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Conditions
SinusHeadache
Headache with facial pressure and pain around the eyes, cheeks, and forehead - often associated with nasal congestion, sinusitis, or allergies.
Check online review fit
Online care is not suitable for every situation. A doctor decides what fits after assessment.
Symptoms
CommonsymptomsofSinusHeadache
Symptoms can overlap across conditions. A doctor considers context, red flags, and whether remote review is appropriate.
Pressure and pain around eyes, cheeks, and forehead
Pain that worsens when bending forward
Nasal congestion or discharge
Reduced sense of smell
Aching in the upper teeth
Fatigue
Our Scope
Whereonlinereviewmayfit
Online review can help with some straightforward situations, but it is not a substitute for urgent care, physical examination, or ongoing GP management.
May fit online review
- Assessment of sinus headache causes
- Treatment advice (decongestants, nasal steroids, analgesics)
- Prescription of antibiotics if bacterial sinusitis is likely
- Medical certificates for debilitating headaches
Needs in-person or urgent care
- CT sinus scans
- ENT specialist procedures
- Emergency assessment for sudden severe headache
Depending on your situation, an AHPRA-registered doctor may be able to issue a medical certificate or arrange a repeat prescription after reviewing your request online.
Clinical Guidance
Whentoseeadoctor
These indicators suggest you should seek professional medical advice promptly.
Signs you need a doctor
- 1Headache with facial pressure lasting more than 10 days
- 2Severe headache with fever
- 3Frequent sinus headaches
- 4Headache not responding to over-the-counter treatment
- 5You need a medical certificate
Seek emergency care if
- Sudden severe headache (worst of your life)
- Headache with fever, stiff neck, and rash
- Headache with vision changes or confusion
- Severe swelling around the eye
Call 000 or go to your nearest emergency department
Clinical Insight
Adoctor'sperspectiveonSinusHeadache
InstantMed Clinical Team
AHPRA-registered medical team · Reviewed 2026-03
The most important thing I tell patients about sinus headaches is that most of them aren't actually sinus headaches - they're migraines. Research consistently shows that 80-90% of self-diagnosed 'sinus headaches' are actually migraines with associated nasal congestion and tearing, which is a well-documented autonomic feature of migraine. This matters because the treatments are completely different: sinus headaches respond to decongestants and nasal steroids, while migraines respond to triptans, which are far more effective for true migraine. True sinus headaches are associated with acute sinusitis: persistent thick nasal discharge, facial tenderness over the sinuses, and symptoms that follow a cold. If your 'sinus headaches' are recurrent, one-sided, throbbing, or associated with nausea and light sensitivity, please consider that migraine may be the real diagnosis.
Treatment
TreatingSinusHeadache
Most sinus headaches (and most self-diagnosed 'sinus headaches') are managed with OTC analgesics, saline irrigation, and short-term decongestants. True bacterial sinusitis requires antibiotics only when symptoms persist beyond 10 days without improvement or follow a 'double worsening' pattern. The majority resolve without antibiotics. If recurrent 'sinus headaches' may actually be migraine, specific migraine treatment is far more effective.
Ibuprofen
Nurofen, Advil
Class:NSAID analgesic / anti-inflammatory
Typical dose:200-400mg every 4-6 hours with food, maximum 1200mg per day OTC
PBS:Available OTC without prescription
- Preferred analgesic for sinus pain due to anti-inflammatory action
- More effective than paracetamol for sinus pressure
- Take with food to reduce stomach irritation
- Avoid in renal impairment or active peptic ulcer
Xylometazoline
Otrivin, Dimetapp Decongestant
Class:Intranasal decongestant (alpha-adrenergic agonist)
Typical dose:1-2 sprays per nostril every 8-10 hours; maximum 3 consecutive days
PBS:Available OTC without prescription
- Rapid onset nasal decongestion (within minutes)
- Use for maximum 3 consecutive days -- longer use causes rebound congestion (rhinitis medicamentosa)
- Useful for short-term relief during acute sinusitis
- Avoid in uncontrolled hypertension
Amoxicillin
Amoxil, Alphamox
Class:Penicillin antibiotic
Typical dose:500mg three times daily for 5-7 days
PBS:PBS listed for acute bacterial sinusitis
- Only indicated for bacterial sinusitis: symptoms persisting beyond 10 days or double-worsening pattern
- Most acute sinusitis is viral -- antibiotics are not needed in the first 10 days
- First-line antibiotic per Australian Therapeutic Guidelines
- Prescribing requires clinical assessment to confirm bacterial indication
Source: Therapeutic Guidelines -- Antibiotic, 2024; Therapeutic Guidelines -- Analgesic, 2024. This information is educational only and does not replace clinical assessment.
Specialist referral: Refer to ENT if sinusitis is recurrent (3+ episodes per year), if CT sinus imaging is needed, if nasal polyps are suspected, or if sinus symptoms persist despite appropriate antibiotic treatment. Refer to a neurologist if recurrent 'sinus headaches' are suspected to be migraine based on symptom pattern.
Sinus Headache in Australia
Up to 90% of self-diagnosed 'sinus headaches' are actually migraines (multiple international studies)
Acute sinusitis affects approximately 1.9 million Australians per year
Antibiotics for viral sinusitis are one of the most common forms of antibiotic overuse in Australia
Saline nasal irrigation is as effective as many medications for sinus symptom relief (Cochrane evidence)
Recovery
Whattoexpect
Typical recovery timeline and return-to-work guidance for most patients.
Typical recovery
True sinus headache from acute sinusitis: 7-10 days as the infection resolves. If migraine is the actual diagnosis, individual episodes last 4-72 hours but recur. Chronic sinusitis may cause ongoing pressure for weeks to months.
Return to work
Mild sinus pressure: most people can work. Severe headaches with facial pain and fatigue: 1-2 days off may be needed during the worst period.
When to reassess
See a doctor if facial pain persists beyond 10 days, if 'sinus headaches' are recurrent (may actually be migraine), if you develop high fever or severe facial swelling, or if headache is sudden and severe (thunderclap headache - needs emergency assessment).
Self-Care
ManagingSinusHeadacheathome
Evidence-based tips to support your recovery alongside medical treatment.
Saline nasal irrigation 2-3 times daily - this is one of the most effective treatments and has almost no side effects
Steam inhalation over a bowl of hot water with a towel over your head - provides temporary but significant relief
Use decongestant nasal spray (oxymetazoline) for no more than 3 consecutive days to avoid rebound congestion
Apply a warm, damp cloth over your face to relieve facial pressure
Stay hydrated - this helps thin mucus and promote sinus drainage
If your 'sinus headaches' recur regularly, consider whether migraine might be the real diagnosis - the treatment is very different
FAQ
CommonquestionsaboutSinusHeadache
Answers to the most common questions from patients.
This is one of the most common misdiagnoses in medicine. Studies show that up to 90% of self-diagnosed 'sinus headaches' are actually migraines. Migraines can cause nasal congestion and watery eyes, mimicking sinusitis. If your 'sinus headache' is one-sided, throbbing, and worse with movement, it's likely a migraine.
Usually not. Most sinusitis is viral and resolves in 7-10 days. Antibiotics are only indicated if symptoms persist beyond 10 days without improvement, or if there is a 'double worsening' pattern (improved then significantly worse).
Saline nasal irrigation, steam inhalation, decongestants (short-term only), and paracetamol/ibuprofen. Intranasal corticosteroid sprays help reduce inflammation. Antibiotics are rarely needed.
Yes. Severe sinus headaches with facial pressure, congestion, and fatigue can be debilitating. Our doctors can provide a certificate and treatment advice.
Where online review may fit for Sinus Headache
Remote review is not suitable for every situation. A doctor reviews the information and decides whether online care is appropriate.
Full refund if the doctor declines.