Why Malaysians Shouldn’t Normalise Sinus Congestion

Waking up with a blocked nose, keeping nasal spray within arm’s reach, or brushing off constant sinus pressure as “just allergies” has become a daily reality for many Malaysians.

In a country where air-conditioning, pollution, and unpredictable weather are part of everyday life, nasal congestion is often treated as a minor nuisance rather than a signal of a deeper issue. In Malaysia, sinusitis affects an estimated 12.8 percent of the population, close to 3 million people living with ongoing sinus problems – underscoring how widespread this issue really is.

Ear, Nose, Throat, Head and Neck Specialists at Sunway Medical Centre Damansara (SMCD), Dr. Natasha Ayla Binti Ahmad Zulkiflee and Dr. Noor Liza Ishak, warn that what feels routine may point to more serious underlying ENT conditions. Early assessment can both relieve discomfort and also prevent symptoms from quietly progressing into chronic conditions.

The Everyday Reality of Sinus Congestion.

Sinusitis, or a sinus infection, occurs when the nasal cavities become inflamed and blocked with mucus, often caused by viruses, bacteria, or allergies. Dr Natasha Ayla, Consultant Ear, Nose, Throat, Head and Neck Surgeon at SMCD, explains the importance of recognising when symptoms require medical attention: “If your nose feels constantly blocked or congested for more than 2-3 weeks, despite taking over-the-counter remedies, it is time to see a specialist. A short cold or viral infection usually clears within 7-10 days, but anything lasting longer could signal sinus inflammation, allergies, or structural issues like a deviated septum.”

Warning signs of a more serious condition include persistent nasal blockage or mouth breathing, thick discoloured mucus, facial pressure, or a reduced sense of smell. “If these come with frequent headaches, post-nasal drip, bad breath, or snoring, it is definitely worth getting checked”, says Dr Natasha. In children, chronic mouth breathing can affect jaw growth, dentition, and sleep, making early attention especially important.

For many Malaysians, sinus symptoms quietly blend into daily life. Long hours in air-conditioned offices, traffic-filled commutes, and exposure to everyday irritants make it easy to dismiss ongoing nasal discomfort. Many adapt with quick fixes like decongestants or antihistamines, rarely questioning whether persistent congestion is normal or something more serious. In fact, these lifestyle and environmental factors can aggravate sinus symptoms. “Constant exposure to air-conditioning, dust, haze, or cigarette smoke can inflame the nasal passages,” Dr Natasha notes, while poor hydration and irregular sleep can further worsen symptoms.

Chronic sinus inflammation can extend beyond the nose, causing fatigue, and even contributing to brain fog due to poor oxygen flow and disturbed rest. In rare cases, untreated sinus infections may spread to nearby structures, such as the eyes – leading to swelling or reduced vision – or, very rarely, the brain. Dr Natasha explains, “While this is uncommon, the bigger concern is how long-term congestion can quietly affect our quality of life, from being constantly tired to having reduced productivity.”

The Hidden Dangers of Quick Fixes

While over-the-counter nasal sprays and antihistamines can provide quick relief, frequent use may mask underlying problems or worsen symptoms over time. Consultant Ear, Nose, Throat, Head and Neck Surgeon at SMCD, Dr Noor Liza Ishak, warns that long-term use of decongestant nasal sprays can cause rebound congestion, where the nose becomes more blocked once the spray wears off. According to Dr. Noor Liza, “Prolonged use may further irritate the nasal lining and cause chronic inflammation. Similarly, depending heavily on antihistamines can mask symptoms without treating the underlying cause, delaying diagnosis of conditions such as chronic sinusitis, nasal polyps, or structural blockages.”

Chronic overuse of decongestant sprays may also lead to rhinitis medicamentosa, a condition where the nasal lining becomes swollen and overly sensitive. “Over time, the tissues may thicken, become dry, or develop small areas of crusting, reducing the natural function of the nasal lining. In severe cases, ongoing swelling can even narrow the nasal passages, causing long-term blockage,” Dr Noor Liza explains.

To avoid these risks, safe use becomes key. Dr Noor Liza advises that use of decongestant sprays should be limited to 3–5 days. “If someone needs the spray more often, this may indicate rebound congestion,” she notes. With antihistamines, dependency is less common, but prolonged use can still mask symptoms. Persistent congestion beyond two to three weeks is a clear sign to seek professional evaluation.

Taking Control of Sinus Health

Consulting an ENT specialist early can prevent complications and significantly improve quality of life. Once the underlying cause is identified, treatment can be tailored ­– through medication, minimally invasive procedures, or lifestyle adjustments – helping patients breathe easier, sleep better, and reduce long-term health risks.

Dr Natasha explains that early intervention allows clinicians to address the root cause before complications develop. “When treated early, inflammation is easier to reverse, sleep improves, and patients often find their energy and focus return. It’s about moving beyond just breathing easier, and properly restoring daily comfort and overall wellbeing,” she says.

Echoing this, Dr Noor Liza adds that early treatment can break the cycle of recurring sinus issues or congestion, and long-term damage to the nasal lining. “Identifying problems such as allergies, sinus inflammation, or structural blockages early allows us to restore normal nasal function and reduce the reliance on repeated medications,” she explains.

Treatment, however, depends on the underlying cause. Medical therapy may include saline rinses, nasal steroid sprays, or allergy management such as immunotherapy, with short courses of antibiotics used when infection is present. For recurrent or chronic symptoms, procedures like endoscopic sinus surgery, septoplasty, or turbinoplasty can help improve drainage and relieve blockage by restoring normal airflow and sinus function.

Determining the right course of action also depends on timing. Clinical indicators help determine not just what treatment is needed, but how urgently it should be started. To ensure the most effective approach, specialists conduct clinical assessments such as nasal endoscopies and allergy testing to guide treatment. According to Dr Natasha, a nasal endoscopy helps identify inflammation, polyps, growths, or any structural issues that may not visibly appear. “If we observe any polyps or pus, or persistent obstruction caused by enlarged turbinates or deviated septums, that usually signals the need for more intensive or surgical treatment”, she says.

Besides that, Dr Noor Liza mentions that allergy testing is equally important in shaping both treatment direction and long-term control. “Strong reactions to triggers like dust mites or pollen can confirm allergic rhinitis and guide us towards targeted therapies such as antihistamines, nasal steroid sprays, allergen avoidance, or immunotherapy,” she explains.

Act Early, Breathe Better

Ultimately, awareness and quick action can make all the difference. Recognising when congestion goes beyond the occasional blockage and seeking professional care early can stop minor symptoms from developing into chronic sinus problems.

Persistent sinus congestion doesn’t have to be part of daily life – don’t let a blocked nose become a silent health risk.

Source: Focus Malaysia