Allergic rhinitis vs sinusitis: You wake up mid-sneeze. Your nose is blocked, your head feels heavy, and there’s that dull pressure behind your cheeks or eyes. At that moment, it’s hard to tell what’s going on: is it allergies, a cold, or a sinus infection?
The symptoms overlap so much that many people call everything “sinus.” But allergic rhinitis and sinusitis are not the same problem, and they don’t respond to the same treatment. Knowing which one you’re dealing with can save you days of discomfort.
Also Read | Can you have a sinus headache without congestion?
The basic difference between allergic rhinitis and sinusitis:
Allergic rhinitis (hay fever) is an immune reaction. Your body overreacts to harmless triggers like dust, pollen, pet dander, or mould. It releases histamine, which leads to sneezing, itching, watery eyes, and a runny nose. It’s irritating, but it’s not an infection.
Sinusitis happens when the lining of your sinus cavities becomes inflamed, often after a cold or flu. The swelling blocks normal drainage, mucus gets trapped, and pressure builds. Sinusitis can be viral (most common) or bacterial (less common), and in some people, it becomes chronic.
| Symptoms | Allergic Rhinitis | Sinusitis |
| Cause | Allergy (dust, pollen, pet dander, etc.) | Infection (virus, bacteria, or fungus) |
| Onset | Sudden (after exposure to allergens) | Gradual (after a cold or flu) |
| Duration | Lasts as long as you’re exposed (can be weeks) | Usually lasts 7–14 days (acute) or longer (chronic) |
| Nasal discharge | Clear, watery mucus | Thick, yellow or green mucus |
| Sneezing | Frequent | Rare |
| Nasal congestion | Common but mild | Often severe and causes pressure |
| Facial pain or pressure | Rare | Very common (forehead, cheeks, eyes) |
| Fever | Uncommon | Sometimes present |
| Cough | Dry cough due to post-nasal drip | Wet cough due to mucus buildup |
| Eye symptoms | Itchy, watery eyes | Usually none |
| Fatigue | Mild | Moderate to strong |
Allergic rhinitis: the one that keeps returning
Allergies often come in patterns like seasonal flare-ups, dusty rooms, certain weather changes, or exposure to pets. Common triggers are
- Pollen (trees, grass, flowers)
- Dust mites (bedding, carpets, upholstery)
- Pet dander
- Mould or damp walls
- Smoke, strong perfumes, and room fresheners
Typical signs of allergic rhinitis:
- Sneezing bouts, especially after waking up
- Clear, watery nasal discharge
- Itchy nose, throat, ears, or eyes
- Watery/red eyes
- Congestion that comes and goes
- Symptoms that worsen in certain places (home, office, outdoors)
Sinusitis: when congestion turns into pressure
Sinusitis often starts after a cold. The nose stays blocked, mucus thickens, and you begin to feel pressure in the face, especially around the cheeks, eyes, and forehead. Sinusitis is usually described as:
- Acute: less than 4 weeks
- Chronic: more than 12 weeks
Typical symptoms of sinusitis:
- Blocked nose that doesn’t ease
- Thick yellow or green mucus (often, not always)
- Facial pressure or pain (cheeks, around eyes, forehead)
- A headache that can feel worse when bending forward
- Post-nasal drip (mucus sliding down the throat)
- Fatigue; sometimes a mild fever
When allergies can turn into sinusitis:
Allergies don’t “cause” an infection overnight, but they can set the stage for one. If your nose stays irritated with swollen lining, nonstop sneezing, constant congestion for weeks, your sinuses don’t drain the way they should. Mucus gets stuck, the space stays damp, and that’s when germs can multiply more easily. So if you keep getting sinus flare-ups again and again, it’s worth asking whether uncontrolled allergic rhinitis is the real starting point.
When to see a doctor:
Get checked if you notice any of the following:
- Congestion that doesn’t improve after 2 weeks
- Strong facial pressure or a headache that’s getting worse
- A high fever
- Smell or taste that stays reduced for days
- Ongoing fatigue, heavy-headedness, or constant pressure
Also Read | What causes sinus infections and how do you treat them?
Allergic rhinitis and sinusitis can feel equally miserable, but they’re different problems. Allergies are your body reacting to triggers. Sinusitis is inflammation that can follow a cold and may become an infection. The right fix depends on which one you’re dealing with, and sometimes, on treating both.