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Column originally published Jun 17, 1998
Column last revised/updated on Jan 12, 2019

Allergy Can Cause Recurrent Sinus Infections

Question: Our nine-year-old son has a lot of headache, stuffed-up nose, and coughs all the time. He was treated several times last year for sinus infections, but he never got completely well. I wonder whether these can be caused by allergies. I have severe spring allergies myself with sneezing, itchy eyes and cough, and allergies run in our family. We have tried just about everything, but nothing seems to help. Do you have any suggestion?


The symptoms that you described about yourself sound like spring allergies. Many people suffer the same problem this time of the year, due to allergies to pollen from trees, shrubs, weeds, and grasses.

Your son’s condition, however, is very different. It is possible, as you suggested, that he is suffering from allergies throughout the year. The allergy can affect his whole respiratory tract, from the nose to his lungs.

In contrast to those who develop spring allergies, people who have allergies year-round are likely caused by indoor environment: at home, at work, or in school.

In general, several groups of indoor “allergens” are involved. These include dust, moulds, and animals. In addition, cigarette smoke and chemicals can cause similar symptoms by irritating the airway. Indoor chemicals that can be harmful include air fresheners, perfumes, colognes, after-shaves, scented candles, etc.

You may wonder why these allergens and chemicals cause so much problem nowadays. The answer is that houses are built more air-tight in the last few decades to conserve energy. As a result, cigarette smoke and chemicals stay inside the house longer.

In addition, moisture also tends to stay inside and increases indoor humidity. This is especially true around the windows and in the basement. Moulds or mildew will grow anywhere with excess moisture. The problem gets worse if there is a water leak.

Moulds are normally microscopic, which means we cannot see them. However, when lots of them are present, they can look like white or black spots (depend on the types of moulds). They can produce chemicals and cause “musty smell” in damp basements.

In some Canadian homes, wood is used as a source of heat. Many homeowners pile wood in the basement. This brings moulds and moisture inside. The additional moisture will further encourage moulds growing.

Dust is also an important indoor allergen. Research has shown that dust allergy is caused by faeces of tiny insects called dust mites. These dust mites cannot be seen even with regular microscopes. They feed on the skin cells that fall off our body everyday, and they grow best when the humidity is higher than 35% to 45%.

Dust mites are mostly collected in the carpets, pillows, mattresses, stuffed toys, and stuffed furniture. Many parents find it hard to believe that their carpets can collect that much dust until they remove the carpets.

The same is true of the pillows and mattresses. Since we sleep for about 8 hours a day, a lot of our skin cells accumulate in bed. Research has shown that new pillows and mattresses get infested with dust mites within several weeks of using.

Because moisture increases the growth of moulds and dust mites, I have recommended parents not to use a humidifier in their children’s room. It is very difficult, if not impossible, to regulate the humidity when we use humidifiers. Although humid air may help a coughing child, the price to pay in the long run is too high. A better choice is to reduce the room temperature by turning down the heat and put on a sweater.

Indoor pets can be another source of trouble. Cats seem to be worse than dogs. Part of the reason is that cats go all over the house more so than dogs. In cats, their saliva can cause allergies, and cats love to lick their fur and touch everything (this is how cats mark their territory). Frequent washing and brushing of pets can reduce spreading of their fur around the house.

You may ask, how can indoor allergens cause your son’s problems? Indoor allergens cause swelling inside the nose and bronchial tubes of the lungs of allergic people. When the inside covering of the nose (called mucosa) is swollen, this will block the opening of sinuses, causing “sinus headaches” and sinus infections. If you only treat sinus infections with antibiotics without dealing with allergy itself, the problem is likely to return when you stop antibiotics.

Treatment includes reducing “allergens” around your son, and giving him allergy medicine. Vacuuming the carpet when he is not at home can reduce the overall dust problem. Newer types of vacuum cleaners have HEPA filters that reduce circulation of dust while you vacuum. If this doesn’t help, you may want to remove the carpets in his room, or throughout the house.

If there are stuffed toys, you can remove them or wash them in washer and dryer weekly. Covering the mattress and pillow with plastic zip-up covers can reduce the dust in bed. Washing blankets and sheets weekly can prevent dust from collecting.

Sealing leaky walls can reduce moisture in the house. Many families also use dehumidifiers in the basement to reduce moisture and moulds. Cleaning around the windows regularly can prevent moulds from growing.

If your son is very allergic to a house pet, it may be necessary to remove this pet. However, it is important to remember that the fur can stay inside the house and continue to cause problems for several more months or longer.

In terms of medicine, there are generally two approaches. Long-acting anti-histamine by mouth once or twice a day can reduce swelling inside the nose and other allergy symptoms. This is very safe even if used for a long time. Another approach is to use a steroid spray in the nostril once or twice a day. This is also very safe. For some severe patients, they may need both to keep them healthy.

You have to look around your house for things that can cause allergies in your son. Also look at his school to see whether part of the problem can be there. Decide what you have to do and then get to work. You should change one thing at a time and look for improvement after several weeks. Most likely you need to combine environmental changes with medicine. Good luck!

[Note to Readers:  Most of the recommendations are still relevant. I have also recommended the use of air purifiers with HEPA filters that can trap dust mites and moulds in the house, one unit in the child’s bedroom close to the bed, and another unit in the room where the child is much of the time, and keep both units on high much of the time. This can reduce triggers in the air and reduce allergy symptoms.]