Flying with Sinusitis: Can You Fly, and How to Avoid the Pain
Why descent is the painful bit, what to do in the days before you travel, and when to postpone.
Part of our Sinusitis condition guide.
The headline: The pain is almost always on descent, not take-off. Climbing, expanding air escapes a blocked sinus fairly easily. Descending, air has to get back in through a swollen channel—and if it can't, a partial vacuum forms and pulls on the sinus lining. That's the pain.
The one-line answer: for most people flying with sinusitis is uncomfortable rather than dangerous, and good preparation makes a substantial difference. Postpone if you have severe facial pain, a fever, or recent sinus or ear surgery.
Can you fly?
| Your situation | Verdict |
|---|---|
| Mild congestion, can breathe through both nostrils | Fly. Prepare, and you'll probably be fine |
| Moderate blockage, some facial pressure | Fly if you need to, but prepare properly |
| Completely blocked both sides | Expect pain. Postpone if you realistically can |
| Severe facial pain or fever | Get assessed before travelling |
| Recent sinus or ear surgery | Ask your surgeon before flying |
| Swelling around an eye, vision changes, severe headache | Urgent medical assessment, not an airport |
Why it hurts—the physics
Your sinuses are sealed air pockets in the bones of your face, each connected to the nose by a channel only a few millimetres wide. Normally air moves freely through those channels and the pressure inside matches the pressure outside without you ever noticing.
Aircraft cabins are pressurised, but not to sea level. A typical cabin sits at the equivalent of roughly 6,000 to 8,000 feet, and that pressure changes over the course of the climb and descent.
Healthy sinuses adjust continuously. Blocked ones can't, and a pressure difference builds across the sinus lining. That's sinus barotrauma, and it can be surprisingly severe—people describe it as an ice pick behind the cheek or eye.
Why descent is worse than take-off
Climbing
Cabin pressure falls. Air inside the sinus expands and pushes outwards through the channel. Air escaping under pressure can usually force its way past some swelling.
Descending
Cabin pressure rises. Air must flow inwards to rebalance. Nothing is pushing it in, and a swollen channel behaves like a one-way valve. A partial vacuum forms and pulls on the lining.
This is why people board feeling fine, have an uneventful flight, and then experience sudden severe pain in the last twenty minutes. The same mechanism affects your middle ear, which is why ears and sinuses tend to hurt together.
Practical consequence: your preparation should peak before descent, not before take-off. A decongestant spray used at the gate will have worn off by the time it matters on a long flight.
The week before
1
Start saline rinsing daily
Begin several days ahead rather than the morning of the flight. Rinsing clears mucus and reduces the amount of blockage you take on board. Our guide on relieving sinus pressure covers technique.
2
If you're past day 10, get assessed
Sinus symptoms that haven't improved after 10 days may warrant a steroid nasal spray. It takes one to two weeks to work fully, so this only helps if you start well before you travel.
3
Treat any underlying allergy
If hay fever or dust allergy is keeping your nose inflamed, controlling it improves your chances considerably.
4
Buy what you need in advance
A decongestant nasal spray, a saline spray, paracetamol or ibuprofen, and chewing gum. Airport prices aren't kind, and you want the spray in your hand luggage.
On the day
- Saline rinse before you leave for the airport—clears mucus so anything else you use can reach the lining
- Take pain relief before you board, not once it starts hurting. Paracetamol or ibuprofen at the full dose on the packet
- Pack the nasal spray in hand luggage, within your liquids allowance
- Drink water steadily—cabin air is very dry and dry mucus is thicker and stickier
- Skip the alcohol—it dehydrates you and worsens nasal congestion
- Take chewing gum or boiled sweets for the descent
- Choose a seat you can stay awake in if you can, since sleeping through descent is the classic mistake
On board, step by step
1
Before take-off
Use the decongestant spray if you're going to. Start chewing gum or sucking a sweet as the aircraft begins its roll.
2
During the climb
Swallow regularly. This part is usually easy—expanding air tends to escape on its own.
3
Cruise
Keep drinking water. Use a saline spray every hour or two to stop the cabin air drying your nose out.
4
Thirty minutes before descent—the key moment
Use the decongestant spray now. Ask cabin crew when descent begins if you're unsure. Set an alarm on a long flight. This single step prevents most of the pain.
5
Throughout descent
Stay awake. Swallow, yawn and chew continuously. Equalise gently and often rather than waiting until it hurts.
Wake me for landing. If you're prone to this, tell a member of cabin crew you have sinus trouble and ask to be woken before descent. They're asked this often and won't find it odd.
How to equalise properly
Start early in the descent and repeat gently. Don't wait for pain—once a vacuum has formed it's much harder to clear.
- Swallow—the simplest and safest. Sip a drink to make yourself swallow more often
- Yawn widely, or fake one. It opens the Eustachian tubes effectively
- Chew gum or suck a sweet—keeps you swallowing without thinking about it
- The gentle blow: pinch your nose, close your mouth, and blow softly against the closed nostrils until your ears click
Be gentle with that last one. Blowing hard against a pinched nose can damage the eardrum or push infected mucus further into the sinuses and middle ear. Soft and repeated beats forceful. Stop if it causes pain, and never do it while descending rapidly with a completely blocked nose.
Flying with children
Children suffer more than adults, because their Eustachian tubes are narrower and more horizontal, and younger ones can't deliberately equalise.
- Babies: feed or offer a dummy during take-off and descent. Sucking and swallowing does the work for them
- Toddlers: a drink through a straw, or something to chew
- Older children: chewing gum, and turn equalising into a game—making their ears pop and click
- Saline drops or spray are safe from infancy and worth using before descent
- Decongestant sprays aren't suitable for young children—don't use an adult product
Speak to a pharmacist, your GP or NHS 111 before flying if your child has a fever, ear pain or seems unwell. Access Doctor treats adults aged 18 and over only. Our guide to sinusitis in children covers what to look for.
When to postpone
Do not fly, and seek urgent assessment, if you have swelling or redness around an eye, a bulging eye, double or reduced vision, a severe headache unlike your usual ones, neck stiffness, or confusion. These are complications of sinusitis that need same-day attention, not a departure lounge.
Consider postponing, and speak to a clinician first, if you have:
- Severe facial pain, particularly on one side only
- A fever, or you feel systemically unwell
- Complete blockage of both nostrils
- Had sinus or ear surgery recently—ask your surgeon specifically
- A history of ear drum perforation while flying
- Symptoms that are clearly worsening rather than settling
Check your travel insurance before deciding. Policies differ considerably on whether a new illness before departure is covered, and a note from a clinician may be required.
Travelling Soon and Symptoms Not Shifting?
If sinus symptoms have persisted past 10 days, a GPhC-registered pharmacist independent prescriber can assess you online and decide whether treatment is appropriate. Steroid sprays take one to two weeks to work fully, so allow time before you travel. Adults 18 and over.
View Sinusitis Treatments →If it still hurts after landing
Some discomfort for a few hours afterwards is common and usually settles by itself with saline rinsing and simple pain relief.
| After the flight | What it suggests |
|---|---|
| Pain settling over a few hours | Ordinary barotrauma. Saline and pain relief |
| Blocked or muffled ear for a day or two | Common. Usually resolves. Keep equalising gently |
| Pain persisting more than 24–48 hours | Get it looked at |
| Sudden relief with fluid or blood from the ear | Possible perforated eardrum—seek advice promptly |
| New fever or worsening facial pain | May have triggered a bacterial infection. Get assessed |
| Hearing loss, severe dizziness or persistent ringing | Seek medical advice without delay |
A note on diving
If your holiday involves scuba diving, treat that as a different and much stricter question. Pressure changes underwater are far greater than in an aircraft, and a reverse block on ascent with blocked sinuses is a serious matter.
Don't dive with active sinusitis or nasal blockage. Diving medicine guidance is clear on this, and a dive operator is entitled to refuse you. Wait until you can breathe freely through both nostrils and equalise easily on land.
Frequently Asked Questions
Can you fly with sinusitis?
It is not dangerous for most people, but it can be genuinely painful and it is best avoided if you have a choice. Flying with blocked sinuses risks sinus barotrauma, where trapped air cannot equalise with the changing cabin pressure and presses on the sinus lining. If you must fly, preparation makes a large difference. Postpone if you have severe facial pain, a fever, or you feel unwell, and seek advice before flying if you have recently had sinus or ear surgery.
Why do my sinuses hurt when the plane descends?
Your sinuses are air-filled cavities that need to equalise with the surrounding air pressure through narrow drainage channels. As the aircraft descends, cabin pressure rises quickly. If those channels are swollen shut, air cannot move in to balance the pressure, so a relative vacuum forms inside the sinus and pulls on the lining. That is what produces the sharp, intense pain. Descent is worse than take-off because equalising in that direction is mechanically harder.
What can I take before flying with blocked sinuses?
A decongestant nasal spray used around thirty minutes before descent is the most effective single measure for short-term relief, and it can be used for a few days around travel provided you do not exceed about a week in total. A saline rinse before you leave for the airport helps clear mucus first. Take regular paracetamol or ibuprofen before the flight rather than waiting for pain. Check with a pharmacist if you have high blood pressure, heart problems or take other medicines.
How do I equalise my ears and sinuses on a plane?
Swallow frequently, yawn, chew gum or suck a sweet during take-off and descent, as these open the Eustachian tubes. If that is not enough, try gently pinching your nose, closing your mouth and blowing softly against the closed nostrils until you feel your ears click. Do this gently and repeatedly rather than forcefully, and stop if it hurts. Staying awake during descent matters, because you swallow far less when asleep.
Is it dangerous to fly with a sinus infection?
For most people it is painful rather than dangerous. The recognised complications are sinus barotrauma, ear barotrauma and occasionally a perforated eardrum, along with temporary dizziness, ringing in the ears or a small nosebleed. Seek advice before flying rather than simply going ahead if you are systemically unwell, have severe or one-sided facial pain, have had recent sinus or ear surgery, or have any swelling around an eye.
How long should I wait to fly after sinusitis?
There is no fixed rule, and it depends on your nose rather than the calendar. The practical test is whether you can breathe through both nostrils reasonably freely. If you can, equalising will usually work. If one or both sides are completely blocked, flying is likely to hurt. Many people are comfortable within a week or two of an acute episode settling, but the blockage is the thing to judge, not the number of days.
Can children fly with sinusitis?
Children are more prone to ear and sinus pain when flying because their Eustachian tubes are narrower and more horizontal, and younger children cannot perform equalising manoeuvres. Encourage swallowing during take-off and descent by offering a drink, a feed for babies, or something to chew. Decongestant sprays are not suitable for young children. If your child has a fever, ear pain or seems unwell, speak to a pharmacist, GP or NHS 111 before travelling.
Should I cancel my flight if I have sinusitis?
Most people do not need to. With preparation, most sinusitis is uncomfortable on a flight rather than prohibitive. Consider postponing if you have severe facial pain, a fever, complete nasal blockage on both sides, recent sinus or ear surgery, or any red flag symptoms such as swelling around an eye or vision changes. If you are unsure, speak to a pharmacist or your GP, and check the terms of your travel insurance before making a decision.
Completing the treatment
If you have a trip coming up and symptoms haven't shifted past day 10, treating the underlying blockage well before you travel is what makes the difference. Access Doctor supplies mometasone nasal spray for sinusitis and beclometasone nasal spray for sinusitis, and where a bacterial infection is genuinely likely, phenoxymethylpenicillin or doxycycline. All follow an online consultation reviewed by a GPhC-registered pharmacist independent prescriber. Allow one to two weeks for a spray to take full effect.
Steroid spray · Rx
Mometasone Nasal Spray for Sinusitis
Start well before you travel—it takes 1–2 weeks to work.
View product →Steroid spray · Rx
Beclometasone Nasal Spray for Sinusitis
Twice-daily alternative steroid nasal spray.
View product →Antibiotic · Rx
Phenoxymethylpenicillin for Sinusitis
Where a bacterial sinus infection is genuinely likely.
View product →Antibiotic · Rx
Doxycycline Capsules for Sinusitis
Alternative where penicillin cannot be used.
View product →References
- NHS. Sinusitis (sinus infection). nhs.uk
- NHS. Ear pressure and flying. nhs.uk
- NICE Clinical Knowledge Summaries. Sinusitis. cks.nice.org.uk
- National Institute for Health and Care Excellence. Sinusitis (acute): antimicrobial prescribing (NG79). nice.org.uk
- Civil Aviation Authority. Fitness to fly: passenger health information. caa.co.uk
- NHS. Decongestants. nhs.uk
- NHS. Perforated eardrum. nhs.uk
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice, and it is not an assessment of your fitness to fly. If you are unwell before travelling, seek advice from a qualified healthcare professional. In a medical emergency, call 999.