The most common symptoms of a sinus infection are a stuffy or runny nose, facial pain or pressure, and thick nasal discharge that may drip down the back of your throat. Most sinus infections start as a viral cold and clear up within 10 days, but some turn bacterial and linger for weeks or months.
The Core Symptoms
Sinus infections inflame the air-filled spaces behind your forehead, cheekbones, and nose. That swelling blocks normal drainage, and the buildup of mucus creates the hallmark set of symptoms: a stuffy nose, a runny nose (often with thick yellow or green discharge), facial pain or pressure, headache, post-nasal drip, sore throat, cough, and bad breath.
Facial pressure tends to concentrate wherever the affected sinuses sit. If your maxillary sinuses (behind your cheekbones) are involved, you’ll feel it across your mid-face. Frontal sinus involvement produces a deep ache behind your forehead, while pressure between or behind your eyes points to the ethmoid sinuses. The pain often worsens when you bend forward, because the shift in head position increases pressure on the inflamed tissue.
Upper Tooth Pain and Other Surprises
One symptom that catches people off guard is aching in the upper teeth. The maxillary sinuses sit directly above the roots of your upper molars and premolars. In some people, those tooth roots actually extend into the sinus cavity. When the sinus lining swells, it can press on nearby dental nerves, creating tenderness across several upper teeth at once. A key clue: the tooth pain gets worse when you change head position, like bending over or lying down. If the pain is isolated to a single tooth and doesn’t shift with position, that’s more likely a dental problem than a sinus one.
Fatigue is another common companion. Your body is fighting off an infection, and the combination of disrupted sleep from congestion and an active immune response leaves many people feeling wiped out.
Sinus Infection vs. Allergies
Allergies and sinus infections share several symptoms, especially nasal congestion, pressure, and discharge. The simplest way to tell them apart is itching. Itchy, watery eyes are a hallmark of allergies and rarely show up with a sinus infection. Frequent sneezing also points more toward allergies.
Sinus infections, on the other hand, tend to produce thicker, discolored nasal discharge along with headaches and pressure concentrated around the eyes, cheeks, and forehead. Sore throat and cough from post-nasal drip are more common with infections than with allergies. If your symptoms follow a seasonal pattern or flare up around specific triggers like dust or pet dander, allergies are the likelier explanation.
How Long Symptoms Last Matters
The timeline of your symptoms tells you a lot about what type of sinus infection you’re dealing with. Most sinus infections are viral, meaning they piggyback on a regular cold and resolve within 10 days. If your symptoms persist beyond 10 days without any improvement, that’s the standard threshold for suspecting a bacterial sinus infection.
There’s also a pattern called “double sickening.” You start feeling better around day five, then suddenly get worse again, with returning or worsening congestion, pain, and fever. This rebound strongly suggests bacteria have moved into sinuses that were already inflamed from a virus. Both persistent symptoms past 10 days and double sickening are the situations where antibiotics become appropriate.
If symptoms drag on for 12 weeks or more, the diagnosis shifts to chronic sinusitis. Chronic sinusitis involves the same core symptoms, but the causes and treatment differ. It’s often driven by ongoing inflammation, nasal polyps, or structural issues rather than a single infection.
Symptoms in Children
Kids don’t always describe sinus pressure the way adults do, so the signs to watch for look a bit different. The American Academy of Pediatrics highlights these as indicators of a bacterial sinus infection in children: cold symptoms (nasal discharge, daytime cough, or both) lasting more than 10 days without improving, thick yellow nasal discharge paired with a fever lasting three or four days, a severe headache behind or around the eyes that worsens with bending over, swelling and dark circles around the eyes (especially in the morning), and persistent bad breath alongside cold symptoms.
Younger children may simply seem more irritable than usual or have trouble sleeping. They’re less likely to report facial pressure directly, so a cough that won’t quit or consistently foul-smelling breath can be the most visible clues.
Symptoms That Need Immediate Attention
The sinuses sit close to the eyes and the brain, and in rare cases an infection can spread to those structures. Certain symptoms signal this kind of complication and call for urgent medical evaluation:
- Swelling or redness around the eyes that persists throughout the day (not just morning puffiness)
- Vision changes, including blurred vision, double vision, or any loss of sight
- Severe headache or pain in the back of the neck
- High fever that doesn’t respond to typical fever reducers
- Persistent vomiting or sensitivity to light
When a sinus infection spreads to the tissue around the eye, it can compress the optic nerve and cause permanent vision loss if not treated quickly. Intracranial spread, where the infection reaches the brain or its lining, is life-threatening. These complications are uncommon, but the warning signs are distinct enough to recognize. Redness or swelling around one eye that won’t go away, combined with worsening pain or any visual disturbance, should prompt a same-day visit to an emergency department.