Is It Allergic Rhinitis or Sinusitis? Know the Difference
Medically Reviewed By:
Dr Leslie Koh
M.B;B.S. (Singapore), MRCS (ENT) Edinburgh, M. Med (ORL), FAMS
Key Takeaways
- Allergic rhinitis and sinusitis may present with similar symptoms, but they arise from different causes, such as allergens or infection.
- Noticing patterns in discharge, facial pressure, and how symptoms change over time can help distinguish between the two conditions.
- Management approaches differ depending on the cause, and may involve allergen control, medication, or further investigation.
- If symptoms do not improve or keep returning, a medical review can help clarify the underlying issue and guide appropriate care.
Introduction
A blocked nose, pressure around the eyes, or a lingering sense of congestion can make daily routines uncomfortable. These symptoms are common, but identifying the cause is not always easy. In Singapore’s humid climate, two conditions are often involved. One is triggered by allergens, the other is linked to infection or inflammation.
In this article, we explore the differences between allergic rhinitis vs sinusitis, how to distinguish between them, and when it may be time to seek medical advice for chronic nasal symptoms.
Why These Conditions Are Often Confused
Nasal conditions with similar symptoms can be challenging to distinguish. Both can lead to congestion, facial pressure, sneezing, or a runny nose. Common signs include:
- Nasal congestion or blockage
- Runny nose or post-nasal drip
- Facial pressure or discomfort
- Loss or reduction in the sense of smell
- Sneezing or a lingering cough
With so much overlap, it is easy to mistake one condition for another. However, understanding the differences between allergic rhinitis vs sinusitis can help you recognise the root cause and choose the right approach to manage ongoing symptoms.
What Causes Allergic Rhinitis?
Allergic rhinitis is caused by the body’s response to certain allergens. These may include dust mites, mould, pet dander, or pollen. The reaction is not caused by an infection, but rather by ongoing exposure to environmental triggers that lead to inflammation in the nasal passages.
In Singapore, this is a common issue due to the constant presence of indoor allergens, especially in air-conditioned spaces. Symptoms may appear throughout the year or flare up in response to weather changes, household cleaning, or close contact with animals.
Common signs include:
- Frequent sneezing, often in bursts
- Clear and watery nasal discharge
- Itching in the eyes, nose, or throat
- Symptoms that worsen indoors or in dusty areas
Local Insight: Singapore’s warm and humid climate creates favourable conditions for dust mites and mould. These are two of the most common triggers for long-term nasal irritation related to allergy.
What Causes Sinusitis?
Sinusitis develops when the lining of the sinuses becomes inflamed, most often due to an infection. It can occur after a cold or flu, or may be related to structural issues in the nasal passages, such as a deviated septum that affects drainage.
There are two common forms:
- Acute sinusitis: usually follows a viral infection and lasts fewer than four weeks
- Chronic sinusitis: involves inflammation that continues for more than 12 weeks, with or without active infection
Typical symptoms include:
- Pressure or discomfort around the cheeks, forehead, or eyes
- Thick, yellow or green nasal discharge
- Headache or pain in the upper jaw or teeth
- Tiredness and occasionally a low-grade fever
Compared to allergic causes, sinus-related symptoms tend to be more localised and may be accompanied by a general sense of feeling unwell.
Key Differences Between Allergic Rhinitis and Sinusitis
| Feature | Allergic Rhinitis | Sinusitis |
| Cause | Reaction to allergens | Infection or nasal obstruction |
| Discharge | Clear and watery | Thick, yellow or green |
| Fever | Uncommon | May occur in acute cases |
| Duration | Can be long-term or seasonal | Acute (less than 4 weeks) or chronic (12+ weeks) |
| Associated symptoms | Sneezing, itchy eyes | Facial pain, pressure, tiredness |
Why It Helps to Know the Difference
Although the symptoms of these two conditions can be similar, their management approaches are quite different. Allergic reactions are typically managed through avoidance of known triggers, the use of antihistamines, or the use of prescribed nasal sprays. Infections affecting the sinuses, on the other hand, may require different forms of treatment such as antibiotics or nasal rinses, particularly if symptoms persist.
Mistaking one condition for the other can result in treatment that does not address the actual cause. For instance, antibiotics will not alleviate allergy-related symptoms and may cause side effects if taken unnecessarily.
Pro Tip: Pay attention to when and where your symptoms occur. If they tend to worsen in dusty or indoor environments, an allergic response could be the reason. If facial discomfort and thick nasal discharge develop after a viral illness, sinus inflammation may be more likely. Understanding this can help you determine whether you are dealing with allergic rhinitis vs sinusitis.
When Should You Seek Help?
If nasal symptoms last more than 10 days, keep returning, or start to interfere with daily life, it may be time to seek medical advice. Certain signs suggest that further evaluation could be helpful, including:
- Persistent congestion or facial pressure that does not go away
- Thick or discoloured mucus
- Ongoing loss or reduction in sense of smell
- Discomfort or swelling around the eyes
- Difficulty sleeping due to nasal blockage
- Lack of response to over-the-counter remedies
A visit to an ENT clinic may include nasoendoscopy or imaging to examine the nasal passages more closely. These tests can be helpful when the cause of chronic nasal symptoms is unclear, particularly in distinguishing between allergic rhinitis vs sinusitis.
Conclusion
Understanding the difference between allergic rhinitis vs sinusitis is not always straightforward, especially when the symptoms overlap. While both can cause nasal congestion, facial pressure, and discomfort, the underlying causes and management approaches differ. Paying attention to how your symptoms develop and respond over time can help indicate when further assessment may be needed.
If your symptoms have persisted for some time, come and go without clear improvement, or are starting to interfere with your daily activities, a medical review may be appropriate. Dr Leslie Koh, an ENT surgeon in Singapore, offers assessments for individuals experiencing ongoing nasal or sinus issues.
To find out what may be contributing to your symptoms, schedule a consultation with Dr Leslie Koh. A detailed evaluation may help clarify the cause and guide the next steps in your care.