Should I use this page, or skip it?
Use this page if your face feels blocked and tender after a cold and you want to know whether a pharmacist, GP or 111 is first. Skip it and call 999 if an eye is swelling, vision is changing, you are confused, or a severe headache comes with a stiff neck. This page cannot drain your sinuses.
Pressure that is worse when you bend forward is typical. A red, bulging eye is not sinusitis-as-usual.
What is sinusitis and what does it feel like?
Sinusitis is swelling of the air spaces behind the cheeks and forehead. It often follows a cold or flu. Typical features are pain or tenderness around the cheeks, eyes or forehead, a blocked or runny nose, reduced smell, and sometimes green or yellow mucus, headache, toothache or bad breath.
Young children may just be irritable and mouth-breathe. NHS advice is that it usually clears within four weeks. Most cases are viral. Green mucus does not automatically mean you need antibiotics.
Can I see a pharmacist first?
Yes, for many people. In England, Pharmacy First can assess some sinusitis without a GP appointment if you fit the pathway. Eligibility applies — including age — so ask rather than assuming. Younger children often need a GP. The pharmacist checks for red flags, then treats, advises, or sends you on.
Scotland has NHS Pharmacy First Scotland, Wales a Common Ailments Service, and Northern Ireland Pharmacy First NI. Find a GPhC-registered pharmacy on Pick My Pharmacy.
Do I need antibiotics?
Usually not. NICE guidance is that most acute sinusitis gets better without them, and withholding antibiotics rarely leads to complications. A clinician may still prescribe if you are very unwell or symptoms are not settling. Follow the course you are given. Do not share leftover antibiotics.
Paracetamol or ibuprofen can ease pain — follow the pack. A steroid nasal spray may be suggested. Decongestants are not for everyone.
How can I ease it at home?
Rest, drink fluids, and clean the nose with a salt-water rinse. NHS describes a homemade cooled boiled-water mix with salt and bicarbonate of soda — a pharmacist can show you a ready-made option if that sounds fiddly. Avoid allergy triggers if hay fever is in the mix. Do not smoke.
Steam over a bowl of hot water is not required and can cause burns, especially in children. Do not use a decongestant spray for more than about a week.
When is it 111 or 999?
Call 999 or go to A&E for swelling or redness around an eye, sudden vision change, confusion, or a severe headache with a stiff neck. Use 111 if you are very unwell, painkillers are not helping, or you have a weakened immune system. See a GP if three weeks of self-care have not helped or sinusitis keeps returning.
In England, Scotland and Wales call 111 (NHS 24 in Scotland). In Northern Ireland there is no general 111 — use GP out-of-hours on nidirect. See pharmacy, GP, 111 or A&E if you are stuck on the door.
What if sinusitis keeps coming back?
See a GP if you have had more than three weeks of self-care without improvement, or sinusitis keeps returning. Long-lasting symptoms sometimes need a steroid nasal spray for longer, an allergy review, or an ENT opinion. One-sided symptoms that never swap sides also deserve a check.
Hay fever can mimic sinus pain in season. Say if this happens every summer. Do not use a decongestant spray for weeks on end — that can make blockage worse. A pharmacist can help you stop and switch plan.
Who should skip this page?
Skip this page if an eye is already swelling or a severe headache has a stiff neck — that is urgent care, not a long read. It is not a chronic-sinusitis surgery clinic, not a year-round hay fever plan, and not for a baby with fever who needs the children’s fever pathway.
Common questions about sinusitis
- What causes sinusitis?
- Most cases follow a viral cold, which blocks the sinuses so mucus cannot drain. Allergies and nasal polyps can contribute, especially if it keeps returning. Green or yellow mucus does not automatically mean bacteria. Because most cases are viral, antibiotics usually do not help the average cold-then-face-pain week.
- How long does sinusitis last?
- NHS advice is that it usually clears within four weeks. NICE notes that acute sinusitis often lasts about two to three weeks and most people get better without antibiotics. If symptoms last longer than 12 weeks it is called chronic sinusitis and needs a GP, not another decongestant spray from the cupboard.
- Can a pharmacist treat sinusitis in England?
- Yes, for many people who fit the Pharmacy First pathway. Eligibility applies, including age, so ask rather than assuming. The pharmacist checks for red flags, then advises self-care, supplies treatment if eligible, or sends you to a GP or 111. Scotland, Wales and Northern Ireland have their own pharmacy schemes.
- How can I treat sinusitis at home?
- Rest, drink fluids, and use paracetamol or ibuprofen — follow the pack. Clean the nose with a salt-water solution. A pharmacist can advise on steroid nasal sprays. Avoid decongestant sprays for more than about a week. Do not smoke. Leaning over a bowl of boiling water is not required and can scald.
- Do I need antibiotics for sinusitis?
- Usually not. NICE guidance is that most acute sinusitis is viral and withholding antibiotics rarely leads to complications. A clinician may still treat if you are very unwell, symptoms are not settling, or you are at higher risk. Follow the course you are given. Do not use leftover antibiotics.
- When is sinusitis an emergency?
- Swelling, redness or pain around an eye, a sudden change in vision, confusion, or a severe headache with a stiff neck needs 999 or A&E — infection can rarely spread. A high temperature with feeling extremely unwell is 111 the same day. One-sided symptoms that never swap sides also deserve a GP review.