As spring arrives and the pollen count rises, many people experience symptoms such as a blocked nose, facial pressure, sneezing or headaches. But how can you tell if you suffer from hay fever or acute sinusitis? The symptoms can be surprisingly similar, yet the causes and treatments vary considerably. Understanding the distinction is crucial for getting proper relief.
What is hay fever?
Hay fever, also known as allergic rhinitis, is an allergic reaction to pollen. In spring, tree pollen is the most common trigger, followed by grass pollen as the season progresses. When the immune system overreacts to these airborne allergens, it causes inflammation of the nasal passages.
Common hay fever symptoms include:
- Sneezing and a runny or blocked nose
- Itchy eyes, nose, throat or ears
- Watery, red eyes
- Post-nasal drip (mucus at the back of the throat)
- Fatigue, especially during high pollen days
These symptoms often occur daily during the pollen season and may worsen outdoors or after exposure to freshly cut grass, trees or flowers.
What is acute sinusitis?
Acute sinusitis is acute inflammation of the sinuses – the air-filled cavities behind your cheeks, forehead and eyes. A viral infection is the usual cause, although bacterial infections, allergies or structural problems can also be triggers.
Symptoms of acute sinusitis often include:
- Facial pressure or pain, particularly around the cheeks or eyes
- A blocked nose with thick yellow or green discharge
- Reduced or lost sense of smell
- Headache or a feeling of heaviness in the head
- Toothache or earache
- Fever (in some cases)
Unlike hay fever, acute sinusitis can develop suddenly and is typically more intense. If symptoms last longer than 10 days or worsen after initial improvement, these could indicate a bacterial infection requiring treatment.
Key differences between hay fever and acute sinusitis
While hay fever and acute sinusitis can cause a blocked nose and facial discomfort, the underlying causes and symptoms differ considerably.
An allergic response that typically leads to itchiness in the nose, eyes or throat and clear nasal discharge causes hay fever.
Acute sinusitis, however, usually results from an infection or inflammation that causes thick mucus, facial pain and a feeling of pressure or heaviness in the head.
Hay fever often responds well to antihistamines, while acute sinusitis may require decongestants, antibiotics or further investigation if symptoms persist.
Here’s a simple table to help you understand if your symptoms could be hay fever or acute sinusitis.
| Symptoms and treatment | Hay fever | Acute sinusitis |
| Onset of symptoms | Gradual, seasonal | Sudden or after a cold |
| Nasal discharge | Clear and watery | Thick and coloured |
| Itchiness | Eyes, nose and throat | Uncommon |
| Facial pain | Mild or absent | Prominent, especially around the eyes and cheeks |
| Fever | Uncommon | Possible if there’s an infection |
| Response to antihistamines | Usually effective | Often no improvement |
When to seek help for hay fever and acute sinusitis
You should seek professional advice if your symptoms persist, worsen, or do not improve with over-the-counter treatments.
You can typically handle occasional hay fever flare-ups. However, a specialist may recommend allergy testing or long-term management strategies if your symptoms affect your sleep, concentration, or daily life.
Most mild cases of acute sinusitis resolve with rest, hydration and decongestants. But if you experience facial pain, thick nasal discharge, congestion lasting more than 10 days or recurrent symptoms, there may be an underlying issue. In these cases, treatment may include prescription medication or minor surgical procedures.
Early assessment by an ENT specialist ensures you receive the correct diagnosis and can prevent unnecessary discomfort or complications.
Specialist support for nasal symptoms
An expert opinion can provide clarity and relief if you’re struggling with seasonal allergies or ongoing sinus discomfort. Mr Wale Olarinde, Consultant ENT Surgeon at ENT Sheffield, offers specialist assessment and management of nasal and sinus conditions using the latest diagnostic tools.
If you’re unsure whether hay fever or acute sinusitis is causing your symptoms this spring, contact us today to find the right treatment for you.