Cold, allergy or sinusitis?
The three conditions feel annoyingly similar. Answer 8 quick questions for a steer, then use the comparison table to be sure — and learn the red flags that mean “see a doctor”.
The differences at a glance
| Sign | Common cold | Allergic rhinitis | Sinusitis |
|---|---|---|---|
| Onset | Gradual, over 1–2 days | Sudden — right after exposure | Gradual, often after a cold |
| Duration | 7–10 days | Weeks to months, or seasonal | 10+ days, or recurring |
| Sneezing | Sometimes | Frequent bursts (3+ in a row) | Rarely the main feature |
| Itching (nose, eyes, palate) | Almost never | Very typical | No |
| Discharge | Starts clear, thickens, may turn yellow/green | Clear and watery, stays thin | Thick, coloured, one-sided possible |
| Fever | Mild, possible (more in children) | Never | Possible, with facial pain |
| Facial pain / pressure | Mild at most | No | Typical — worse bending forward |
| Sore throat / cough | Common, often first sign | Only from post-nasal drip | Cough from drip, worse at night |
| Seasonal pattern | Any time; more in winter | Same season each year, or year-round | Often follows colds or allergy flares |
| Antihistamine response | Little effect | Clear improvement | Limited |
A rule of thumb that helps: itch = allergy, fever + sore throat = infection, 10+ days of thick discharge + facial pain = sinusitis.
Why it matters
Treat the wrong condition and you stay miserable. Antibiotics do nothing for colds (viral) or allergies (immune). Antihistamines barely touch sinusitis. And untreated allergies are one of the most common reasons sinus infections keep coming back — which is why doctors often test for allergy when sinusitis recurs.
Red flags — when to see a doctor promptly
- High fever, severe one-sided facial pain or swelling
- Symptoms that improve then come back worse (“double worsening”)
- Vision changes, severe headache, or swelling around the eyes — urgent
- Symptoms lasting more than 10–14 days without improvement
- One-sided persistent blockage or blood-stained discharge (get checked)
- Wheezing, chest tightness or shortness of breath
If it keeps coming back in the same season. That pattern points strongly to allergy, not repeated colds. A simple allergy test can confirm it — see the diagnosis guide.