Sinusitis or Just a Bad Cold? How to Tell — and When to Get Treated

Every sinus infection starts life looking like a cold — which is exactly what makes sinusitis confusing. The congestion, the pressure, the endless tissues. So when does a cold officially become sinusitis, and when does sinusitis need treatment?

Here's the practical guide we give patients at Lyng Pharmacy in West Bromwich, where sinusitis is assessed and treated on the NHS under Pharmacy First for anyone aged 12 and over.

The tell-tale signs of sinusitis

Pain, pressure or tenderness around the cheeks, eyes or forehead that worsens when you bend forward. Thick green or yellow discharge rather than clear. Reduced sense of smell. Upper toothache with no dental cause. A cold peaks and fades within about ten days — sinusitis is what's still there, or getting worse, after that.

The ten-day rule for antibiotics

Most sinusitis is viral and clears within two to three weeks with self-care: paracetamol or ibuprofen, fluids, steam, saline rinses, and sleeping propped up. Antibiotics enter the picture when symptoms have persisted around ten days without improving, or are severe from the start — high fever, intense one-sided facial pain. That's the assessment our pharmacist runs through, supplying NHS treatment where the pathway supports it.

Self-care that actually works

Saline nasal rinses physically wash mucus and inflammation out of the nose — undervalued and genuinely effective. Steam from a hot shower loosens congestion. Decongestant sprays help short-term but cause rebound congestion beyond a week, so use them as a bridge, not a habit. And a warm flannel over the painful area is simple, free relief.

Frequently asked questions