September 30, 2020/Ear, Nose & Throat

How to Tell If Your Cold is Actually a Sinus Infection

Decoding which is which

woman with cold and sinus infection

Without fail, that pesky cold hits you out of nowhere again. You feel miserable but still have to go on with your daily responsibilities, even when you know the cold isn’t serious.


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But how do you know if your runny nose, headache and nagging cough are actually signs of a sinus infection? While it’s true that many of the symptoms of both illnesses overlap, there are clues to help you tell the difference.

Rhinologist Troy Woodard, MD, describes these illnesses and shares four questions you should ask yourself to decide which you have, plus tips for treating your symptoms.

What does a cold look like?

A cold is a virus at work in your upper respiratory system (nose, mouth, throat and lungs). Typically, adults get between two and four colds per year with symptoms like:

How a sinus infection happens

Colds can progress to become sinus infections, but not all sinus infections are viral. Bacteria and even allergies also can cause sinus infections.

“A sinus infection occurs when the sinus lining becomes inflamed, preventing the sinuses from draining,” he says. “The trapped mucous becomes a breeding ground for bacteria, which can lead to a sinus infection.”


Conditions that may make you more likely to get a sinus infection include:

  • Allergies.
  • Nasal polyps (small growths occurring in your nasal lining).
  • Immunodeficiencies (conditions that impact how well your immune system works).

Sinus infection versus cold: How to tell the difference

When it comes to the battle between a sinus infection vs. cold, knowing which one you have is tricky. Dr. Woodard suggests that you consider these questions to tell the difference between the two:

  1. How long have you had symptoms? Cold symptoms typically peak after three to five days and then improve over the next week. A sinus infection can stick around longer, though. If you have a runny nose, stuffy nose or sinus pressure that lasts for more than 10 days, suspect an infection.
  2. Do you have sinus pressure? If you have persistent facial pain, pressure or tenderness, you may have a sinus infection.
  3. What color is your discharge? If you have clear mucous, you probably have a cold. If you have yellow or green mucous, it’s probably a sinus infection.
  4. Do you have bad breath? If your breath has you reaching for a piece of gum, you could have a sinus infection.

Other symptoms of a sinus infection may include loss of smell and taste, cough, congestion, fever, headache, fatigue or aches in your upper jaw and teeth.

Start treating your symptoms right away

Since viruses can’t be cured, treating colds is primarily aimed at improving symptoms.

“It’s important to remember that with colds and other viruses, taking an antibiotic won’t help you feel better any faster,” says Dr. Woodard. “In fact, taking an antibiotic unnecessarily can do more harm than good.”


The overuse of antibiotics can lead to antibiotic resistance, which can make subsequent infections more difficult to treat.

“Get plenty of rest, stay hydrated and rinse out your sinuses with saline irrigation, which can help thin mucous and flush it from your nasal cavity,” he says.

When a sinus infection won’t go away

While it’s true that sinus infections sometimes clear on their own, antibiotics can sometimes shorten their duration.

Talk with your doctor if your symptoms don’t subside within 10 days or if you have persistent fevers, facial swelling or neck stiffness. As with colds, make sure you hit the sheets and get enough rest and drink your H2O. Proper hydration and nasal irrigation can ease sinus infection symptoms.

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