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Cold, Allergy or Sinus? How to Tell What Is Really Blocking Your Nose

Cold, Allergy or Sinus? How to Tell What Is Really Blocking Your Nose

"Doctor, I have had a cold for three weeks." I hear this a lot, especially when the weather changes. And most of the time, it is not a cold at all. A cold, an allergy and a sinus infection can all give you a blocked nose, so people mix them up. The trouble is that each one needs a different approach.Taking the wrong medicine for weeks can leave you feeling worse.

Cold, Allergy or Sinus
Fig 1. How to Tell What Is Really Blocking Your Nose

Why this matters

A cold is caused by a virus and mostly clears on its own with rest and fluids. Allergic rhinitis is your body overreacting to dust, pollen, smoke or sudden weather change, so it keeps returning until the trigger is handled. Sinusitis happens when the sinus openings get blocked and mucus gets trapped. Antibiotics do not help colds or allergies, and even in sinusitis they are not always needed. This is one reason I ask people not to start a course from the medical shop.

Fig 2.  Cold, Allergy or Sinus

What you can try at home

- Saline nasal rinse or spray, once or twice a day

- Plenty of water and enough sleep

- Know your allergy triggers: dust mites, bedding, strong smells, smoke, pets. Wash bedsheets in hot water every week.

- Avoid using over-the-counter nasal decongestant drops for more than a few days. They can make the blockage worse (rebound congestion).

See an ENT specialist if

- Symptoms last more than 10 days or keep coming back

- You had improvement and then suddenly got worse

- Facial pain, a one-sided blocked nose, or loss of smell

- Sinus problems have lasted more than 12 weeks (this is called chronic sinusitis)

- Urgent: swelling or redness around the eye, severe headache, vision changes or high fever. Please do not wait.

A short examination, sometimes with a nasal endoscopy, usually tells us exactly what is going on. Once the cause is clear, treatment becomes much simpler. 


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