The inflammation of chronic sinusitis can be more than just an annoyance. Here's what you can do about flare-ups.
Stuffy nose? Constant blowing? A head on the verge of exploding? Everyone battles clogged sinuses at times, and often the discomfort goes away after a few days. However, if the condition lingers or becomes more severe, you could be battling chronic sinusitis, which can affect your quality of life.
"Besides the stress of dealing with the symptoms, the condition can interfere with your sleep, lead to depression, and keep you from being active," says Dr. Ahmad R. Sedaghat, an otolaryngologist with Harvard-affiliated Massachusetts Eye and Ear Infirmary.
A look at your sinuses
Your sinuses are moist air spaces between the eyes and behind the forehead, nose, and cheeks. Normally, mucus in the sinuses drains through small openings into the nose.
Chronic sinusitis develops when the immune system creates inflammation that causes swelling within the lining of the sinuses. This can interfere with drainage, so mucus builds up. Breathing becomes difficult, and you feel painful pressure in upper parts of the face, such as the forehead or cheeks, behind the nose, or between or behind the eyes.
Any of a number of factors might lead to chronic sinusitis. It is thought that the immune system may react to bacteria or fungi that normally live in the sinuses, or to allergens, like dust, mold, or pollen. "More than likely, however, the exact cause of chronic sinusitis is different from person to person," says Dr. Sedaghat.
Chronic sinusitis also may arise from blockage of the sinus drainage passages — for instance, from a nasal tumor or polyps caused by inflamed tissues. The condition also occurs more frequently in people with asthma, cystic fibrosis, or an immune deficiency.
Chronic sinusitis typically begins with annoying flare-ups that last several days to a week. If symptoms last longer than a week or become severe, including unusually thick, discolored drainage, you probably have a sinus infection, which often improves — with or without antibiotics — within four weeks. If symptoms don't improve, chronic sinusitis sets in.
"See your doctor if you have two of the four main symptoms — nasal blockage, nasal drainage, decreased sense of smell, and facial pain — for more than 12 weeks," says Dr. Sedaghat.
The best course of action
There is no cure for chronic sinusitis, and once you have a history of it, you will always be at risk for flare-ups. The goal is to manage the symptoms when they arise and take steps to protect against additional episodes.
The strongest evidence suggests that the best way to reduce inflammation and calm symptoms is to use a daily nasal steroid spray, such as fluticasone (Flonase), triamcinolone (Nasacort AQ), or budesonide (Rhinocort Aqua).
Although these sprays are now available over the counter, Dr. Sedaghat suggests checking with your doctor if you use them regularly, as they can have side effects, such as nosebleeds, or can even create a hole in the nasal septum, the tissue that separates the two nasal passages. Sometimes endoscopic sinus surgery is necessary to open the inflamed sinuses and remove blockages or polyps.
Once your chronic sinusitis is under control, you can take steps to help prevent its return:
Clean your nasal passages daily with a saline solution. (See "Rinse with a saline solution.")
Don't smoke and avoid contact with secondhand smoke.
Get an allergy test. If you know what you are allergic to, you can try to avoid it or reduce your exposure. For example, if you are allergic to pollens, minimize outdoor activities when there are high levels.
(Harvard Men's Health Watch)
