You wake up congested. Your nose runs. Your throat burns slightly. These early signs feel like a cold. And most of the time, they are. Viruses begin fast. They fade gradually. A cold stays shallow. It rides in the throat and nose. Sinus infections wait. They show up when the cold overstays.
Mucus color changes, but it doesn’t always confirm which infection is present
People say green mucus means bacteria. That’s not always true. Viral colds can produce yellow, green, or thick discharge. The color reflects immune response, not necessarily bacteria. Sinus infections might have clear mucus early on. The real sign is duration and intensity, not color alone.
Facial pressure that worsens over days starts to suggest something deeper than a virus
Colds may bring minor discomfort. Sinus infections bring pain. Behind the eyes. Under the cheekbones. Along the forehead. Especially when bending down. That pressure builds slowly. It gets worse instead of better. Colds usually peak by day four. Sinus infections keep climbing.
If symptoms last more than ten days, doctors begin to consider bacterial involvement
Most viral colds resolve within one week. Some stretch slightly longer. But once you cross the ten-day mark, with worsening symptoms, the suspicion shifts. Bacterial sinusitis often develops after a viral cold. The virus opens the door. Bacteria step in. That timeline matters more than individual symptoms.
Fever may appear in both, but persistent high temperature tilts the scale toward sinus infection
Low-grade fever is common in colds. It spikes early, then fades. In sinus infections, the fever might rise later. It lingers. It accompanies the pressure. It doesn’t break after rest. High temperature after day five raises concern. Especially if paired with facial pain.
Tooth pain or ear pressure often reflects sinus involvement more than a general cold
Your upper molars hurt. Your ear feels full. These symptoms aren’t usual with simple colds. The maxillary sinuses sit close to dental roots. Inflammation there radiates pain downward. Middle ear pressure increases when sinus drainage backs up. These are clues. Not proof—but clues.
Postnasal drip can occur in both, but it becomes thicker and more irritating during infection
That dripping feeling in the throat isn’t exclusive to sinusitis. Colds do it too. But when it thickens, scratches, or triggers a constant cough, infection becomes more likely. Nighttime coughing worsens. Sleep breaks. The drip becomes more than a nuisance—it’s a pattern.
Antibiotics don’t help colds and only sometimes treat sinus infections effectively
Most sinus infections resolve on their own. Even bacterial ones. Antibiotics get reserved for severe, prolonged, or recurrent cases. Taking them early won’t shorten a cold. They might cause side effects. ENT doctors evaluate based on timing, severity, and history. Not pressure from the patient.
Over-the-counter decongestants may relieve symptoms, but they don’t shorten the illness
Nasal sprays reduce swelling. Oral decongestants clear passages. But neither cures the cause. They improve comfort. Temporarily. Overuse leads to rebound congestion. Especially with sprays like oxymetazoline. Relief becomes dependency. Management requires restraint, not just medicine.
Nasal irrigation flushes viruses and allergens but may not touch bacterial colonies deep inside
Saline rinses help both colds and sinus infections. They remove debris. Soothe tissues. Thin mucus. But their reach stops short. Deep infections inside the ethmoid or sphenoid sinuses may remain untouched. Still, rinses offer relief without side effects. They’re part of care, not the cure.
Steroid sprays reduce inflammation and support sinus drainage when swelling blocks normal flow
Fluticasone. Mometasone. These sprays don’t fight germs. They calm tissues. Reduce swelling. Open channels. When mucus drains, pain eases. They don’t work immediately. They need consistency. They’re useful in both viral and bacterial cases—especially when congestion won’t budge.
Sinus infections that return often need imaging or ENT referral for deeper answers
Recurrent sinusitis raises questions. CT scans look for blockages. Deviated septums. Polyps. Fluid-filled spaces. ENT specialists assess anatomy. Chronic cases may need surgery. Or allergy testing. Or long-term nasal therapy. Repetition means something isn’t healing right—not that you just “catch colds often.”
Coughing that worsens at night may reflect lingering postnasal irritation from unresolved inflammation
The cold ends. But the cough doesn’t. It continues after lying down. It pulls from deep. This isn’t always bronchitis. It’s often postnasal drainage. Inflammation lingers. Sinuses haven’t cleared. The infection fades, but irritation remains. That’s why the cough feels out of place.
Headache location and timing often reveal which sinuses are affected during infection
Pain at the forehead? Likely frontal sinuses. Cheeks? Maxillary. Between the eyes? Ethmoid. Deep inside? Sphenoid. Colds don’t follow this map. Sinus infections often do. The pattern gives clues, especially if the headache worsens with pressure or posture.
When your smell disappears completely, the reason may be deeper than congestion alone
Colds dull smell. Sinus infections block it. But when anosmia lasts beyond recovery, nerves may be involved. Olfactory nerves sit near the upper nasal cavity. Inflammation there disrupts signal. ENTs check for polyps, nerve injury, or chronic inflammation. Smell rarely vanishes entirely during a cold.
Source: Otolaryngology in Dubai / Otolaryngology in Abu Dhabi