Recurring Sinus Infections: Diagnosis and Treatment

Recurring Sinus Infections

Sinusitis is diagnosed in nearly 30 million Americans every year, making it one of the most common health conditions in the United States.

Struggling with frequent sinus infections is known as recurrent sinusitis. Recurrent sinusitis is defined by three or more acute infections in a year. Untreated acute sinusitis further damages the mucous membranes, making you more vulnerable for another infection. Allergens, a weakened immune system or structural abnormalities, such as a deviated septum, are also big contributors to recurrent infection.

Acute Sinusitis is a temporary inflammation of the sinuses, usually either bacterial or viral, following a cold or allergies. Swelling of mucous membranes causes congestion and prevents mucus drainage. This allows pressure to build in the face, causing pain, discomfort and inflammation in the sinuses. In acute sinusitis, symptoms usually worsen, peak and eventually vanish. Acute infections last up to four weeks, subacute infections last four to 12 weeks, and chronic sinus infections last 12 weeks or longer.

Why Are Sinuses Susceptible to Infection?

Acute sinusitis often follows the cold virus. The reason for this is not usually the cold virus itself, but the inflammation caused by the cold virus. More than 85% of people with colds suffer from inflammation in the sinus cavities. The inflammation and congestion caused by a cold will obstruct the sinuses, creating an environment in the sinus cavities hospitable for bacterial growth, as mucus will not drain and eliminate such pathogens as it would normally. Inflammation and congestion of nasal passages is known as rhinitis, and is such a common precursor to sinusitis that doctors often refer to many cases of sinusitis as rhinosinusitis.

  • The maxillary sinuses (behind the cheekbones) are the most common sites.
  • The ethmoid sinuses (between the eyes) are the second most common sites affected by colds.
  • The frontal (behind the forehead) and sphenoid (behind the eyes) sinuses are involved in about a third of cold-related cases.

Why Do I Keep Getting Sinus Infections?

If you have more than three infections per year, you suffer from recurring sinusitis. Some people are more prone to recurring sinusitis than others. What could be causing your repeated infection?

Untreated acute sinusitis- Acute sinusitis, if not treated properly, may result in the damaging of the mucous membranes, which makes you more at risk for future infections.

Allergies and asthma - The risk for non-infectious inflammation is significantly higher for those with allergies and asthma. This inflammation, though not caused by sinusitis, can make you more vulnerable to a sinus infection due to swollen mucous membranes which create a breeding ground for unwanted bacteria, resulting in a bacterial sinus infection. This continued and frequent inflammation makes those with asthma and allergies more likely to have repeated acute infections.

Weakened immune system - Having a weak immune system will make recovery from an acute infection more difficult, and cause you to be more vulnerable to infection the next time, particularly if you had to take antibiotics. Antibiotics will destroy your bacterial infection as well as beneficial bacteria in the microbiome which is needed to prevent sickness in the future. Unnecessary antibiotics can create a vicious cycle of repeated infection, so it’s important to only take antibiotics if your doctor is confident that the infection is indeed bacterial and will not likely go away with care and rest.

Structural abnormalities -

Structural abnormalities can also be the cause of frequent sinus infections, such as:

  • Nasal polyps - small, benign growths in the nasal passages will prevent the passage of mucus and obstruct natural drainage and airflow. Polyps themselves may be exist as a result of a former sinus infection which caused an overgrowth of the nasal membrane.
  • Deviated septum - when the center part of your nose- the septum- is slightly shifted to one side, this is known as a deviated septum. This is a common structural abnormality which blocks or obstructs sinus openings, preventing necessary mucus drainage. A deviated septum may be congenital or the result of injury or facial trauma, such as a broken nose.
  • Narrow sinus openings - those with anatomically smaller sinus openings are more susceptible to issues with mucus drainage problems and more likely to suffer from recurring infection.

Chronic Sinus Infection Symptoms and Treatment

Chronic sinusitis symptoms may vary in severity, but most people will experience the same general symptoms. These include:

  • Low grade fever - a low grade fever may or may not be present in those suffering from chronic sinusitis.
  • Acute sinusitis symptoms - These last for more than 12 weeks and occur throughout the year, including non-allergy seasons.
  • Impacted quality of life - The most common is extreme fatigue throughout the day.

Treatment for chronic sinus infections should be discussed with a doctor, but can include:

  • Lifestyle changes - Quitting smoking and limiting your exposure to allergens and pollution is extremely important if you suffer from recurrent sinusitis. These risk factors are particularly damaging for those who have damaged mucus membranes from repeated sinus infections. Getting an in-home air purifier or certain indoor plants is one way to purify your air at home if moving cities is not an option.
  • Antibiotics - If you suffer from recurring or chronic sinusitis, it’s important to see a specialist for your antibiotic prescription. A specialist will use a nasal endoscope to obtain a bacterial culture and determine exactly what type of antibiotic you need to target the infection. Otherwise, the antibiotic prescription may be random and therefore less effective, essentially destroying beneficial bacteria in your microbiome and weakening the immune system for nothing.
  • Home remedies - When antibiotics and traditional methods have failed and you still suffer from frequent, various home remedies for sinus infection exist with a lot of anecdotal, and in some case research-based, evidence to back them up. Essential oils in particular have been studied for antimicrobial properties, which may be powerful tools in solving the problem of recurrent infection.
  • Nasal wash - washing nasal passages with a large volume of salt water using something called a neti pot is one method recommended in conventional and alternative treatments for sinusitis. This process is also known as sinus irrigation.
  • Nasal steroid spray - a steroid spray will reduce the irritation and swelling caused by recurrent sinusitis, which will help break the cycle of repeated infection.
  • Surgical intervention - Surgical intervention, while a last resort, may be necessary to restore quality of life in someone who has tried everything but continues to suffer from recurring or chronic infection. Surgery for deviated septum will restore normal function of nasal passages. If you don’t have a deviated septum or any structural abnormality, but still need surgical intervention to combat recurrent sinusitis, a balloon sinuplasty is a minimally invasive surgery that dilates the sinus cavity to relieve obstruction and possibly irrigate any infection out of the affected sinus.

When to Contact a Doctor

If you exhibit any symptoms of sinus infection for several weeks, make an appointment with your doctor as soon as possible. You should also contact your doctor if you experience any pressure or pain in your upper face, accompanied with postnasal drip, nasal discharge, bad breath that isn’t related to dental issues, or a high fever that lasts several days.

If left untreated, your sinus infection can pose more serious health issues, including:

  • Changes to vision and potential blindness
  • Changes to the personality
  • Seizures
  • Meningitis
  • Osteomyelitis, or Pott’s puffy tumor, a condition indicating an infection of the frontal bone in the forehead (this is mainly limited to children)

Sinus infections, particularly those caused by viruses, will generally clear up on their own. Treatments for other sinus infections are available and mainly center around a course of antibiotics. However, even if you have a simple acute sinus infection, you should consider consulting your doctor or visit an urgent care center for relief from any uncomfortable symptoms.

Doctor on phone
Jillian Stenzel

Jillian Stenzel

A Nevada-bred traveler & food nerd who dances & eats spinach, sometimes simultaneously. She writes from wherever her curiosity demands, and is passionate about spreading the wisdom of better health.

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