Treatment options
Sinusitis is usually caused by viruses or bacteria. The treatment of sinusitis aims to reduce the inflammation of the nasal mucous membranes and restore the flow of mucus from the paranasal sinuses. First and foremost, measures should be taken to liquefy the mucus, which improves its excretion.
This is achieved, for example, by increased fluid intake (e.g. drinking), but high humidity, steam inhalations and nasal rinsing or showers with isotonic saline solutions or seawater sprays can also help to alleviate the symptoms of sinusitis. In addition, mucosal decongestant nasal sprays or drops (e.g. active ingredient: xylometazoline, oxymetazoline) and herbal secretion dissolvers (drugs containing myrtol or cineol) can be used. The use of nasal sprays containing cortisone can help to reduce inflammation.
Over-the-counter painkillers containing active ingredients such as paracetamol or ibuprofen can help against headaches and facial pain. There are also herbal medicines such as Sinupret ®forte or Sinupret® drops. In cases of sinusitis with severe symptoms or if a bacterial infection has been diagnosed, the administration of antibiotics may be indicated.
In some cases with severe progressions, surgery may be necessary to facilitate the flow of mucus (e.g. polyp removal, straightening of the nasal septum). The healing of a sinusitis can be supported by the use of some drugs. Drugs that are always used are nasal sprays.
They are very well suited for decongestant treatment, but should not be used for longer than max. 1 week. In addition, herbal medicines such as Sinupret have become established in the treatment of sinusitis.
Sinupret® is a combined preparation with various active ingredients from gentian, verbena, elderberry, sorrel and primrose. In protracted cases of paranasal sinusitis, the treatment can be extended by nasal sprays containing cortisone. Nasonex® or Rhinocort® are examples.
Drugs often used to treat pain are ibuprofen, paracetamol or Aspirin®. In rare cases, antibiotics must also be used. Amoxicillin is a frequently used drug in these cases.
Antibiotics may only be used if there is bacterial evidence with a severe clinical picture or complications. In this case, however, they are essential to avoid further complaints. The use of antibiotics is extremely rarely necessary in the treatment of sinusitis, as both bacterial and viral inflammations heal within a fortnight without complications in 60 to 80 percent of cases.
Nevertheless, acute sinusitis is one of the most common reasons for prescribing antibiotics. However, antibiotic therapy is only indicated in cases of severe symptoms or threatening complications. The administration of antibiotics is recommended for certain symptoms such as high fever, swelling around the eyes, severe facial pain, sensitivity to light or stiff neck.
In cases where antibiotics are indicated, the active substance amoxicillin is particularly recommended. However, sinusitis is most frequently caused by respiratory viruses. In these cases antibiotics have little or no effect.
Treatment without antibiotics, which aims to reduce the swelling of the mucous membranes and to allow normal drainage of secretions and adequate ventilation of the paranasal sinuses, is sufficient in most cases to relieve the symptoms of a sinusitis and to accelerate the healing process. Various home remedies are suitable for the treatment of sinusitis. Even at the first signs of symptoms, it is advisable to tackle the symptoms with simple household remedies.
For example, it is advisable to inhale warm vapours to reduce the swelling of the irritated mucous membranes. To do this, put eucalyptus oil or chamomile flowers in a bowl of hot water and inhale the vapours under a towel for 10 to 15 minutes several times a day. Not only the warmth of the vapours can have a beneficial effect, but also infrared light directed at the sinuses can accelerate the healing process.
However, the application of heat is only useful if it is perceived as pleasant. In the case of very severe inflammation, heat can also increase the discomfort. Other household remedies used in sinus treatment are compresses of warm water and eucalyptus oil or lemon.
A linen cloth or washcloth is soaked in these and then placed on the sinuses. A very important household remedy for sinusitis is a high fluid intake to liquefy the mucus. Herbal and peppermint teas can also have a decongestant effect.
In addition, care should be taken to ensure that there is sufficient humidity in the living areas and that cigarette smoke in the vicinity is avoided, as it irritates the mucous membranes. If the symptoms of sinusitis do not improve despite the use of home remedies, a doctor should be consulted so that the disease can be fully cured and a chronic course can be prevented. Naturopathic treatment methods such as homeopathy, salts or acupuncture can also be used for the typical symptoms of sinusitis.
Homeopathic remedies are generally well tolerated and can be used to treat acute or chronic sinusitis. A balanced combination of different homeopathic remedies can also be used specifically against the symptoms of a sinusitis. The homeopathic active substances have a decongestant effect on the nasal mucous membranes, reduce the feeling of pressure in the paranasal sinuses and facilitate nasal breathing.
Homeopathy can also help to strengthen the body’s own defence system and relieve pain. Most homeopathic remedies can also be used in children from the age of two years, but their use should be discussed with the treating physician in each individual case. The treatment of sinusitis is often successful without antibiotics.
Most infections heal after 1 or 2 weeks, even if they are bacterial. In the treatment of an acute sinusitis without antibiotics, decongestant and calming measures are of primary importance. Nose drops or sprays are used.
They reduce the swelling of the mucous membranes in the nose and sinuses so that the accumulated secretion can drain off more easily. Herbal remedies also promote the healing of a sinusitis without antibiotics. Successfully used active ingredients are e.g. gentian, elderberry, chamomile or peppermint.
In addition to the decongestant effect, they also have an anti-inflammatory component and can be taken in tablet form or inhaled as steam. Painkillers are also used to treat sinusitis. The treatment of chronic sinusitis without antibiotics may require the use of other measures.
Nasal sprays containing cortisone can be considered here. In rare cases, chronic sinusitis requires surgical intervention. A swelling of the nasal mucous membranes often occurs during pregnancy; about one fifth of all women suffer from so-called pregnancy rhinitis.
There is often fear of harmful side effects of typical medications for sinusitis (e.g. antibiotics or decongestant nasal drops). Home remedies such as herbal teas, steam inhalations or infrared light can be used during pregnancy without hesitation and have a soothing effect on the symptoms of the sinusitis. Decongestant nasal drops are generally not recommended during pregnancy; only in the case of severe symptoms is very short-term use justifiable.
On the other hand, natural nasal sprays, for example with the active ingredient dexpanthenol, may also be used during pregnancy to moisten the mucous membranes without side effects. A bacterial infection should also be treated with antibiotics during pregnancy despite the possible side effects. The active substance group of penicillins is suitable here, as these drugs can be taken relatively safely even in the first third of pregnancy.
During pregnancy, especially in the case of severe symptoms, it is important not to forego the treatment of sinusitis with medication, as an insufficiently treated sinusitis also carries risks during pregnancy. However, low doses of medication and the combination with suitable non-drug measures to alleviate the symptoms are recommended. Which medication (e.g. antibiotics) and which dosage is appropriate in the case of a sinusitis during pregnancy should always be discussed individually with the treating doctor.
