Treatment options

When the features associated with infection are absent, treatment should be aimed at symptom relief. NICE advises considering paracetamol or ibuprofen for relief of pain or fever.

One of the issues in treating sinusitis is that for many OTC remedies there is a lack of high-quality evidence with few randomised clinical trials.

Hence NICE’s comment that patients with sinusitis “may wish to try self-care with nasal saline or nasal decongestants to relieve nasal congestion, but it should be explained that there is not enough evidence to recommend these. It should be explained to people that no evidence was found for using oral decongestants, antihistamines, mucolytics, steam inhalation or warm face packs in acute sinusitis”. 

However, patients may have found specific preparations or remedies helpful in the past and their personal experience is important. 

The NHS Health A-Z for sinusitis advises: “A pharmacist can advise you about medicines that can help, such as: decongestant nasal sprays or drops to unblock your nose (decongestants should not be taken by children under six years of age), or salt water nasal sprays or solutions to rinse out the inside of your nose. You can buy nasal sprays without a prescription, but they should not be used for more than one week.”

Self-care advice

• Analgesics
  Paracetamol or ibuprofen (if suitable for the patient) can be used for acute sinusitis.
• Saline irrigation
  See panel below and more information here.