Sinusitis affects children and adults differently, and the distinction matters because it influences how you recognise it, manage it, and decide when to seek help. A child with a sinus infection may not complain of the facial pain or pressure that most adults associate with the condition, making it easier to miss or mistake for a straightforward cold.
This article sets out the key differences between sinusitis in children and adults, what parents should watch for, and when a pharmacist or GP needs to be involved.
Why Children’s Sinuses Are Different
Children’s sinuses are not fully developed at birth and continue developing throughout childhood and into adolescence. The sinuses most commonly affected in adults, the frontal sinuses above the eyebrows, are not fully formed until the teenage years. Younger children are more likely to develop infections in the ethmoid sinuses, which sit between the eyes, and the maxillary sinuses in the cheeks.
Because children’s airways are smaller and their immune systems are still maturing, they are also more susceptible to the viral upper respiratory tract infections that typically precede sinusitis. Children in nursery or school settings can experience a cold seemingly every few weeks, and when one of those colds does not resolve normally, sinusitis may be the reason.
How Sinusitis Symptoms Differ Between Children and Adults
The symptom picture varies considerably between age groups. The table below highlights the key differences:
| Symptom | Children | Adults |
| Facial pain or pressure | Less common; children may not report it clearly | Common; often localised above cheeks or forehead |
| Nasal discharge | Thick, coloured discharge lasting more than 10 days | Thick, coloured discharge; often with reduced smell |
| Blocked nose | Prominent; may cause mouth breathing and snoring | Common; often with loss of smell |
| Cough | Frequently present, often worse at night | Less prominent |
| Fever | More common, particularly in acute episodes | Less common in adults |
| Irritability or fatigue | Often marked; child may seem generally unwell | Fatigue common; less likely to present as irritability |
| Headache | Less commonly reported by younger children | Common, particularly across the forehead |
| Bad breath | Often present | Less commonly noticed |
The most reliable indicator of sinusitis in a child, rather than a simple viral cold, is the persistence and pattern of symptoms. A cold that shows no improvement after 10 days, or one that initially improves and then worsens again, is more likely to involve sinusitis.
What Causes Sinusitis in Children?
The causes of sinusitis in children largely mirror those in adults, though the relative frequency differs:
- Viral upper respiratory tract infections are the most common trigger, as in adults
- Allergic rhinitis, including hay fever, is a significant contributing factor in children who are atopic
- Enlarged adenoids, which are more prominent in young children, can obstruct nasal drainage and increase susceptibility to sinus infections
- Exposure to second-hand smoke, which irritates and inflames the nasal mucosa
- Structural factors such as a deviated septum, though these are less common in childhood
Recurring sinusitis in a child warrants a GP assessment to explore whether an underlying cause such as allergies or adenoid enlargement is contributing.
Sinusitis Treatment for Children: What Is Recommended?
For most children with acute sinusitis, treatment mirrors the self-care approach recommended for adults. The NHS advises:
- Age-appropriate pain relief such as paracetamol or ibuprofen, following dosage guidance for the child’s weight and age
- Saline nasal rinses or drops, which are safe for children and help clear congestion
- Steam inhalation under careful supervision for older children
- Encouraging adequate fluid intake and rest
Decongestant nasal sprays are not recommended for children under six and should be used with caution in older children. Antihistamines may be appropriate if allergic rhinitis is a contributing factor, but should be chosen carefully for paediatric use.
Antibiotics are not routinely prescribed for sinusitis in children, as the majority of cases are viral. They may be considered if symptoms are severe, prolonged, or suggest bacterial involvement, but this decision should be made by a clinician rather than assumed.
Does Pharmacy First Cover Sinusitis in Children?
The NHS Pharmacy First sinusitis service is available for patients aged 12 and over. Children under 12 with sinusitis symptoms are not within the scope of the Pharmacy First service for this condition and should be seen by a GP if symptoms are persistent or worsening.
For children aged 12 and over, a pharmacist can carry out an assessment and, if appropriate, supply treatment under the Pharmacy First service without a GP appointment. This is the same process as for adults. If you are unsure whether your child’s symptoms qualify, contacting a participating pharmacy directly to discuss is a reasonable first step.
When Should You See a GP About a Child’s Sinusitis?
Contact your GP if your child:
- Has symptoms that have lasted more than 10 days without improvement
- Initially improved but has then deteriorated again
- Has a high temperature that is not settling with paracetamol or ibuprofen
- Is very unwell, unusually drowsy, or difficult to rouse
- Has swelling around the eyes, which can indicate spread of infection and requires same-day assessment
- Has severe headache or neck stiffness, which warrants urgent review
- Has had recurring episodes of sinusitis over the past year
Swelling around the eyes in a child with a sinus infection is a red flag that must not be left until the next available appointment. It can indicate orbital cellulitis, a serious complication requiring prompt treatment.
How Pharmacy To My Door Can Help
If your child has been prescribed medication for sinusitis, or if you are managing a repeat prescription for any ongoing condition, Pharmacy To My Door can deliver your NHS or private prescription directly to your home. Our GPhC-registered pharmacy team is available to answer questions about your child’s medication and ensure prescriptions are handled accurately.
We deliver NHS prescriptions free across the UK. For children aged 12 and over whose sinusitis symptoms may fall within the Pharmacy First service criteria, we can also point you in the right direction.
Need a prescription managed for your child or another family member? Book an appointment with Pharmacy To My Door today. We deliver NHS prescriptions free across the UK.
FAQs
How do I know if my child has sinusitis or just a cold?
A cold that persists beyond 10 days without improving, or one that improves and then worsens again, is more likely to involve sinusitis. A GP can assess and confirm.
Can children use decongestant nasal sprays for sinusitis?
Decongestant nasal sprays are not recommended for children under six. They should be used with caution in older children and not for more than a few days. Saline drops are a safer option for younger children.
Is Pharmacy First available for sinusitis in children?
Pharmacy First sinusitis is available for patients aged 12 and over. Children under 12 with persistent sinus symptoms should be seen by a GP rather than assessed under this service.
Should my child take antibiotics for sinusitis?
Not routinely. Most sinusitis in children is viral and will not respond to antibiotics. A clinician will decide if antibiotics are appropriate based on the severity and pattern of symptoms.
When is swelling around the eyes serious in a child with sinusitis?
Always. Eye swelling alongside sinus symptoms in a child requires same-day medical assessment. It can indicate orbital cellulitis, a serious complication that needs prompt treatment.
