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December 27th, 2010
09:16 AM ET

Is nasal mucus always a sign of infection?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Mondays, it's pediatrician Dr. Jennifer Shu.

Question asked by Amy, Minnesota:

Is colored (yellow, green or brown) nasal mucus always a sign of infection?

Expert answer:

Thanks for your question. Nasal discharge that is yellow, green or brown can be a sign of an infection of the upper respiratory tract. In the vast majority of instances, the infection is caused by a common cold virus and will get better on its own within seven to 10 days.

There are also several noninfectious causes of nasal discharge, such as allergies, trauma, the use of intranasal drugs or medications, and anatomical problems of the nasal passages or sinuses. In noninfectious conditions, however, the discharge is more likely to be clear.

Sometimes nasal discharge can be a sign of a sinus infection caused by bacteria. While the color of the mucus does not distinguish between a viral or a bacterial infection, several other signs make it more likely that bacteria are present and an antibiotic may be needed.

These include having a thick nasal discharge of any color for more than seven days or having mucus that gets a little better at the beginning of an illness but then worsens.

A bacterial infection is also more likely if the mucus is accompanied by headache or facial pain especially when bending forward, fever, bad breath, loss of smell, stuffy ears or a persistent cough.


soundoff (55 Responses)
  1. Dieter Zerressen

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    December 27, 2010 at 10:50 | Report abuse | Reply
    • Slab Hardcheese

      I saw my two favorite words put together, 'nasal' and 'mucous' and just HAD to read this article. Boy am I glad I did!

      December 27, 2010 at 19:39 | Report abuse |
  2. budgie girl

    The answer is NO, nasal mucous is not always caused by infection, and even when it is , it is typically viral and will go away on its own. so PLEASE stop hounding your doctor for antibiotics. this is just one reason why the US healthcare system is run amock. I can spend 30 minutes explaining to an angry patient why he/she does not need antibiotics, or I can spend 3 minutes and write for a z-pack and make them happy. The pressures to prescribe meds are ridiculous. This contributes to antibiotic resistance, puts you at risk of side effects (your yeast infection or diarrhea will be next), and adds cost to the healthcare system. Thank you.

    December 27, 2010 at 11:11 | Report abuse | Reply
    • hairy

      Amen sister.

      December 27, 2010 at 12:58 | Report abuse |
  3. Bob

    To help fight infections, A Nasal rinse works wonders for me in preventing sinus and conjestion..

    December 27, 2010 at 12:17 | Report abuse | Reply
    • Yo

      In ayurvedic medicine, the neti pot is a great thing. Clears out stuff that could cause infection from your nasal passages, keeps you more comfortable. Real handy, cheap or free, check it out.

      December 27, 2010 at 15:14 | Report abuse |
    • Khaleas

      It really depends. I was using a Neti Pot and was actually doing more harm than good. The drying out the rinsing also does was causing more mucus to be produced. It can work well for some but it's good to check with an ENT to see if it will help or cause more issues. Some people also have issues because the angle of eustacian tubes... and the rinse will enter the tubes and cause an ear infection.

      December 27, 2010 at 20:40 | Report abuse |
  4. joe

    Neilmed sinus rinse! Get it at drugstores. Costco has a killer deal on bulk package. I haven't had a sinus infection in three years since I started using this. I used to get two a year.

    December 27, 2010 at 12:32 | Report abuse | Reply
  5. Marcus14006

    100% agree

    December 27, 2010 at 13:42 | Report abuse | Reply
  6. Anon

    Budgie, you are correct except for people with a post-nasal drip like myself. For me, the viral infection eventually turns bacterial every time due to the drip and can last long after the virus is gone (months) if untreated by antibiotics.

    December 27, 2010 at 14:30 | Report abuse | Reply
    • MikeA

      Agreed.
      If I don't do at least a basic z-pack or minor course of antibiotics, any viral sinus infection becomes bronchitis which takes a month to get rid of.

      December 27, 2010 at 16:55 | Report abuse |
    • tralfaz

      Anon, how have you physicians proven that you had a bacterial infection. The only sure way is sinus puncture and aspiration and culture, have you had this done?

      December 27, 2010 at 22:04 | Report abuse |
  7. Anon

    It's frustrating for me because I have to spend 10 minutes convincing every doctor like yourself that I really do need antibiotics and that it will not go away with the virus because of the drip. In fact, pretty much every time I get a nasal infection (viral or bacterial), it spread to my chest and lungs within 2 days because of the drip. I've found that antibiotics prevent the spread to my chest and lungs, and therefore, need them whenever I get a sinus infection.

    December 27, 2010 at 14:36 | Report abuse | Reply
    • KD

      Use Alavert or another allergy medicine to dry everything up to prevent the drip. Alavert 12 hour rocks. I just did this about 2 weeks ago & avoided the bronchial infection followup. Though, my nostrils are so dry every breath kind of feels like I'm breathing fire. I grabbed a saline spray to help with that. Worked like a charm.

      December 27, 2010 at 21:36 | Report abuse |
    • tralfaz

      Anon I am not a doctor just a well informed patient who reads medical studies to check on what my doctor says. I would suggest you review the literature on sinusitis. > 90% are viral in nature and this is from studies where more than 1000 subjects had sinus symptoms and underwent sinus puncture and aspiration the most common thing that grew was rhinovirus.

      December 27, 2010 at 22:11 | Report abuse |
  8. dewey

    My MD said a neti pot didn't really rinse out the sinuses, the liquid doesn't reach that far. Maybe? I take an OTC antihistamine every day. Every AM after rising, I am coughing up sticky green 'junk'. Been doing this for over 12 months. I don't bother the MD about it anymore, they don't seem to know how to make it go away. Should I be concerned? next steps?

    December 27, 2010 at 15:43 | Report abuse | Reply
    • Ooey Gooey

      Your doctor is just a typical drone paid by the Drug Industry. They blast anything and everything natural that PROVES to work and people have been taking for thousands of years in favor of their drugs. I am not surprised by his response. The Neti Pot works wonderfully for many people. If not for you, try another time but don't use too many antihistamine's. You could have food allergies. Have you been tested? MANY people have food allergies and their docs just dismiss it. Look into it.

      December 27, 2010 at 19:42 | Report abuse |
  9. grofys

    simple saline rinses do wonders.

    December 27, 2010 at 15:49 | Report abuse | Reply
  10. Jim

    Suffered from sinus infections every winter for many years. Allergies and nasal congestion were part of the issue. Antibiotics at least once or twice over the winter. Doctors recomended allergy shots weekly and nasal steriods to control the swelling which is what was leading to the infections. No one ever mentioned nasal wash. Did some research on my own and came across the Sinupulse machine. I don't get evangelical about many things, but this machine STOPPED the sinus problems. I have not had an antibiotic in 3 years. It is similar to a neti-pot, except it is much easier to use. It is like a gentle water pick for your nose. Everyone I have mentioned it to that has bought one loves them. I don't work for the company (don't honestly even remember who makes it). Do a google search for SinuPulse and you will find them from various makers (got mine on amazon). If you have chronic sinus or allergies – washing with saline water and this machine will change your health – it did for me.

    December 27, 2010 at 17:31 | Report abuse | Reply
    • Crow T. Robot

      I believe you. Your doctor will refuse to tell you about it because he makes no money off of you getting better. Its as simple as that.

      December 27, 2010 at 19:43 | Report abuse |
  11. A Mom

    Budgie, I don't typically "hound" my doc for a prescription for until I've tried home treatment (fluids, tylenol, decongestants, saline rinses) for 2-3 weeks. I once had a doc prescribe steriods for the inflamatory part, which did nothing but make me sicker than I already was. I needed the antibiotics a few days later.

    December 27, 2010 at 20:47 | Report abuse | Reply
  12. Khaleas

    I don't know what doctors you all see but every single one of my docs have suggested a Neti Pot or alternative options for sinus issues. Even the walk in clinic doc (who actually turned out to be the one doc who figured out what meds would work for my post nasal drip). When I saw an ENT it actually turned out that it wasn't a good option for me (caused more mucus and issues with my eustacian tubes) but can't blame the regular docs because you wouldn't know until the ENT had put a scope up my nose.
    I just saw a medical section on tv about sinus issues and it said that humming actually helps reoccuring sinus issues.
    http://www.nytimes.com/2010/12/21/health/21really.html
    I've tried it for a few days and I don't know for sure yet but my sinuses feel more functional.

    December 27, 2010 at 20:47 | Report abuse | Reply
    • Lynn

      I know these posts are very old, but hoping someone might still be reading – especially Khaleas. I have an 18 year old son who has chronic sinus problems – main issue is tons of thick mucus. About 7 years ago an NP recommended a nasal irrigation system to treat chronic sinus infectsions (he had had 10 infections in a year). He start using a Hydromed Nasal Irrigation system every day which pretty much cured him of sinus infections. However, it seems the more he uses it, the more dependant he is on using it. He was up to 3 times a day when his ENT recommended surgery for deviated septum and turbinate reduction (hoping this would also help the tons of much). Well we are 5 months out of surgery and he has just as much mucus. He has tried every oral antihistamine, nasal antihistamine, nasal steroid . . . no relief. And we've tried stopping the nasal irrigation (probably only for 3 or 4 days because he gets some miserably plugges with mucus way back in his head that he can't blow out). I really wonder if the irrigation is causing more mucuc production and he just needs to stop completey and see what happens. Has anyone else had this experience? Any advise will be SO MUCH APPRECIATED!

      August 3, 2013 at 09:55 | Report abuse |
  13. Navybill

    I had a bad sinus infection lasting more than a year and previous infections lasting a few days or a week. After 9 rounds of antibiotics that were having some effect, but not resolving the problem I decided surgery was the best route. I had sinuplasty this year and the infection cleared in a couple of weeks. Chronic sinus infection is part of a cycle of infection leading to congestion and inflammation. Inflammation prevents drainage and thereby inhibits draining of the sinuses, ergo unresolved infection, congestion and inflammation. I take sinus infections very seriously, more so today than in the past. Infections prevent proper drainage; contribute to poor sleep and possibly sleep apnea. Sleep apnea contributes to high blood pressure, CAD and heart failure. Today I irrigate daily (sometimes more than once) with a saline/xylitol mixture, take allergy shots (molds and some grass) and when feeling a bit congested, reach for the Mucinex. Xylitol also happens to be a naturally occurring antibiotic.

    December 28, 2010 at 07:39 | Report abuse | Reply
  14. Snot Doc

    Get rid of mucas fast. Try a ballon treatment. Google' balloon in nose". It takes 5 minutes and you're done.
    Everyone should do it.

    December 28, 2010 at 08:44 | Report abuse | Reply
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      'Snot Doc' ... freakin hilarious!

      December 28, 2010 at 12:22 | Report abuse |
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    December 28, 2010 at 21:05 | Report abuse | Reply
  16. Jo

    The best medicine for allergy and mucus is Sinus Rinse. NetiPot can work wonders too. I have been using NeilMed Sinus Rinse for quite sometime and find a great relief. This is natural and absolutely no side effects. And yes, CostCo has great deals too.

    December 28, 2010 at 23:38 | Report abuse | Reply
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    January 9, 2013 at 20:46 | Report abuse | Reply
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    June 16, 2013 at 10:52 | Report abuse | Reply
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