Is it an allergy or a sinus infection?

I have had allergies since childhood, both spring and fall. However, in the past month I have been experiencing more congestion and mucus, and I even have some facial pain. I’m starting to wonder if my symptoms are really from allergies or if they are instead caused by a sinus infection. How can I tell the difference?

ANSWER: Allergies and sinusitis are often confused. But they are two separate conditions. By paying close attention to the specific symptoms you have, you can usually identify which one is more likely to cause the problem.

When someone is allergic, it means that their body reacts negatively to allergens, such as pollen, dust mites or pet dander. This reaction occurs when the immune system releases certain substances, such as histamine, into the bloodstream. This leads to allergy symptoms, including itching, sneezing, sinus pressure, nasal congestion, and discharge. While allergies can cause many of the same symptoms as a sinus infection, the condition is different.

A sinus infection, also called sinusitis, affects the cavities around your nasal passages. The infection causes your sinuses to become inflamed and swollen. The swelling makes it hard for your sinuses to drain and mucus builds up. You become constipated and have trouble breathing through your nose. Sinusitis often causes thick runny nose. In addition, you may experience headaches and pressure around your eyes, cheeks, nose or forehead. Although more common, cough and sore throat can also accompany sinusitis.

One of the telltale signs to distinguish whether you have allergic rhinitis or a sinus infection is if you have itchy, watery eyes along with other symptoms. Itching is rarely a symptom of a sinus infection. Contrary to popular belief, the color of your mucus doesn’t help tell the difference between allergies or sinus infections.

Since you’ve noticed seasonal allergies, pay attention to the timing of your symptoms. This can also help decide if they are likely caused by allergies. For example, tree pollen is most common in the spring. Grass pollen is common in late spring and early summer, while ragweed pollen is common in the fall. Mold and mildew spores tend to be more abundant in warm weather months. Of course, the seasons may differ depending on the region of the country where you live.

Finally, medication response can also help you determine if you need additional medical care. For allergies, over-the-counter medications, such as antihistamines, can be quite effective in relieving allergy symptoms, especially itching and a runny nose. You can also try adding an over-the-counter nasal corticosteroid daily to help with allergy symptoms. These nasal sprays help prevent and treat nasal inflammation and nasal congestion, especially if you have seasonal allergies and use them just when allergy symptoms start.

If you suspect your nasal congestion and other symptoms are due to sinus problems rather than allergies, you may need to be patient. In most cases, viruses cause sinusitis. These viral infections usually go away on their own within a week to 10 days. Self-care measures, such as extra rest and fluids, saline sinus rinses, and over-the-counter pain relievers and decongestants can help. But if symptoms are persistent or severe, antibiotics may be needed to treat the infection.

If your symptoms increase, do not improve with current therapy, or persist for more than two weeks, you may benefit from a visit to your primary care physician or an allergist. There are other options to relieve symptoms and address persistent allergies or recurring sinus infections.

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