The symptoms of a sinus infection (sinusitis) are facial pain or pressure, a stuffy or runny nose, thick nasal discharge, reduced sense of smell, and sometimes headache, cough, or fatigue. The tricky part is that these overlap with a common cold. The key differences: sinusitis often brings notable facial pressure and tends to linger past 10 days or worsen after seeming to improve, while a cold usually peaks around days 3 to 5 and fades within a week to 10 days. Importantly, most sinus infections are viral and clear on their own. Here is how to tell them apart.

TL;DR: Key takeaways

  • Sinus infection symptoms: facial pain/pressure, congestion, thick discharge, reduced smell, headache.
  • A cold and sinusitis overlap; the differences are timeline and facial pressure.
  • Colds usually peak around days 3 to 5 and improve within 7 to 10 days.
  • Suspect sinusitis when symptoms last past 10 days, or improve then worsen ("double worsening").
  • Most sinus infections are viral and don't need antibiotics; a few warning signs need urgent care.

What are the symptoms of a sinus infection?

To answer what are the symptoms of a sinus infection, sinusitis is inflammation of the sinuses (the air-filled spaces behind your forehead, cheeks, and eyes), and it produces a recognizable, if cold-like, set of signs.

Common sinus infection symptoms include:

  • Facial pain, pressure, or fullness, often over the cheeks, forehead, or around the eyes, sometimes worse when bending forward
  • Nasal congestion (a blocked, stuffy nose)
  • Thick nasal discharge, which may be yellow or green, or postnasal drip down the throat
  • Reduced or lost sense of smell and taste
  • Headache
  • Cough, often worse at night
  • Fatigue, and sometimes a low fever
  • Tooth pain in the upper jaw, or ear pressure

The standout that most distinguishes sinusitis from an ordinary cold is the facial pain and pressure, per the Mayo Clinic. But because congestion and discharge appear in both, the real question people have is how to tell a lingering cold from a genuine sinus infection, which is next.

Cold vs sinus infection: how to tell the difference

The practical heart of this page is cold vs sinus infection, because the two share so many symptoms. Two clues matter most: the timeline and the facial pressure.

A common cold typically peaks around days 3 to 5 and then steadily improves, resolving within about 7 to 10 days. Its mucus often shifts from clear to thick and colored and back to clear as it resolves, which surprises people: colored mucus alone does not mean a bacterial infection or that you need antibiotics. A sinus infection is more likely when symptoms persist beyond 10 days without improving, when facial pain and pressure are prominent, or, classically, when you experience "double worsening", you start to get better, then suddenly get worse again, per the Centers for Disease Control and Prevention. So the rough guide: a cold that follows the usual peak-and-fade over a week to 10 days is just a cold; symptoms dragging past 10 days, prominent facial pressure, or a get-better-then-worse pattern point toward sinusitis. This distinction matters for what you do next, and whether treatment even helps.

The part that matters: most sinus infections are viral

Here is the anchor that keeps sinus infection information honest and useful: most sinus infections are caused by viruses, not bacteria, which means most do not need, and will not respond to, antibiotics. This is genuinely important and widely misunderstood.

Acute sinusitis usually follows a cold and is viral, resolving on its own with time and symptom care, and the CDC specifically notes that antibiotics are not needed for most sinus infections. Colored or thick mucus is a normal part of your immune response and of a resolving cold, not proof of a bacterial infection, this is one of the most common reasons people request antibiotics they do not need. Bacterial sinusitis is suspected mainly when symptoms are severe, last beyond about 10 days without improving, or show the double-worsening pattern, and even some of those improve without antibiotics. Why this matters practically: unnecessary antibiotics carry side effects and fuel resistance without helping a viral infection. So the goal with a suspected sinus infection is not automatically "get antibiotics", it is to judge, ideally with a clinician when it is dragging on, whether treatment beyond symptom relief is actually warranted.

How long do sinus infection symptoms last?

Setting expectations helps you judge what you are dealing with, so how long do sinusitis symptoms last? It depends on the type, and the timeline itself is a diagnostic clue.

Viral sinusitis (the common kind) typically improves within about 7 to 10 days, following or extending a cold. Acute sinusitis is defined as lasting up to 4 weeks, and many cases resolve well before that with symptom care. When facial pressure and congestion persist for 12 weeks or longer despite treatment, that is chronic sinusitis, a different situation that warrants evaluation for underlying causes (allergies, structural issues, nasal polyps) and often specialist care, per the American Academy of Otolaryngology. So a sinus infection lingering a bit past a cold is common and usually self-limited; symptoms stretching well beyond 10 days without improvement deserve a clinician's look, and symptoms lasting months are their own category needing investigation. Our companion guide to sinus self-care covers what actually helps symptoms while a case runs its course.

When to see a clinician, and the warning signs

Most sinus infections are managed at home, but some situations call for care, and a few are urgent. Here is the practical guidance.

See a clinician if symptoms last beyond about 10 days without improving, are severe (intense facial pain, high fever), or follow the double-worsening pattern, these are the situations where evaluation for possible bacterial sinusitis makes sense, and where treatment might be warranted. A sinus infection is well suited to a video visit: a clinician can assess your symptom pattern, timeline, and history, and prescribe when appropriate. August's online urgent care offers that for a flat $39, starting with a free AI symptom check, and if you just want help gauging whether it is a cold or sinusitis, describe your symptoms to August, the free AI health assistant, first. Seek urgent or emergency care for these red flags, which can signal a serious complication of sinusitis spreading beyond the sinuses: a severe headache with a stiff neck, vision changes or double vision, swelling, redness, or bulging around the eye, confusion or altered mental state, or high fever with severe illness. These are uncommon but important, when they appear, do not wait.

Frequently asked questions

What are the symptoms of a sinus infection?

Sinus infection symptoms include facial pain, pressure, or fullness (often over the cheeks, forehead, or around the eyes), nasal congestion, thick nasal discharge or postnasal drip, reduced sense of smell, headache, cough, fatigue, and sometimes upper-tooth pain or a low fever. Facial pain and pressure are the most distinguishing signs versus a cold. Many symptoms overlap with a cold, so the timeline and facial pressure help tell them apart.

How do I know if it's a cold or a sinus infection?

The main clues are timeline and facial pressure. A cold usually peaks around days 3 to 5 and improves within 7 to 10 days, while a sinus infection is more likely when symptoms last past 10 days without improving, when facial pain and pressure are prominent, or when you improve and then suddenly worsen ("double worsening"). Colored mucus alone does not distinguish them, it is normal in a resolving cold too.

Does a sinus infection need antibiotics?

Usually not. Most sinus infections are viral and resolve on their own with symptom care, so antibiotics are not needed and will not help. Antibiotics are considered mainly when symptoms are severe, last beyond about 10 days without improving, or show a double-worsening pattern that suggests a bacterial infection, and even some of those improve without them. Colored mucus is not proof of a bacterial infection or a reason for antibiotics.

How long does a sinus infection last?

Viral sinus infections typically improve within about 7 to 10 days. Acute sinusitis is defined as lasting up to 4 weeks, though many cases resolve sooner with symptom care. If facial pressure and congestion persist for 12 weeks or longer despite treatment, that is chronic sinusitis, which warrants evaluation for underlying causes like allergies or structural issues. Symptoms dragging well past 10 days without improvement deserve a clinician's assessment.

Is green or yellow mucus a sign I need antibiotics?

No. Thick, colored (yellow or green) mucus is a normal part of your immune response and of a resolving cold or viral sinus infection, not proof of a bacterial infection and not, on its own, a reason for antibiotics. This is one of the most common misconceptions. What better suggests a possible bacterial infection is the pattern, severe symptoms, symptoms lasting past 10 days without improving, or double worsening, rather than mucus color.

Can a cold turn into a sinus infection?

Yes, in a sense, most acute sinus infections actually follow a cold, because the viral inflammation and congestion of a cold can extend into the sinuses. This is usually still a viral sinus infection that resolves on its own. Occasionally, blocked, inflamed sinuses can develop a secondary bacterial infection, which is suspected when symptoms are severe, last beyond 10 days, or worsen after improving. Most post-cold sinus symptoms, though, clear with time and symptom care.

What are the warning signs of a serious sinus infection?

Seek urgent or emergency care for a severe headache with a stiff neck, vision changes or double vision, swelling or redness around the eye or bulging of the eye, confusion or altered mental state, or high fever with severe illness. These are uncommon but can indicate the infection spreading beyond the sinuses to nearby structures, which is serious. Ordinary sinus symptoms, even uncomfortable ones, do not usually signal danger, but these specific signs do.

When should I see a doctor for a sinus infection?

See a clinician if symptoms last beyond about 10 days without improving, are severe (intense facial pain or high fever), or follow a double-worsening pattern, these are the situations where evaluation for a possible bacterial infection and treatment may be warranted. A telehealth visit works well for assessing the pattern and prescribing if appropriate. And seek urgent care immediately for warning signs like vision changes, eye-area swelling, stiff neck, or confusion.