The hallmark symptoms of a sinus infection are a stuffy or runny nose, thick discolored mucus, and pain or pressure in the face. These symptoms overlap heavily with a common cold in the first few days, which is why timing matters: most colds improve within a week, while a sinus infection either lingers beyond 10 days or gets noticeably worse after briefly seeming to improve.
The Core Symptoms
A sinus infection, also called sinusitis, produces a cluster of symptoms that center on the nose and face. The most common include:
- Nasal congestion that makes it difficult to breathe through your nose
- Thick nasal discharge that’s yellow, green, or cloudy, draining from the front of the nose or down the back of the throat
- Facial pain or pressure around the nose, eyes, forehead, or cheeks
- Reduced sense of smell and taste
- Headache that often worsens when you bend forward
Post-nasal drip, where mucus drains down the back of your throat, is particularly common and often triggers a cough, sore throat, or a feeling of constantly needing to clear your throat. This tends to be worse at night or first thing in the morning.
Where Your Face Hurts Tells You Which Sinuses Are Involved
You have four pairs of sinus cavities, and the location of your pain maps directly to which ones are inflamed. Pressure in the forehead points to your frontal sinuses, which sit above your eyebrows. Pain in the bridge of your nose suggests the ethmoid sinuses, located between your eyes. Cheekbone pain or aching in your upper back teeth signals the maxillary sinuses, the largest pair, which sit just below your eye sockets on either side of your nose. Pain behind the eyes or deep in the ears can mean the sphenoid sinuses, tucked behind the eyes near the center of your skull.
Many people feel pressure in more than one area at once, since infection commonly affects multiple sinus pairs simultaneously.
Symptoms You Might Not Expect
Beyond the obvious congestion and facial pressure, sinus infections cause several symptoms people don’t always connect to their sinuses.
Toothache is one of the most surprising. The roots of your upper back teeth sit very close to (and sometimes extend into) the maxillary sinus cavity. When that sinus becomes inflamed, the swelling presses on those roots and produces genuine tooth pain. If your upper teeth ache on both sides and you also have nasal symptoms, your sinuses are the likely culprit rather than a dental problem.
Bad breath is another common sign. Infected mucus draining down the back of your throat creates a persistent foul odor that brushing won’t fix. Ear fullness or pressure can also develop because the sinuses and middle ear share drainage pathways. And fatigue that feels out of proportion to your other symptoms is typical, since your immune system is actively fighting inflammation.
Loss of smell affects a large percentage of people with sinusitis. In chronic cases, studies using standardized smell tests have found that anywhere from 30% to nearly 80% of patients show measurable reductions in their ability to detect odors, depending on how sensitively the testing is done. Many people notice food tastes bland or “off” as a result.
How to Tell a Cold From a Sinus Infection
Nearly every sinus infection starts as a viral cold, which makes the early days impossible to tell apart. The distinction comes down to three patterns.
The first is persistence. If your runny nose, congestion, and facial pain haven’t improved at all after 10 days, that suggests bacteria have settled into the swollen sinuses. A typical cold peaks around days 3 to 5 and then gradually improves.
The second is the “double worsening” pattern. Your symptoms start to get better, then come back worse than they were initially. This rebound is a strong signal that a bacterial infection has developed on top of the original viral illness.
The third is severe onset. A high fever (102°F or higher) alongside thick, discolored nasal discharge lasting at least three consecutive days from the start points toward a bacterial infection rather than a garden-variety cold.
The practical difference matters because viral sinus infections resolve on their own, while bacterial ones sometimes need antibiotics.
When Symptoms Last Months: Chronic Sinusitis
Acute sinus infections typically clear within 10 days to four weeks. When symptoms persist for 12 weeks or longer, it’s classified as chronic sinusitis. The symptoms are largely the same, but they tend to be less intense and more grinding: ongoing nasal congestion, a persistent post-nasal drip, facial tenderness that never fully goes away, and reduced smell that may have crept up so gradually you didn’t notice it worsening.
Chronic sinusitis isn’t just a long cold. It’s driven by ongoing inflammation that can stem from allergies, nasal polyps, a deviated septum, or immune system issues. The treatment approach is different from acute infections and typically focuses on controlling inflammation rather than killing bacteria.
Sinus Infection Symptoms in Children
Children get sinus infections, but their symptoms look different enough that parents often miss the connection. Kids rarely complain of facial pressure the way adults do. Instead, the key signs are a runny nose or daytime cough lasting more than 10 days without improving, thick yellow nasal discharge paired with a fever that persists for three or four days, and persistent bad breath alongside cold symptoms.
Swelling and dark circles around the eyes, especially noticeable in the morning, can also signal sinusitis in children. A severe headache behind or around the eyes that worsens when bending over is another clue, though younger kids may simply seem more irritable or cranky than usual rather than describing head pain. Increasing irritability in a child with prolonged cold symptoms warrants a call to their pediatrician.
Symptoms That Need Immediate Attention
Most sinus infections are uncomfortable but not dangerous. A small number, however, can spread beyond the sinuses to surrounding structures, including the eye socket and the membranes around the brain. Seek immediate medical care if you notice pain, swelling, or redness around the eyes, double vision or other visual changes, a high fever that isn’t responding to treatment, confusion, or a stiff neck. These symptoms suggest the infection may have moved beyond the sinuses and requires urgent evaluation.