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If you came here from my article on “What you NEED to Know about Chronic Sinusitis” then you’re almost done!  At the end of this article, you’ll have a great chronic sinusitis treatment plan.

And if you came here from some ninja google-fu searching, then WELCOME!  I recommend you read the first part on diagnosing chronic sinusitis first (it will be helpful and this article will make more sense afterwards).

Treatment for chronic sinusitis begins with a good plan
Get the best chronic sinusitis treatment plan today!

 

Treating chronic sinusitis is one of the best things you can do for your health.

If you remember from my prior article, having chronic sinusitis lowers your quality of life the same as if you had chronic heart or chronic lung disease!

Unlike many of my articles, where I show you how you can treat symptoms with over-the-counter medications, treating chronic sinusitis NEEDS you to see your primary care provider.

The purpose of this article is to make sure you know what proper chronic sinusitis treatments so that you can feel better as fast as possible (and without wasting your money).

Who should read this article?

This article is written to help you if you have chronic sinusitis. Specifically, you should consider this as a good treatment if you have 2 of these symptoms:

  • Have chronic nasal congestion or nasal stuffiness
  • Have thick mucus or post-nasal drip
  • Have frequent sinus pain, sinus pressure or sinus fullness
  • Have a decrease or loss of your sense of smell

If you think you might have chronic sinusitis, you can consider taking this quiz to find out:

Flow of this article

treating chronic sinusitis the right way by reading this article
This article will make sure you get the RIGHT chronic sinusitis treatment

This is a rather complex topic. To make it easier, I have divided it into three main treatment sections and, if I did my internet magic right, made it so only the most relevant parts are shown to you.

Not sure you need this article right now but think you might in the future?


Like MyAllergyFriend on Facebook so you can find it again:


The three types of chronic sinusitis

Although the symptoms of chronic sinusitis are similar, chronic sinusitis treatment is based on the type of sinus infection you have.

There are 3 types of chronic sinus infections:

  1. Chronic sinusitis without nose polyps
  2. Chronic sinusitis with nose polyps
  3. Allergic fungal sinusitis
Chronic sinusitis treatment requires finding what type of infection you have
You need to find out your type in order to best treat chronic sinusitis

How can you tell the difference?

In short, you can’t. But when you see your primary care provider to ask about chronic sinusitis treatment, they should look in your nose to see if you have polyps.

  • If they see polyps, then you pick the treatment pathway with polyps
  • If they don’t… pick the one without

Note: when I am talking about polyps, this is NOT cancer polyps.

Instead, these are polyps caused by frequent inflammation. Kind of like how an oyster turns sand into a pearl. But instead of a pearl, your nose made an inflammatory polyp that makes it harder to breathe. Yay nose!

Do you have peanut buttery mucus

peanut butter mucus is a sign of allergic fungal sinusitis
Peanut butter: good on bread, not good if it describes your mucus. Or if you’re allergic, I guess.

Too early in our relationship to ask this question? Probably.

But if your mucus is a thick yellowy-brown mucus that ‘looks like peanut butter’ or has a peanut butter consistency, then you might have allergic fungal sinusitis. This is NOT covered in today’s post.

If you think you have this, please email me and I’ll help guide you to the next steps.

Goals of chronic sinusitis treatment

If you read any article online about chronic sinusitis treatment, you’ll read that there is no ‘cure’ for chronic sinusitis. That it is a problem that will keep coming back.

This is both true and not true.

If you have a history of recurrent sinus infections throughout your life then getting your chronic sinus infection treated MIGHT not be a forever cure.

  • In this case, we can still get you feeling better
  • Plus, I will tell you some of the ways to help prevent recurrence and keep you healthy as long as possible

But if this is your first chronic sinus infection, then it is possible that it is a single infection that didn’t clear properly or was complicated by allergies.

  • If this is the case, then it is likely we can fix you and fix you for good
  • Plus, we can help prevent this from happening again

Find the right type of treatment you need

Prolonged antibiotics help treat chronic sinus infections
More antibiotics? Yes, actually. But as you’ll see it really is a different plan.

If you want to most likely treatment for you, then read the treatment plan for chronic sinusitis without polyps. It is the most likely cause of your symptoms.

But if you want to read any of the others, or you need to adjust your treatment plan AFTER seeing your primary care provider, just click the button you of the plan for you:

Chronic Sinusitis Treatment – for Sinusitis WITHOUT polyps

If you have chronic sinusitis without polyps, then your nasal passages are red, boggy, full, congested, inflamed and swollen.

This causes the bacteria in your sinuses to live a happy, full bacteria life: buy a bacteria house, raise 2.5 bacteria kids, and try to tell the difference between bacteria real news and bacteria fake news.

Our treatment goal needs to be:

1) Kill the bacteria with effective antibiotics
2) Reduce inflammation in your sinus and nasal passages so everything can drain away
3) Keep your sinus and nasal passages clear so there is less of a chance of this happening again

Side note about antibiotics:
If you have had sinus infections in the past, you have been given antibiotics. When I tell you that you need antibiotics, you’ll think I’m saying the EXACT SAME THING.

But I’m not.

In a chronic sinus infection, the bacteria get covered by something called a ‘biofilm’ which is, essentially, a protective cocoon that prevents many antibiotics from fully treating an infection. This is the major difference between a regular sinus infection and chronic sinusitis.

This guide is for treating chronic sinusitis. If you have a regular sinus infection, you can read about how to treat an acute sinusitis here.

Chronic Sinusitis Treatment WITHOUT polyps – Step 1

First, you need an appropriate antibiotic.

It is usually best to pick a penicillin with a bacterial resistance fighting component. If you are think you are allergic to penicillin (9 out of 10 people aren’t) then you will need a stronger antibiotic.

The best recommended antibiotics for chronic sinusitis treatment are:

  • Augmentin (amoxicillin + clavanulate acid)
  • Levaquin (levofloxacin)

The trick is not just to pick these antibiotics, but to use them for a long enough duration.

A regular sinus infection gets treated for 10-14 days.
Chronic sinusitis treatment lasts for 3-6 WEEKS of antibiotics!

When you are facing a long treatment course like this, it is best to fully discuss the possible antibiotic side effects with your provider and have a plan to treat them OR prevent them.

I’m working on this post right now, but if you have questions feel free to ask me and I’ll be happy to help.

Chronic Sinusitis Treatment WITHOUT polyps – Step 2

In addition to antibiotics, it is recommended you also start an oral steroid such as Prednisone.

Oral steroids are essentially the great ‘shut down’ switch for inflammation. Since you sinuses are so inflammed, prednisone will reduce swelling and allow the killed bacteria to drain away.

Prednisone is recommended for the first 10 days of treatment.

Please don’t skip the prednisone
It is a medication that does have side effects, but in the short term the side effects are limited and the benefits to getting your chronic sinus infection treated is huge!

Chronic Sinusitis Treatment WITHOUT polyps – Step 3

The third step is to add a nasal steroid, which provides topical support to help reduce your nose’s swelling and inflammation.

I’ve written an article on the ‘Best Nasal Steroids’ which you should read before picking the nasal steroid for you.

Note: if you’re worried about too many steroids, let me put your fears to rest.
The oral steroid is only for 10 days and the topical steroid has minimal if any whole body side effects. And using them both will front-load your treatment and get you feeling better… faster.

Chronic Sinusitis Treatment WITHOUT polyps – Step 4

The final step to getting you better is to add symptomatic treatment.

As you can imagine, the mucus that gets cleared from chronic sinusitis treatment is often very thick, gross and disgusting (hey, better to have it leave your body than stay in your sinuses, right?!)

To help you clear your sinuses properly, consider adding any of these medications to help ‘thin the mucus’ and have it leave your body:

  • Add a sinus rinse and use the sinus rinse properly
  • Consider adding mucinex (guaifenesin) to thin the mucus
  • Remember to drink plenty of fluids and stay hydrated

Chronic Sinusitis Treatment WITHOUT polyps – Step 5

At this point, you should be done!

If you give your provider this treatment pathway, they should be able to get you feeling dramatically better within the next 3-6 weeks (often you’ll start to feel better sooner).

Chronic Sinusitis Treatment – WITH polyps

If you have chronic sinusitis with polyps, then your nasal passages have a lot of inflammation, which caused your nasal mucosa to ‘bubble’ into a polyp.

The problem is that these polyps can block your nose from draining. They also enable the bacteria in your sinuses to live a happy, full bacteria life: buy a bacteria condo, raise some bacteria kids, and enjoy endless bacteria Facebook posts about politics.

Because of this, your treatment goal is:

1) Kill the bacteria with effective antibiotics
2) Reduce inflammation in your sinus and nasal passages so everything can drain away
3) If needed, get ENT involved to remove any blocking polyps

Side note about antibiotics:
If you have had sinus infections in the past, you have been given antibiotics. When I tell you that you need antibiotics, you’ll think I’m saying the EXACT SAME THING.

But I’m not.

In a chronic sinus infection, the bacteria get covered by something called a ‘biofilm’ which is, essentially, a protective cocoon that prevents many antibiotics from fully treating an infection. This is the major difference between a regular sinus infection and chronic sinusitis.

This guide is for treating chronic sinusitis. If you have a regular sinus infection, you can read about how to treat an acute sinusitis here.

Chronic Sinusitis Treatment WITH POLYPS – Step 1

First, you need an appropriate antibiotic.

There are two main choices of antibiotics. A penicillin or a fluroquinolone (if you are allergic to penicillin… atlhough you might NOT actually be allergic to penicillins) are the two best choices:

  • Augmentin (amoxicillin + clavanulate acid)
  • Levaquin (levofloxacin)

The trick is to use them for a long enough duration.

A regular sinus infection gets treated for 10-14 days.
Chronic sinusitis treatment lasts for 3-6 WEEKS of antibiotics!

When you are facing a long antibiotic treatment course, make sure to fully discuss the possible side effects with your provider and have a plan to treat them OR prevent them.

I’m working on this post right now, but if you have questions feel free to ask me and I’ll be happy to help.

Chronic Sinusitis Treatment WITH POLYPS – Step 2

In addition to antibiotics, you also NEED to start an oral steroid such as Prednisone.

You will definitely need oral steroids to try an reduce the size of the polyps and you will need it for 15 days.

The recommendation is not optional if you have chronic sinusitis WITH polyps.

If the prednisone cannot reduce the size of the polyps, then you will need surgery to remove them!

Chronic Sinusitis Treatment WITH POLYPS – Step 3

In addition to oral steroids, you ALSO need to add topical steroids in the form of a nose spray.

The nose spray can help in 3 additional ways:

  1. Reduce the inflammation of your nose / sinus passages
  2. Reduce the size of the polyps
  3. Give you the best chance at preventing polyps from growing back

I’ve written an article on the ‘Best Nasal Steroids’ to help you with Step 3.

Chronic Sinusitis Treatment WITH POLYPS – Step 4

If you had really severe polyps, then it is recommended to ADD a leukotriene inhibitor such as montelukast (Singulair) to reduce help reduce the inflammation and size of the polyps.

Choosing the best over the counter antihistamine can also help but I would start with montelukast first.

Chronic Sinusitis Treatment WITH POLYPS – Step 5

Surgery!

Hopefully the first 4 steps helped you and you are feeling better without surgery. If your nasal polyps respond to the treatment above then perfect, you’re all done.

But if you’re doing the treatment and it isn’t getting better then you need to consider ENT surgery for ‘polyp debulking and removal’.

If you’re at this point, an ENT surgeon would be the next appropriate step.

Allergic Fungal Sinusitis

If you think you have allergic fungal sinusitis, then your next step is to see an ENT.

I have not finished my article on allergic fungal sinusitis yet so if you might be in this category, please email me and I’ll help you find the best plan.

If you want to read about a different plan, you can return to the plan section and pick a different option.

Preventing future chronic sinusitis

As you can see, it takes a lot to properly treat a chronic sinusitis.

And the last thing you want is for it to return.

I have created a detailed plan to help you reduce the chance of chronic sinusitis coming back and prevent it as much as possible.

If you want a copy of this plan, email me and ask for my “How to Prevent Chronic Sinus Infections” instructions.

treat and prevent chronic sinus infections
Follow this plan to help treat and then prevent chronic sinus infections

Summary

Ok, admit it: you got here by scrolling fast down this page. I understand… the topic is boring.

I don’t think this article is one that you can just casually read through and think to yourself ‘wow, what an interesting topic!’

Instead, you got here because you need a treatment plan OR you think you might need one. Because of this, I divided the topic into three treatment plans that you can reference and download:

If you want, click the link above and it will take you to the right treatment plan.

Or, like MyAllergyFriend on Facebook so that you can reference this topic in the future if you need it.

Next Steps

If you read through this page or my article on What you NEED to know about chronic sinusitis and you think you have a chronic sinusitis, then there is only one thing for you to do:

Make an appointment with your primary care provider and get treated!

Chronic sinusitis is a problem that can easily be put off for a long time (odds are, you’ve been putting it off yourself) so take this opportunity to do something nice for yourself and get this fixed!

I’ll even make it easier:
Fill out this easy quiz and I’ll look up ENT doctors in your area so that you can feel better faster:
Click here to have me find a good ENT near you (let me make it easy for you!)

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