Your face is full of holes. Sort of. Well, maybe it’s more accurate to say that your face is full of hollow spaces–four of them to be exact. These are called sinuses. (Or sinus cavities.) Your sinuses are there because they help facilitate the drainage of mucus out of your nose, removing allergens and germs in the process. As a result, you breathe easier and you stay healthier.
This system works really well most of the time. But sometimes… well, sometimes, your sinuses can themselves become infected.
What is a sinus infection?
When you have a sinus infection, these hollow spaces become inflamed and swollen. This traps the germs and mucus that should be draining–and this mucus backup results in headaches, stuffy noses, and other symptoms that can make you miserable. Because they impair drainage, sinus infections can be pretty persistent.
For some people, though, this persistence takes on a whole new level: their misery can last for months… or longer. It’s a condition called chronic sinusitis.
What is chronic sinusitis?
A typical, non-chronic sinus infection will resolve itself in a few days or so. Some of the more persistent ones can hang on for up to four weeks. That sounds pretty annoying–but it’s not quite a chronic sinus infection yet.
Chronic sinusitis is typically characterized by an infection that lasts for 12 weeks or longer. And over the course of these twelve weeks, your sinus infection will never go away. (When it goes away and comes back that’s called recurring sinusitis–which is a similar but distinct ailment.) Your symptoms may ebb and flow, but they will persist and they’ll feel constant. This can lead to a significant amount of misery (or, at the very least, impact your day-to-day living).
Chronic sinusitis risk factors
So who gets chronic sinusitis? As with any illness, there’s a great deal of random variability here, but there are some risk factors that can make you more likely to develop this condition. Those risk factors include:
- Nasal polyps.
- A deviated septum or other abnormal nasal structure that makes it difficult for mucus to properly drain.
- Repeated illness (whether caused by bacteria or viruses).
- Chronically blocked airways, often caused by asthma, allergies, or cystic fibrosis.
This list is not exhaustive. But you can think about it like this: anything that increases inflammation and or makes it difficult for mucus to drain normally will increase your chance of developing a chronic sinus infection in the future.
How are chronic sinus infections diagnosed?
So how does your physician know for sure that it’s chronic sinusitis you’re dealing with? Well, there are a couple of things your ENT will do to make sure this is the disease you have:
- Medical history and physical exam: Just as with any other diagnosis, a medical history and physical exam can provide a wealth of information.
- Imaging tests and diagnostic procedures: Your provider may order an X-ray, CT, or MRI scan to get a better idea of what’s happening in your sinuses.
- Nasal endoscopy: In some cases, your ENT may need to take a look inside your nostrils! This is performed by a tiny camera called an endoscope.
- Sinus cultures: To find out what’s causing your sinus infection, your provider may order a culture to be taken. This can help determine whether the initial infection is bacterial or viral.
There are lots of ways to treat sinus infections–but they aren’t all right for all types of infection sources. In other words, getting a proper diagnosis is critical to success.
How are chronic sinus infections treated?
Sinus infections are relatively common, so your provider may start with a fairly conservative approach. (The idea is that your body may simply need a bit of help to get over this illness. So most treatments start slowly–saving more powerful or invasive options for when they are truly needed.)
Conservative treatments
The most conservative treatments may include the following, most of which patients are responsible for doing at home:
- Nasal irrigation and saline sprays: This may help diminish irritation and dryness of the sinuses and assist with drainage.
- Avoiding allergy triggers: If allergies and asthma lead to sniffling and that sniffling leads to a chronic sinus infection, then avoiding the initial cause can provide significant relief. If you’re allergic to cats, for example, avoid those feline friends.
- Humidifiers and steam: Breathing in humid air can help relieve dryness and promote discharge–and that can help relieve your symptoms.
Medications
When those at-home, conservative treatments don’t work, your provider may recommend a medication or two. Some of those medications may include the following:
- Antibiotics: This will only help when your sinus infection is caused by a bacteria. It won’t help with viruses, unfortunately. (This is one reason why your ENT may order a culture.)
- Corticosteroids: These are designed to reduce inflammation in the body. Reduced swelling in your sinuses can promote drainage.
- Decongestants: These medications are designed to get things (mostly mucus) moving again!
Many medications come in either pill or nasal spray forms. You’ll be able to talk to your ENT about which you prefer–and which will work best.
Surgery
Sometimes, surgery may be required to provide relief. Surgical options include:
- Functional changes: These surgical procedures can change the way your sinuses function, improving drainage (for example, fixing a deviated septum would count as this type of procedure).
- Balloon sinuplasty: This procedure helps create extra space in the sinuses by dilating the cavities, relieving symptoms and promoting drainage.
Surgery isn’t right for everyone, so make sure to talk to your provider.
How to better manage chronic sinusitis
In some cases, treatment will only take you so far. For some people, simply managing chronic sinusitis can help alleviate symptoms by preventing a flareup before it begins. There are several important ways you can change your lifestyle to help promote sinus health. They include the following:
- Changing your environment: You can take steps to reduce your exposure to irritants and allergens (avoid seasonal allergies, for example). You should also make sure that you’re changing your indoor air filters and preserving good indoor air quality.
- Changing your diet: Include foods that are good for your sinuses, such as citrus, pineapple, and hot tea. Additionally, take steps to drink tons of water. Dehydration is your enemy! Staying hydrated can help minimize the symptoms of your sinus infection.
- Lower your overall stress levels: Believe it or not, stress can lead to all sorts of physical manifestations in the body, including a higher propensity for sinus infections (and a harder time fighting them off). Take up meditation or yoga–or at least find some time for some self care!
Managing your chronic sinusitis is something that occurs in conjunction with your provider. So make sure to talk to your ENT about steps you can take at home to avoid sinusitis symptoms.
Taking care of your mental health
It’s important to remember that any chronic illness can have an impact on your mental health. After all, being in pain constantly (especially face pain) is incredibly draining. So seek support from mental health professionals, support groups, and your peers. It’s okay and understandable to have a hard time coping with your chronic sinusitis. And it can take a toll. So make sure to get help where needed.
What does the future look like?
Over 11% of the United States population suffers from chronic sinusitis. So scientists and physicians are always working on new treatment options. New therapies may include novel nasal sprays and brand new drugs (such as Dupixent, an injectable treatment that aims to reduce nasal polyps). Whether these new treatment options are right for you will vary depending on your symptoms and outlook.
Surgeons are also consistently evolving new techniques designed to deliver results with only minimal incisions.
Get the help you need
For many, chronic sinusitis will not be something you can conquer on your own. You’ll need help–and that’s okay! With successful treatment, you can start enjoying all those daily activities again–instead of focusing on how much your head hurts or when you might stop feeling stuffy.
Is chronic sinusitis getting you down? Find a provider near you!