Sinus Infection vs. Cold: How to Tell the Difference

Dr. Menachof, MD, has specialized in conditions around the head, throat, ear, nose, neck and face for over 20 years, and was the first to bring sublingual allergy drops to Colorado in 2005. He has been recognized as a Fellow by multiple academies, named one of America’s Top Facial Plastic Surgeons continually since 2003 and is featured in multiple national publications.

When you’re feeling sick, it can be tough to tell whether you are struggling with a sinus infection or simply have the common cold. The symptoms of these conditions can be very similar, but there are important differences between the two and they must be treated differently in order for you to find relief.

Symptoms of Cold vs. Sinus Infections

The table below displays the likelihood of each symptom developing as a result of sinus infections versus the common cold.

What Does a Cold Look Like?

When you have a cold, this means your body is fighting off a viral infection in your upper respiratory system. There are over a hundred types of viruses that can cause the common cold, which is also known scientifically as rhinitis. These illnesses are spread either by exchanging contaminated water droplets in the air (usually through coughing or sneezing) or by touching surfaces where the virus is lingering.

Most adults get between two to four mild colds per year, but certain factors such as smoking or a weakened immune system can increase your risk. The areas most affected by a cold are typically the nose, mouth, throat and lungs, but full body aches and other discomforts can also be experienced because of the virus. Cold symptoms often appear one to three days after exposure to the virus, and should resolve within 5 – 7 days.

Symptoms of the common cold often include:

• Runny nose
• Stuffy nose
• Sneezing
• Cough
• Sore throat
• Chest congestion
• Headache
• Watery eyes
• Body aches
• Fatigue
• Fever

What Does a Sinus Infection Look Like?

A sinus infection develops when the lining of the sinus cavities becomes irritated and inflamed, preventing proper mucus drainage and airflow. When mucus builds up in the nasal or sinus passages it becomes a perfect breeding ground for bacteria and fungus, which can lead to an infection. Recurrent acute sinusitis is a condition where shorter sinus infections keep returning throughout the year.

Sinusitis symptoms like nasal blockage and facial pain can be frustrating, especially when they continue for long periods of time or return frequently. Common symptoms of sinus infection include:

• Facial pain or pressure
• Stuffy nose or congestion
• Loss of smell
• Coughing
• Headache
• Fever
• Fatigue
• Bad breath
• Dental pain
• Pus in the nasal cavity

It is possible to start out with a cold, and later end up with a sinus infection because of the lack of drainage caused by cold symptoms. Root causes of a sinus infection include:

• Allergies
• Nasal polyps
• Deviated septum
• Cold or virus
• Immunodeficiencies

When a sinus infection appears quickly, produces green or yellow colored mucus, and lasts for up to two weeks, it is usually acute sinusitis. When symptoms last for many weeks or return frequently, this is usually a sign of chronic sinusitis. Acute sinusitis will often resolve itself by treating the symptoms of swelling and congestion, without a visit to a doctor. If symptoms carry on and you think you may have chronic sinusitis, seeing an experienced ENT doctor is the best way to determine the root cause of your sinus issues and get the right treatment.

How to Tell the Difference Between Colds and Sinus Infections

The most helpful clues to determine whether you have a sinus infection or a cold are:

Length of Symptoms

The duration and intensity of your symptoms can sometimes help determine whether a cold or sinus infection is at play. A cold typically causes peak symptoms around days three to five and then will improve over the next week. A sinus infection can cause symptoms for longer, with up to 10 or 12 days of more consistent symptoms. If your peak symptoms last for more than a week you can suspect a sinus infection.

Sinus and Facial Pressure

While a cold can sometimes irritate the sinuses and cause swelling, experiencing constant facial pressure and pain for many days is often a sign of a sinus infection. An infection is caused by bacteria that breed in the sinus cavities themselves, meaning the symptoms can last longer and over the counter decongestants may be less effective to relieve this pressure than congestion from a cold.

Mucus Color

Clear, watery mucus is usually a sign of a cold. A sinus will often cause mucus to become thick and green or yellow in color. If you experience nasal discharge that is colored and have a difficult time blowing your nose, you may have a sinus infection.

Bad Breath

The bacteria that cause a sinus infection can also cause germs and fungi that give you bad breath. If you feel like your breath smells or is stale along with other symptoms, you may consider a sinus infection as the culprit.

Because a common cold is caused by a virus, it can’t be treated effectively with antibiotics. Some medicines and treatment can help reduce symptoms, but usually rest is the best way to beat a cold virus. Sinusitis is commonly caused by a bacterial infection, though it can also be caused by a virus or other root causes.

How to Diagnose Your Cold vs Sinus Infection

When symptoms become bad enough or last long enough that you want to seek medical advice, an experienced ENT specialist can diagnose what is causing your discomfort. A cold can often be diagnosed with a standard physical exam, and some viruses can be confirmed with blood testing if necessary.

If the doctor suspects a sinus infection, they may perform a rhinoscopy or endoscopy to view the inside of your sinus cavities with a thin endoscope device. Once it is confirmed that a sinus infection is the source of your symptoms the doctor can then work to determine the root cause of the infection, be it allergies, nasal polyps, or another underlying source. If allergies are suspected as the cause, testing can be completed to diagnose which allergies are at play. The best form of treatment for your infection will depend on the diagnosed source of the issue.

How To Treat Your Symptoms

Whether you have a cold or a sinus infection, getting plenty of rest and water is key for healing. Antibiotics are only effective if your issues are caused by a bacterial infection, in which case you will likely be prescribed a course of antibiotic pills or liquid to help the body fight bacteria. There are no effective medications to treat colds or viral infections directly, so treating your symptoms is often the best way to help your body heal and normalize.

Relieve Congestion

There are several ways to reduce congestion and allow for better airflow and drainage in the nasal passages. Saline spray can be effective, but watch out for some nasal decongestant sprays like Afrin which should only be used for a few days in a row to avoid damage. Over the counter decongestants and antihistamines can help as well, especially if your congestion and infection are stemming from allergies. A corticosteroid, usually a spray or pill, is also sometimes prescribed for severe sinus swelling.

Reduce Pain and Pressure

Taking an over the counter pain reliever such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help reduce swelling and aching that stem from a cold or sinus infection. Rest is also one of the best ways to allow healing in the body, but change positions frequently enough to avoid the body becoming stiff (which makes it feel more sore). If you are suffering from a severe headache or headache lasting more than 5 days, see a doctor as soon as possible.

Treat the Root Cause

If you are suffering from chronic sinusitis, your body will continue to suffer until you have addressed the root of the issue. If the sinuses passages are simply too small to allow for proper airflow and drainage, a balloon sinuplasty can expand the sinuses to avoid future issues. If it is determined that allergies are the source of your issues, immunotherapy allergy drops can be used daily under the tongue to eliminate allergies long term. Nasal polyps or a deviated septum that cause sinus issues can be fixed with specialized procedures.

Still Wondering if it’s a Cold or Sinus Infection? See a Doctor.

Colds and sinus infections can both heal on their own, but when your symptoms become intense or linger for weeks you should seek help from an Ear, Nose and Throat (ENT) expert. An experienced doctor will be able to review your symptoms and timeline, examine your sinuses to determine the root cause, and provide you with a treatment plan to help you heal quickly. If you’re sick and wondering if you have a cold or sinus infection, stop suffering through symptoms and consult with an ENT expert today.