A nasal infection can look like anything from clear, watery discharge that thickens into yellow or green mucus, to crusty sores around the nostrils, to visible swelling of the nose and surrounding skin. The specific appearance depends on what type of infection you’re dealing with, where it’s located, and how long it’s been developing. Nearly 29 million adults in the U.S. are diagnosed with sinus infections each year, making this one of the most common reasons people find themselves inspecting their nose in the mirror.
What Your Mucus Color Actually Means
The color and thickness of nasal discharge is usually the first thing people notice, and it’s also the most misunderstood. A viral infection like the common cold typically starts with thin, watery, clear mucus. Over the course of several days, that discharge gradually thickens and turns white, then yellow, and sometimes green before the infection resolves. This progression happens because your immune cells flood the nasal lining and their byproducts tint the mucus as they break down.
Here’s the part most people get wrong: green or yellow mucus does not automatically mean you have a bacterial infection. Both viral and bacterial infections produce discolored discharge. The difference is timing. With a virus, the thick colored mucus shows up several days in, after an initial period of clear, runny discharge. With a bacterial infection, thick, discolored mucus tends to appear right from the start or very early on, often alongside a high fever and facial pain.
Signs at the Nose Opening
Not all nasal infections happen deep inside the sinuses. Nasal vestibulitis is an infection of the skin right at the entrance to your nostrils, and it has a very distinct look. You’ll typically see small pimples or sores forming just inside or around the nose, along with yellow crusting or scabbing around the septum (the strip of tissue between your nostrils). The surrounding skin may appear red, swollen, or discolored.
This type of infection is often caused by bacteria entering through small cracks in the skin from nose-picking, frequent nose-blowing, or nasal piercings. It looks similar to a small boil or pimple cluster and can be tender to the touch. Most cases clear up with topical treatment, but if the redness and swelling start spreading across the nose or toward the cheek, that signals the infection is moving deeper.
What a Sinus Infection Looks Like Inside
When a doctor looks inside an infected nose with a light or scope, they typically see swollen, puffy nasal tissue on both sides, often with a visible stream of thick mucus draining from the sinus openings. The lining appears red and inflamed. That drainage can flow forward out the nostrils or drip down the back of the throat, which is why sinus infections so often come with a sore throat and a persistent cough, especially at night.
From the outside, a sinus infection may cause subtle puffiness around the eyes and cheeks. The skin over the affected sinuses can feel tender when you press on it, though this isn’t always a reliable sign. In more serious cases, you might notice visible swelling around one or both eyes, particularly in the morning.
How to Tell Bacterial From Viral
Since both types of infection can produce similar-looking discharge, the Infectious Diseases Society of America identifies three patterns that suggest a bacterial infection rather than a virus:
- The 10-day rule. Symptoms last 10 days or longer with no sign of improvement. A typical cold should be trending better by then.
- Severe onset. A fever of 102°F (39°C) or higher with thick, discolored nasal discharge or significant facial pain that persists for at least 3 to 4 days from the start.
- Double sickening. You start improving after a typical cold, then suddenly get worse again around day 5 or 6, with new fever, worsening headache, or a fresh surge of nasal discharge. This rebound pattern is a classic sign that bacteria have set up a secondary infection.
If none of these patterns apply, you’re most likely looking at a viral infection that will resolve on its own within about 10 days.
What Chronic Infections Look Like
When nasal infections persist or keep returning over months, the appearance changes. The nasal lining stays chronically swollen rather than acutely inflamed. In some cases, nasal polyps develop: soft, translucent, teardrop-shaped growths along the nasal lining. A developing polyp looks pearly white; a mature one resembles a peeled seedless grape. Polyps aren’t painful, but they block airflow and trap mucus, creating a cycle of congestion, thick postnasal drip, and reduced sense of smell.
People with chronic infections often describe a constant feeling of pressure rather than sharp pain, along with persistent bad breath and a nasal quality to their voice. The discharge tends to be thick and may drain continuously down the back of the throat rather than flowing out the front of the nose.
Fungal Infections: A Different Appearance
Fungal nasal infections are uncommon but look distinctly different from bacterial or viral ones. In invasive cases, which primarily affect people with weakened immune systems, the sinuses contain dark, thick, greasy-looking material. The infection can destroy tissue it contacts, and in severe cases, dark patches or dead tissue may become visible inside the nose. This is a medical emergency that progresses rapidly and requires immediate treatment.
How It Looks Different in Children
Children’s nasal infections present a bit differently than adults’. Kids under five rarely complain of headaches from sinus infections. Instead, the hallmark signs are a runny nose lasting longer than 7 to 10 days (the discharge is usually thick green or yellow, though it can stay clear), a cough that’s worse at night, and swelling around the eyes. Older children and teens are more likely to report facial pressure and headaches.
One telling sign in children that parents often overlook is bad breath. Persistent foul-smelling breath in a child with a stuffy nose that won’t quit is a strong indicator of bacterial sinusitis, since the trapped, infected mucus produces sulfur compounds as it stagnates.
Swelling That Signals Spreading Infection
Certain visual changes around the nose and eyes indicate an infection has moved beyond the sinuses into surrounding tissue. Periorbital cellulitis, an infection of the skin around the eye, causes eyelid swelling and skin redness or discoloration. This can develop when a sinus infection spreads through the thin bone separating the sinuses from the eye socket.
More severe orbital cellulitis produces the same swelling but adds eye pain, difficulty moving the eye, the eye pushing forward in its socket, and sometimes double vision. In the case report from the Emergency Medicine Journal, a 24-year-old man presented with a swollen, red left eyelid along with swelling extending to the scalp region, all stemming from a sinus infection. Any noticeable swelling around the eye during a sinus infection, especially if it’s getting worse or affecting your vision, requires urgent evaluation.