Common sinus and allergy problems I treat
- Allergic rhinitis — persistent sneezing, itchy nose, runny nose, often worse at certain times of year.
- Chronic sinusitis — facial pressure, post-nasal drip, reduced sense of smell lasting 12+ weeks.
- Nasal polyps — soft growths inside the nose that block airflow and dull smell. Often respond to medical therapy first.
- Deviated nasal septum — the wall inside the nose is crooked, blocking one or both sides. Common, fixable.
- Recurrent nosebleeds — usually from a small dry blood vessel that can be sealed in clinic.
- Sinus headaches and pressure that wax and wane with weather changes.
How sinus problems get diagnosed
A focused clinic visit usually involves a quick nasal endoscopy — a slim flexible scope that gives a clear view of the inside of the nose and sinus openings. It's well tolerated, takes under a minute, and shows exactly what's going on. If we need more detail, a CT sinus scan is the gold standard and your insurance often covers it.
For suspected allergies, a simple skin prick test or blood IgE panel identifies specific triggers so treatment is targeted rather than blanket antihistamines forever.
Treatment options, simplest first
- Most cases respond to medical therapy: a targeted nasal steroid spray (used correctly — most people are using them wrong), saline rinses, occasionally a short course of oral steroids.
- Balloon sinuplasty is a 30-minute office-based or day-care procedure for blocked sinus openings. No bone removed, fast recovery, day discharge.
- Functional Endoscopic Sinus Surgery (FESS) is the modern approach for more advanced cases — done entirely through the nostrils, no external cuts, day care or one-night stay.
- Septoplasty (correction of a deviated septum) is often combined with turbinate reduction; recovery is typically a week off work.
Frequently asked questions
How do I know if I have sinusitis or just a long cold?
Symptoms lasting beyond 10 days, or improving and then worsening again, point to sinusitis. Facial pain or pressure, thick coloured discharge, and reduced sense of smell are typical. A clinic visit with nasal endoscopy quickly settles it.
Are nasal steroid sprays safe long-term?
Yes, the modern molecules (mometasone, fluticasone) are safe for years of daily use — they're locally acting, not systemic. The catch: most people use them incorrectly. The right technique — head forward, opposite hand, aim at the outer wall — makes a huge difference in effect.
Will sinus surgery be painful?
Modern endoscopic sinus surgery is much gentler than the older 'crash through the sinuses' approach. Most patients describe day 1–3 as moderate stuffiness rather than pain, and are off strong painkillers by day 4. Day care discharge is standard.
What is balloon sinuplasty and is it for me?
Balloon sinuplasty is a less invasive option where a small balloon is inflated to widen blocked sinus openings — no bone is removed, no tissue cut. It suits straightforward chronic sinusitis without polyps or anatomical complications. About 30 minutes, fast recovery.
Can allergies be cured or only managed?
True 'cure' is rare, but well-managed allergic rhinitis should not affect your daily life. Identifying triggers, optimising medications, and in selected cases sublingual immunotherapy (drops under the tongue for 2–3 years) can substantially reduce symptoms long-term.