The Difference Between a Sinus Infection and a Cold

Symptoms like stuffy nose, headache, and sore throat may sound a lot like your run-of-the-mill cold, but they could also be acute bacterial sinusitis, a type of sinus infection. But the two conditions—the common cold and sinus infections—have similar enough symptoms that they're often confused.

So how do you tell if you have a cold versus a sinus infection? Unfortunately, it's not a clear-cut answer. "The distinction can be difficult and no one rule applies to everybody," said Neil Bhattacharyya, MD, a professor of otolaryngology at Harvard Medical School. "Only about 2% to 6% of common colds progress to become a true bacterial sinus infection that could benefit from antibiotics," said Dr. Bhattacharyya. Here's what you need to know about both types of illnesses.

Defining Sinus Infection and the Common Cold

Each year, about 31 million people experience sinus infections—also called sinusitis—which is usually caused by germs growing in the sinuses, the hollow cavities found behind the nose, eyes, brows, and cheekbones.

Most often, viruses cause sinus infections, but bacterial infections can cause sinusitis too. Bacterial or viral infection causes mucous membranes in the sinuses to swell and block the tiny openings into the sinuses, which interferes with their ability to drain. The trapped mucus allows bacteria to breed, causing pain and pressure in the head and face.

Colds are mild viral upper respiratory infections, and they are not caused by a buildup of germs and inflammation in the sinuses. However, a cold can lead to a sinus infection.

Antibiotics can be helpful for those with bacterial sinus infections, but these medications are useless when it comes to fighting cold viruses or viral sinus infections.

Symptoms

While some symptoms of a cold and a sinus infection may be similar—stuffy nose, sore throat, and cough—there are some differences.

The color of your nasal discharge can clue you in about whether you have a cold or sinusitis. Unlike colds, which generally produce clear mucus, bacterial infections can produce green or yellow mucus. However, viruses sometimes produce colorful discharge as well, so this isn't considered a fail-safe test.

Cold Symptoms

The main difference between the symptoms of a cold and sinus infection is how long they linger. Dr. Bhattacharyya said cold sufferers typically have a runny nose for two to three days, followed by a stuffy nose for two to three days. Most people will recover in 7–10 days from their symptoms.

The following symptoms are common with colds:

• Sneezing
• Stuffy nose
• Runny nose
• Sore throat
• Coughing

Sinus Infection Symptoms

Alternately, sinus infections usually last longer than a common cold and may hang around for 3–8 weeks. A fever may also signal a bacterial infection. Sinus infections are sometimes accompanied by a low-grade fever, while colds typically are not. Other viral infections (such as the flu) do cause fevers, however.

Here are some other symptoms of sinus infections:

• Runny nose
• Stuffy nose
• Facial pain/pressure
• Headache
• Mucus dripping down the throat (post-nasal drip)
• Sore throat
• Cough
• Bad breath
  

Dr. Bhattacharyya said there is no rhyme or reason as to why some people tend to develop sinus infections and others don't.

Treatment

For most people, there are some preventive measures that can help stave off a sinus infection, or, if one occurs, help relieve symptoms, said William Marshall, MD, an infectious disease specialist previously on staff at the Mayo Clinic. Dr. Marshall recommended the same things "mothers recommend for a cold," like rest, drinking lots of fluids, breathing steam, and irrigating the sinuses with saline spray or a neti pot, a container used to rinse the sinuses with saline solution.

Over-the-counter decongestants can also be helpful, but Dr. Marshall said they should not be used for more than three days because some products can exacerbate congestion and raise patients' blood pressure and heart rate.

Bacterial sinus infections can last for up to 8 weeks, but the use of antibiotics speeds up the recovery process. Still, according to Dr. Bhattacharyya, about 70% of sinus infections resolve on their own, and many patients prefer to let them run their course.

"Antibiotics mainly help to speed up the healing process," Dr. Bhattacharyya said. "But before antibiotics were around, people weren't dropping dead of sinus infections—and they still aren't," Dr. Bhattacharyya explained.

If left untreated, however, sinusitis can cause permanent damage to the sinuses and, in very rare cases, can lead to meningitis, Dr. Marshall said. If patients miss work or other activities due to sinus infections, or if their symptoms recur frequently, they should see a healthcare provider for evaluation.

A Quick Review

While colds and sinus infections may have similarities, they also have differences. Both illnesses can cause sore throat, stuffy nose, and cough. But as far as treatment, you can treat a sinus infection with antibiotics but antibiotics will not treat the common cold. Both illnesses can benefit from rest and drinking plenty of fluids. If you have any questions regarding how to treat your symptoms, always seek advice from your healthcare provider.