You can usually fly with a sinus infection, but MedlinePlus advises avoiding flying while you are congested when you can, because a blocked nose makes pressure injury to the ear (barotrauma) more likely. If you must fly, a decongestant used as its label directs, saline spray, and swallowing or yawning during descent can help. Ask a doctor before using a decongestant if you have high blood pressure or heart disease. See a doctor before you fly if symptoms have lasted more than 10 days, are severe, or got better and then worse.
Why does flying hurt more with a sinus infection?
Your middle ear connects to the back of your nose through a small passage called the eustachian tube. Normally the pressure inside your ear matches the air around you. When the plane climbs or descends, the cabin pressure changes and the tube has to open to even things out.
Swelling and mucus from a cold, allergies, or a sinus infection can block that tube. MedlinePlus says nasal congestion from allergies, colds, or infections makes ear barotrauma more likely, and altitude changes like flying are a common trigger. Its sinusitis home care advice also says to avoid flying while congested, and it lists changes in altitude, such as flying, as a risk factor for sinusitis.
- Common signs: ear pain or discomfort, a full feeling in the ear, and slight hearing loss.
- More severe signs: stronger ear pain, a pressure feeling like being underwater, moderate to severe hearing loss, dizziness, and nosebleeds.
Should I cancel or change my flight?
MedlinePlus advises avoiding travel to high altitudes during a respiratory infection or allergy flare. If the trip is flexible and your nose is fully blocked, moving the flight a few days may spare you a painful landing.
If you can breathe through your nose and you feel well apart from some stuffiness, many people fly without trouble. The bigger reasons to pause are signs that the infection needs a doctor (see below). Get those checked before you travel, not after you land somewhere far from your usual care.
CDC says viruses cause most sinus infections, and many sinus infections do not need antibiotics. To help avoid spreading germs on the trip, wash your hands often.
What can I take before a flight?
MedlinePlus suggests using a nasal decongestant before altitude changes to help prevent ear barotrauma. CDC lists a decongestant or saline nasal spray among ways to relieve sinus symptoms, and says to read and follow the label directions on over-the-counter medicines.
Check the active ingredients on every label before you add another product. Some sinus products also contain a pain reliever. If a product already lists acetaminophen, do not take Tylenol on top of it, because Tylenol is acetaminophen too. Use only one decongestant pill at a time, and do not pair two products that contain the same decongestant.
- Pseudoephedrine pill (Sudafed Sinus Congestion): the label lists pseudoephedrine 30 mg. Adults and children 12 and over take 2 tablets every 4 to 6 hours, and no more than 8 tablets in 24 hours. Do not use it if you take a prescription MAOI or stopped one in the last 2 weeks.
- Oxymetazoline spray (Afrin Original): the label lists oxymetazoline 0.05%. Adults use 2 or 3 sprays in each nostril no more often than every 10 to 12 hours, and no more than 2 doses in 24 hours. Do not use it for more than 3 days, because longer use can make congestion come back or get worse.
- Ask a doctor or pharmacist first if you have high blood pressure, heart disease, thyroid disease, diabetes, or trouble urinating from an enlarged prostate. Both labels list these.
- Saline spray or rinse: MedlinePlus suggests saline nasal spray several times a day, and rinsing with a neti pot or saline squeeze bottle.
- For facial pain: MedlinePlus says acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen may help. Pick one NSAID only: ibuprofen and naproxen are both NSAIDs, so do not take them together.
How do I protect my ears during the flight?
Descent is usually the hardest part. MedlinePlus gives these steps to help the eustachian tube open.
- Chew gum, suck on candy, yawn, or swallow often.
- Breathe in, then gently breathe out while you pinch your nostrils closed and keep your mouth shut. Keep it gentle.
- Stay awake as the plane descends, so you can keep using these steps.
- For babies and small children, nursing or sips of a drink during descent may help.
My ear still feels blocked after landing. What now?
Keep trying the swallowing and gentle exhale steps. MedlinePlus says to contact a provider if the discomfort lasts more than a few hours.
Contact a provider sooner if you have drainage or bleeding from the ear, a fever, or severe ear pain.
When should you get care?
In an emergency, call 911Get care the same day for a severe headache that over-the-counter pain medicine does not relieve, any change in your vision, or redness and swelling around the eye. MedlinePlus says to contact a provider right away if fever comes with eye symptoms, if it is hard or painful to move your eye, if the eye seems to bulge out, or if your vision changes.
Get care the same day after a flight for bleeding or drainage from the ear, a fever, or severe ear pain. Contact a provider if ear discomfort lasts more than a few hours.
Call 911 for a severe headache with a stiff neck, fever, or confusion or other changes in how alert you are. MedlinePlus says these can be signs of meningitis, a very rare complication of sinusitis, and to get emergency medical help immediately.
How our AI doctor decides when to send you to care ›When does a sinus infection need a doctor before I fly?
Many sinus infections do not need antibiotics, and CDC says antibiotics will not help when they are not needed. But CDC says to see a healthcare provider in these cases.
- Severe symptoms, such as a severe headache or facial pain.
- Symptoms that got better and then got worse.
- Symptoms that have lasted more than 10 days without getting better.
- A fever that lasts longer than 3 to 4 days.
- Several sinus infections in the past year.
Common questions
Can I fly with a sinus infection?
Usually yes, but MedlinePlus advises avoiding flying while congested, because a blocked nose raises the risk of ear barotrauma. If you fly, use a decongestant as its label directs, use saline spray, and swallow or yawn often during descent. See a doctor first if symptoms are severe, have lasted more than 10 days, or got worse after improving.
Can flying make a sinus infection worse?
MedlinePlus lists changes in altitude, such as flying, as a risk factor for sinusitis, and its home care advice says to avoid flying while congested. The main problem most people notice is pressure pain in the ears during descent.
Should I use Afrin before a flight?
MedlinePlus suggests using a nasal decongestant before altitude changes to help prevent ear barotrauma. The Afrin Original label says not to use it for more than 3 days, and no more than 2 doses in 24 hours. Ask a doctor first if you have high blood pressure, heart disease, thyroid disease, diabetes, or trouble urinating from an enlarged prostate.
Can I take Sudafed if I have high blood pressure?
Ask a doctor or pharmacist first. The Sudafed Sinus Congestion label lists high blood pressure and heart disease under ask a doctor before use. Do not use it at all if you take a prescription MAOI or stopped one in the last 2 weeks.
Do I need antibiotics before I fly?
Usually not. CDC says many sinus infections do not need antibiotics, and antibiotics will not help when they are not needed. A provider can decide if you need them, especially if symptoms last more than 10 days, are severe, or get worse after improving.
Is it safe to fly with a sinus infection and a fever?
A fever is a reason to check in with a provider, and the Sudafed label says to stop use and ask a doctor if symptoms occur with a fever. CDC says a fever lasting longer than 3 to 4 days needs a provider. If you fly, wash your hands often.
Pymander is not a replacement for a physician and does not provide medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with questions about a medical condition. If you think you may have a medical emergency, call 911.