Sinus Infection or Common Cold? How to Tell the Difference

Why the confusion?

A common cold and a sinus infection (sinusitis) share many symptoms, which is why they are so often mixed up. Both can cause a blocked nose, facial discomfort and feeling run down. The good news is that the vast majority of both conditions are caused by viruses and get better on their own without antibiotics.

What is a common cold?

A cold is a viral infection of the upper airways. Symptoms usually build over a day or two and then ease, typically clearing within one to two weeks. Common features include:

• Runny or blocked nose
• Sneezing and a sore throat
• Cough
• Mild headache and tiredness

What is sinusitis?

Sinusitis is inflammation of the sinuses, the air-filled spaces behind the cheeks, forehead and eyes. It often develops after a cold and can be viral or, less commonly, bacterial. Typical features include:

• Pain, pressure or tenderness around the cheeks, eyes or forehead
• A blocked nose and reduced sense of smell
• Thick nasal mucus
• Pain that may worsen when bending forward

Telling them apart

The two overlap, but some clues help:

• A cold tends to improve within a week or two, while sinusitis may linger
• Sinusitis often causes more focused facial pain and pressure
• Symptoms that improve and then suddenly worsen again can suggest a bacterial sinus infection

Coloured nasal mucus alone does not prove a bacterial infection, as it is common in viral illness too. You can read more about bacterial illness in bacterial infections explained.

Looking after yourself

Most colds and cases of sinusitis improve with self-care:

• Rest and drink plenty of fluids
• Use paracetamol or ibuprofen for pain or fever, following the leaflet
• Try saline nasal sprays or rinses to ease congestion
• Inhale steam from a bowl of warm water for comfort
• A pharmacist can suggest decongestants or other suitable remedies

Do you need antibiotics?

Because most colds and sinus infections are viral, antibiotics usually make no difference and are not recommended. Using them unnecessarily contributes to antibiotic resistance explained. A doctor may consider antibiotics only if sinusitis is severe, lasts a long time, or shows signs of being bacterial. In those cases, medicines such as those in our Amoxicillin guide and the broader antibiotics range are among the options a clinician might weigh up. If prescribed, always complete the course.

When to see a doctor

Seek medical advice if:

• Symptoms last more than about ten days without improving
• Symptoms are severe or getting worse
• You have a high fever
• Sinusitis keeps coming back

Get urgent care if you have swelling or redness around the eyes, severe headache with a stiff neck, vision changes, or confusion, as these can indicate a rare but serious complication.

General information only — not medical advice. Always read the patient information leaflet and consult a doctor or pharmacist before starting any medication.