November in New England seems to come with an unofficial soundtrack of coughing, sneezing and someone asking, “Is something going around?” At the same time, fall allergies haven’t necessarily packed up for the year and indoor allergies can be worsening. How do you know if your stuffy nose is allergies, a cold, or an actual sinus infection?
One of the biggest clues is simply how you feel. Allergies commonly cause sneezing, an itchy or stuffy nose, clear drainage, and itchy, watery eyes. They shouldn’t cause a fever, and although allergies can certainly make you tired, they usually don’t give you that unmistakable “I think I’m getting sick” feeling.
A cold can look very similar at first. You may start with a scratchy throat and then develop congestion, coughing, and fatigue. And yes, your nasal drainage may turn yellow or green. We hear this all the time: “My mucus turned green, so I know I have a sinus infection.” Not necessarily! The color of your mucus alone doesn’t tell us that an infection is bacterial or that you need an antibiotic.
So when do we start wondering about a bacterial sinus infection? One of the things we look at is timing. Symptoms lasting more than 10 days without getting better can be a clue. Another is what we sometimes call “double worsening.” You start to feel better from a cold and then suddenly get worse again. High fever along with significant facial pain and thick nasal drainage are also a concern and require an evaluation by your healthcare provider.
And then there are allergies. Ragweed may be winding down by November, but outdoor mold can stick around in piles of damp leaves, sometimes until we get a good hard frost. Meanwhile, we’re closing the windows, turning on the heat, and spending more time inside, where dust mites, pets and indoor mold may become more noticeable.
If you’re trying to figure out what’s going on, think about the pattern. Are your eyes and nose itchy? Does this happen every year around the same time? Did it start with a sore throat and that lousy “I’m coming down with something” feeling? Were you getting better and then suddenly got worse? Those details are often much more helpful to us than the color of what’s coming out of your nose.
Of course, sometimes it really is hard to tell, even for us! Symptoms that aren’t improving, become significantly worse, or come with high fever, significant facial pain, or difficulty breathing should be evaluated by a healthcare provider.
If you’re the person who feels like you’re always getting a sinus infection, that’s worth looking into. Recurrent or chronic sinus problems can sometimes be related to environmental allergies, and occasionally frequent infections can be a sign that the immune system deserves a closer look. Your primary care provider is a great place to start, or give us a call at Asthma & Allergy Physicians. Figuring out why it keeps happening can be just as important as treating the next episode.
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