TL;DR Sinus infections resist antibiotics and your immune system by physically walling themselves off with biofilms. Destroy this biofilm with any gentle surfactant, such as baby shampoo mixed into ordinary saline sinus rinse, and a normal immune system will quickly take out the undefended infection. You can accelerate this further by adding topical antibiotic to the saline wash *after* first breaking up the biofilm. Limit future reinfection by deliberately infecting yourself with lactobacillus, in the form of lacto-fermented foods.
U.S. doctors seem unaware of the most basic features of sinus infections, even though the information is widely available, especially in tropical countries.
Certain home remedies work well, but are usually so poorly explained or misunderstood, even by their purveyors, that they seem flaky or suspect.
Engineers and scientists don’t want to simply trust. They want to understand the underlying mechanisms. I suffered, and eventually cured, a ridiculously painful series of sinus infections several years ago — months of incapacitating pain day and night. This post ties together years of reading and self-experimentation into a single explanation of how sinus infections work, and how to kill them.
Understand these six mechanisms
Biofilms block antibiotics.
- Sinus infections construct biofilms around themselves as a physical barrier that limits contact with your immune system and antibiotics.
- Antibiotics and immune cells don’t pass through the biofilm, so the infection survives.
- Hence oral antibiotics tend to kill every bacteria in your body except the sinus infection.
Surfactants easily defeat biofilms.
- Biofilms are robust against oral antibiotics, but highly vulnerable to simple surfactants.
- Johnson’s Baby Shampoo, for example, is a surfactant, effective at breaking up biofilms, and specifically designed to be relatively painless on mucus membranes (“no more tears”).
- With its biofilm dissipated, the infection becomes defenseless against antibiotics or your immune system.
- The delivery mechanism for the surfactant is saline sinus rinse, aka “neti pot.”
Sinuses are like your belly button.
- Some people find the idea of sinus rinse strange or foreign. The process does look funny, but is completely logical.
- You wash the exterior of your body every day, and consider it healthy and normal.
- You wash your belly button because it is an exterior but concave surface, tending to collect lint and dirt.
- Sinuses are another exterior but concave surface of your body, like your belly button. Sinuses collect even more gunk, because they are more concave.
- Viewed this way, there is nothing odd about washing your sinuses, and in fact it starts to seem weird not to wash there occasionally.
Your body is a bacteria farm.
- Many different strains, some harmful, some benign.
- Benign bacterial strains limit the growth of harmful strains by competing for resources.
Oral antibiotics carpet-bomb the farm.
- Oral and intravenous antibiotics kill all strains in your whole body indiscriminately.
- This eliminates competition for resources, allowing any surviving harmful bacteria to come roaring back, this time with no resource competition.
- Topical antibiotics (unlike oral or intravenous) are precision weapons that don’t blow up the whole farm (more on this later).
You can replant your bacterial farm to limit future infection.
- The strains of lactobacillus bacteria found in everything from yogurt to kimchee are harmless to your body, yet compete for resources with other, more harmful bacteria.
- Eating fermented foods has been shown to spread lactobacillus throughout your body, including your sinuses.
- At least one strain of lactobacillus (lactobacillus sakei, the one in kimchee), when present in the sinuses, has been shown to limit sinusitis, again by competing for resources.
Sinus recovery plan
- Buy equipment.
- NeilMed sinus rinse squeeze bottle and salt packets. My experience has been that off-brand and store-brand squeeze bottles don’t work right. NeilMed works.
- Johnson’s Baby Shampoo (or the NeilMed equivalent, which I haven’t tried).
- (Optional but awesome) Find a doctor that will prescribe (and a compounding pharmacy that will mix) a small amount of topical antibiotic into sterile saline solution, to use as a secondary nasal rinse, as described below. I invented this myself and am proud of it (though undoubtedly others have thought of it too).
- Repeat the following every day, until cured.
- Fill NeilMed bottle with water, add one drop shampoo and one packet salt. Shake.
- Rinse sinuses gently per package instructions. Don’t squeeze the bottle too hard.
- Wait 30 minutes for the surfactant to break up biofilm.
- Repeat the above rinse cycle; this second round will be much more effective at washing away the infection, because the biofilm is broken up.
- (Optional) For this second cycle, instead of the normal mix, rinse with topical antibiotic described above. This will put the antibiotic in direct contact with the infection you just exposed in the first cycle above. In my experience, this is a neutron bomb, instantly destroying the exposed sinus infection while leaving buildings standing.
- Recovery takes several days without the topical antibiotic, or just 1-2 days with it.
- Buy kimchee, sauerkraut and yogurt.
- Only works if it is a live culture: kimchee and sauerkraut should be under pressure, and bubble up a little when you open the package.
- Eat daily.
- Feed the farm by also eating whatever the bacteria is living on. I.e. for kimchee, eat steamed bok choy. For sauerkraut, eat steamed cabbage. For yogurt, drink milk (organic to make sure it doesn’t have trace antibiotic).
- Redo the above procedures every time the infection recurs.
Things to worry about (and not to worry about).
- Squeeze the NeilMed bottle gently. If your sinus is blocked, water may flow through slowly, so if you squeeze too hard, water will seek other paths out, including your Eustacian tubes. This can cause an ear infection. If you are gentle, no ear infection.
- After sinus rinse, wait 30 minutes before lying down, to let any water drain. If you lie down too soon, water can drain into your Eustacian tubes or middle ear, creating conditions for an ear infection.
- Recurrent sinus infection is never permanently cured. Periodically it comes back, but you just treat it again, and are fine again for a few months or years.
- The scare stories about Naegleria fowleri in nasal rinses are wildly overblown. Yes, there is a nasty waterborne amoeba that can kill you if it finds a hole from your sinus into your brain. However:
- Naegleria only occurs in very warm water, above 70 degrees.
- Fewer than 200 Naegleriasis cases worldwide in the past 50 years.
- Your odds of getting this from chlorine-treated urban tap water are basically zero.
- If you use distilled water, the odds are lower still.
- You are much more likely to die in a car crash driving to the supermarket for distilled water than you are to die from Naegleriasis.
I can’t guarantee this works for everyone, but it totally, completely works for me. It seems to have the added benefit of making colds less severe, probably by washing away the nasal component of the infection.
Using my topical antibiotic idea in particular, my experience has been that lasting relief comes in 1 to 2 days, even after months of chronic sinus pain.