Is It Allergies or a Sinus Infection? Key Differences Explained

Is it allergies or a sinus infection? Knowing how to tell the difference is essential for getting the right treatment—especially in a place like New York City where both conditions are common. Allergies and sinus infections (sinusitis) share similar symptoms such as nasal congestion, pressure, and headaches, but they have different causes and require different treatments.

This blog explains how to distinguish between the two and what to do if your symptoms persist or worsen.

Understanding the Root Causes

• Allergies: Allergic rhinitis is caused by an immune system overreaction to substances like pollen, pet dander, or dust mites. It’s a chronic condition that can flare up seasonally or year-round, depending on your triggers.
• Sinus Infections: Sinusitis is usually caused by a virus, bacteria, or fungus infecting the sinus cavities. It can follow a cold or respiratory infection and may be acute (short-term) or chronic (lasting longer than 12 weeks).

While both conditions inflame the nasal passages, allergies are immune-based, while sinus infections are typically infectious.

Key Symptom Differences

Although the symptoms overlap, there are some telltale signs that can help you tell allergies from sinus infections:

• Fever: Usually present with sinus infections, but not with allergies.
• Discolored Nasal Mucus: Thick yellow or green mucus often points to infection. Clear mucus is more typical of allergies.
• Itchy Eyes: Common with allergies, rare with sinus infections.
• Facial Pain/Pressure: Can occur with both, but is usually more intense and localized in sinus infections.
• Duration: Allergy symptoms may last for weeks or months. Acute sinus infections often resolve within 10–14 days, although chronic cases may linger.

If symptoms worsen over time or persist beyond 10 days with facial pressure and fever, it’s likely an infection.

Diagnosis: What to Expect at the Allergy Clinic

A board-certified allergist will conduct a thorough medical history and may recommend:

• Skin Prick Testing: To identify allergens like mold, pollen, or dust mites.
• Blood Tests (IgE): To confirm allergic responses.
• CT Scan or Nasal Endoscopy: In cases of chronic sinus infections, imaging may be necessary to evaluate structural blockages or chronic inflammation.

Correct diagnosis is essential to avoid using antibiotics when they’re unnecessary or ineffective.

Treatment Options for Each Condition

Allergy Treatment Options:

• Antihistamines and nasal corticosteroids to reduce symptoms.
• Decongestants for temporary relief of nasal swelling.
• Allergy immunotherapy (shots or drops) to desensitize the immune system over time.
• Environmental controls like HEPA filters and allergen-proof bedding.

Sinus Infection Treatment Options:

• Saline nasal rinses to flush out the sinuses.
• Decongestants to promote sinus drainage.
• Antibiotics (only if a bacterial infection is confirmed).
• Steroid sprays to reduce inflammation in chronic cases.

Patients who suffer from recurring sinus infections may benefit from further evaluation to rule out allergies or structural issues.

When Allergies Lead to Sinus Infections

In some cases, untreated allergies can set the stage for sinus infections. Constant inflammation and mucus buildup create the perfect breeding ground for bacteria. That’s why managing allergies can help prevent sinus problems altogether. Patients who treat their allergies often experience fewer sinus infections and a better quality of life.

Take the First Step Toward Relief

If you’re unsure whether your symptoms are caused by allergies or a sinus infection, don’t guess—get answers from a qualified expert. Schedule a comprehensive evaluation with Dr. Boyan Hadjiev today for personalized allergy and sinus care in NYC.

Allergy, Asthma and Sinusitis P.C
Boyan Hadjiev, MD
30 East 40th Street
Suite 1200
New York, NY 10016
212-319-5282