weeks. Chronic sinusitis is different because symptoms continue for 12 weeks or longer and may involve ongoing inflammation, allergies or structural problems.
Common Symptoms
Common features include:
- A blocked or stuffy nose
- Thick nasal discharge
- Mucus running down the throat
- Pain or pressure around the cheeks, eyes or forehead
- Reduced sense of smell
- Headache or upper tooth discomfort
- Cough, ear pressure, tiredness or fever
No single symptom confirms a sinus infection. Yellow or green mucus can occur during a viral cold and does not, by itself, prove that bacteria are responsible.
Facial pain is more suggestive when it occurs with nasal blockage, discharge or reduced smell. Without nasal symptoms, another cause may be responsible.
Why Can Acute Sinusitis Cause Facial Pain?
Blocked drainage can create pressure in the affected sinuses, causing aching around the forehead, between the eyes or over the cheeks.
Because the cheek sinuses sit close to the upper teeth, some people notice tooth discomfort. Bending forwards may worsen pressure, but this does not confirm sinusitis.
Severe, one-sided or rapidly worsening facial pain should be assessed, especially when it occurs with swelling, high fever or eye symptoms.
What Causes Acute Sinusitis?
Viral and Bacterial Infections
Most cases begin with a viral infection such as the common cold. The virus causes swelling and increased mucus production, and symptoms usually ease as drainage returns to normal.
A smaller proportion involve bacteria, sometimes after a viral infection blocks the sinuses. Viral and bacterial infections can feel similar, so the cause cannot be identified reliably from mucus colour or one symptom alone.
Other Contributing Factors
Allergic rhinitis, nasal polyps, a deviated nasal septum, cigarette smoke, haze, a weakened immune system and, occasionally, an upper-tooth infection may increase the likelihood of blockage.
In Singapore, dust mites may contribute to allergic nasal inflammation. Air-conditioned environments may cause dryness, while haze can irritate the airways. Humid weather itself does not directly cause every sinus infection.
Is the Sinus Infection Viral or Bacterial?
Readers should not try to diagnose the cause themselves. A doctor considers the duration, severity, and progression of the symptoms.
A viral cause is more likely when symptoms start with a cold and improve within about seven to ten days. A bacterial infection may be considered when symptoms:
- Continue for at least ten days without meaningful improvement
- Improve at first but then become clearly worse again
- Are unusually severe, such as persistent high fever with marked facial pain or thick discharge
The second pattern is sometimes called “double worsening”. These clues help guide treatment decisions, but they are not absolute.
How Long Does Acute Sinusitis Usually Last?
Many viral cases improve within seven to ten days, although some symptoms may take longer to settle. Acute sinusitis may continue for up to four weeks.
Arrange a medical assessment if symptoms continue beyond ten days without improvement, worsen after easing, or interfere significantly with daily activities. Repeated episodes may also need investigation.
What Can Help Relieve the Symptoms?
Treatment often focuses on improving comfort and helping mucus drain. Useful measures may include:
- Resting and drinking enough fluids
- Applying a warm compress over the cheeks or forehead
- Using a saline nasal spray or rinse
- Avoiding smoking, second-hand smoke, and irritating haze
- Taking suitable pain relief according to the product label or medical advice
Use sterile or distilled water for nasal rinsing, or water that has been boiled and allowed to cool. The rinsing device should also be cleaned properly.
Some nasal decongestant sprays may provide short-term relief, but prolonged use can cause rebound congestion, making the blockage worse. Follow the product instructions and ask a doctor or pharmacist for advice if you have other medical conditions or take regular medicines.
A doctor may recommend a steroid nasal spray when allergy-related inflammation contributes to the symptoms. Treatment varies between individuals.
Do You Need Antibiotics?
Antibiotics do not treat viruses and are not routinely needed for every sinus infection. Many cases improve without them.
A doctor may consider antibiotics when bacterial sinusitis is suspected, symptoms are severe, or there is a higher risk of complications. Monitoring may be appropriate before antibiotics are started in some uncomplicated cases.
Unnecessary antibiotics can cause side effects and contribute to antibiotic resistance. Do not take leftover medicine, share antibiotics with another person or request them only because the mucus is coloured.
How Is Acute Sinusitis Assessed?
A doctor will review when the symptoms began, how they are changing and whether similar episodes have occurred before. The nose, throat, ears and areas of the face may be examined.
Scans are not routinely needed for a straightforward first episode. For persistent, recurrent or unusual symptoms, an ENT doctor may use nasal endoscopy to examine the nasal passages more closely.
Imaging may be considered when there is concern about a complication, an unclear diagnosis or a possible structural problem. These tests are not necessary for everyone with sinusitis.
When Should You Seek Medical or ENT Care?
A GP can manage many first episodes of acute sinusitis. An ENT assessment may be helpful when symptoms are persistent, recurrent, severe, or not improving despite appropriate care.
Arrange a medical review if symptoms:
- Last more than ten days without improvement
- Worsen after initially easing
- Keep returning
- Cause severe or persistent facial pain
- Occur severely in someone with a weakened immune system
Seek urgent medical attention for:
- Swelling or redness around the eye
- Double vision or other vision changes
- A severe or rapidly worsening headache
- Confusion, unusual drowsiness or neck stiffness
- Significant facial or forehead swelling
- Difficulty breathing
These complications are uncommon, but prompt assessment is important when any of these warning signs appear.
Conclusion
Acute sinusitis commonly develops during or after a viral cold when swelling blocks normal sinus drainage. Most cases improve with rest, hydration, saline nasal care and suitable symptom relief, while antibiotics are reserved for selected situations.
Seek medical advice when symptoms are severe, last beyond ten days without improvement or worsen after initially easing. Urgent assessment is needed for eye swelling, vision changes, confusion, neck stiffness, significant facial swelling or breathing difficulty.
If your symptoms are persistent, recurrent or not improving as expected, arrange an ENT assessment. A review of your medical history and a nasal examination can help identify the likely cause and guide treatment suited to your needs.
Frequently Asked Questions (FAQs)
1. How Can You Tell if a Sinus Infection Is Viral or Bacterial?
You cannot usually tell with certainty at home. Doctors consider how long the symptoms have lasted, their severity, and whether they are improving or worsening.
2. Why Does My Face Hurt with Acute Sinusitis?
Blocked sinus drainage can create pressure around the cheeks, eyes or forehead. Persistent or severe pain should be assessed because facial pain can also have other causes.
3. Do You Always Need Antibiotics for Sinusitis?
No. Most cases are caused by viruses, which do not respond to antibiotics. Antibiotics may be considered when a doctor suspects a bacterial infection.
4. How Long Should a Sinus Infection Last?
Many cases improve within seven to ten days, although some symptoms may continue for longer. Acute sinusitis lasts less than four weeks.
5. When Should I See an ENT?
Consider an ENT assessment for repeated infections, persistent nasal blockage, reduced smell, or symptoms that do not improve as expected.