Are Sinus Infections Contagious? An Expert MD Reveals the Answer

A board-certified doctor clears the air about whether a sinus infection can spread, and healthy practices to keep you and others protected.

Classic signs of a sinus infection that can differentiate this diagnosis from a cold are a stuffy nose, throbbing headache, and pressure across the face than can cause a tender feeling. Especially with the respiratory viruses that have increased in the past five-plus years, it’s important to consider whether a sinus infection can be contagious.

That’s especially true because sinus infections are pervasive. According to the American College of Allergy, Asthma & Immunology, Americans spend over $1 billion annually on over-the-counter remedies for sinus infections. An additional $150 million is spent on prescription medications to treat them.

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Understanding how sinus infections spread and who is most at risk can help you protect yourself and the people around you. Ahead, an internal medicine doctor speaks to the contagious potential of some sinus infections and tips to minimize the spread.

What’s a sinus infection?

“A sinus infection is either a viral or a bacterial infection within the sinus spaces in the skull,” explains Carrie Horn, MD, a board-certified internal medicine physician, hospitalist, and Chief Medical Officer at National Jewish Health in Denver. These infections cause inflammation in the sinus areas as your body works to fight off the infection.

The degree of infection can vary from case to case: “Sinus infections can be acute, subacute, or chronic,” Dr. Horn says. Acute sinus infections are short-term and the most common type, while subacute cases can linger for up to three months. Chronic sinus infections last longer than three months and often require specialized care.

“Sometimes it is confused with sinusitis,” Dr. Horn adds, “which is just inflammation of the lining of the sinuses and can be infectious or not.”

Sinus infection symptoms

Dr. Horn explains that sinus infections often mimic the symptoms of a common cold. Colds, which are caused by viruses, also trigger an inflammatory response in the body. This reaction increases mucus production in the nose and sinuses as your body works to expel the virus. Sometimes, these viral infections can pave the way for a bacterial sinus infection. Most viral symptoms resolve within a few days to a week. However, if symptoms persist beyond 10 days, it could indicate a bacterial infection, and you should reach out to your healthcare provider.

Additionally, there are some important indicators to watch for to help determine a sinus infection:

• Runny nose
• Congestion
• Headache
• Facial pain or pressure that may be felt in the forehead above the eyes, along the cheekbones under the eyes, and deep behind the nose
• Fever that lasts more than three to four days

Are sinus infections contagious?

“Yes, sinus infections can be contagious,” says Dr. Horn. “When the sinus infection is caused by a virus, viruses are transmitted from person to person in respiratory droplets from when someone is coughing or sneezing.”

While bacterial sinus infections are generally less contagious, their transmissibility depends on the specific bacteria involved and the health of the exposed individual. According to Dr. Horn, “Children under the age of about 5, adults over the age of 65, or people with chronic health conditions are more susceptible to infection with bacteria that often cause sinus infections.”

Common bacteria that lead to sinus infections include Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. These bacteria, like viruses, are also transmitted through respiratory droplets.

“When talking about sinus infections, generally speaking, people are thinking of bacterial infections, but it is important to know that sinus infections are often viral in nature,” Dr. Horn adds.

What causes sinus infections?

Dr. Horn shares the common causes of sinus infections:

• Viruses
• Bacteria
• Allergic reactions can cause inflammation and swelling in the nasal passages, leading to mucus buildup that may result in a bacterial sinus infection.
• Nasal or sinus polyps can block mucus drainage, increasing the risk of bacterial infections.
• Though rare, fungal infections can also cause sinus infections, particularly in individuals with weakened immune systems or certain medical conditions.

Treatment of sinus infections

“Most sinus infections start as viral and do not need antibiotics,” explains Dr. Horn. She notes that the color of your mucus is not a reliable indicator of whether antibiotics are necessary. “If you have a fever lasting more than about four days or symptoms persisting longer than 10 days, it is possible antibiotics would help, and you should see a healthcare professional.”

In the meantime, there are steps you can take to manage symptoms and find relief:

• Humidified air: Use steam from a hot shower or a clean humidifier in your room to moisten nasal passages and alleviate congestion.
• Nasal rinses: Saline rinses can flush out irritants and improve sinus drainage.
• Over-the-counter pain relievers: Medications like ibuprofen or acetaminophen can ease headaches and pressure.
• Decongestants: Pseudoephedrine may reduce nasal swelling and improve breathing, but limit use to avoid rebound congestion.
• Expectorants: Guaifenesin can thin mucus, making it easier to clear.
• Cough suppressants: If postnasal drainage causes coughing, a cough suppressant can provide temporary relief.

Dr. Horn re-emphasizes you should be mindful to limit your use of over-the-counter medications to no more than three or four days.

How to stop the spread of sinus infections

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There are several ways to reduce the risk of sinus infections. Here are Dr. Horn’s recommendations:

• Control chronic health conditions: Keeping chronic health issues well-managed and staying up to date on recommended vaccines are essential for maintaining overall health and reducing your risk of sinus infections.
• Practice good hand hygiene: Washing your hands frequently and properly can help prevent sinus infections, much like it helps prevent the spread of colds.
• Manage allergies and nasal polyps: If you have allergies or nasal polyps, work with your healthcare team to ensure they are effectively treated and controlled.
• Consider sinus rinses: Regular sinus washes can help reduce mucus buildup. Dr. Horn advises talking to your healthcare team before trying this. If you decide to use a sinus rinse, it’s important to use distilled, boiled, or sterilized water to avoid introducing bacteria or other contaminants.
• Wear a mask to reduce respiratory droplet spread: Masks can help limit the spread of respiratory droplets from coughing or sneezing. If you have symptoms, try to stay home as much as possible. If you need to go out, wearing a mask can protect others from infection.

About the expert

Carrie Horn, MD, is a board-certified internal medicine physician and hospitalist, serving as the Chief Medical Officer at National Jewish Health. She also leads as Chief of the Division of Hospital & Internal Medicine. Dr. Horn has been practicing as a hospitalist since 2008.