Is your nose red again? Kleenex at your bedside? Feel absolutely miserable and not sure if it's a cold or allergies? Or maybe it's another "sinus infection." Millions of Americans suffer with these same symptoms, and the answer is not that simple-not even for a doctor. But there are some clues to differentiate the three common "nose woes."

A common cold frequently starts with "not feeling well" and perhaps a scratchy throat. Then a profuse watery nasal discharge occurs, which after a few days usually thickens and changes color to yellowish or green. The common cold is caused by one of more than a hundred viruses and does not respond to antibiotics. The common cold usually lasts about ten days. A cough with nasal congestion is usually part of the picture. Treatment is usually with water for hydration and aspirin (except for children and people who are allergic to aspirin) or Tylenol (acetaminophen). Sometimes a mild decongestant will also help. Stay away from antibiotics unless there are secondary complications of infection.

Allergies may present symptoms similar to the common cold. There is usually nasal congestion, runny nose and sneezing. But unlike the common cold, allergies usually persist for several weeks or may never seem to go away. There is no fever although some people with allergies "feel poorly." Upon careful questioning, there is usually a positive family history of allergies in parents, and frequently the patient recognizes dust, mold, animal dander and pollen as the aggravating factors. Treatment starts with avoiding the offending allergen and taking medications including antihistamines and decongestants. Topical steroid sprays have been shown to be very effective and are considered the first line treatment by many doctors. Two newer medications are now available. Astelin is a nasal spray that contains a powerful antihistamine as well as actions to prevent nasal drainage. The second medication is Singulair, a medication used to treat asthma that is now indicated for patients with an allergic nose.

Sinusitis can develop secondary to a common cold or allergies. The sinuses are actually open spaces in the head with no known specific purpose. If they become blocked, frequently mucus will get trapped and will become infected. Symptoms may include pressure in the areas beside the nose as well as the forehead and temples. Frequently the nasal exudate is greenish or yellowish, and headaches are common. Fever is variable and the duration is usually two weeks or longer. Although acute sinusitis usually requires no antibiotics, chronic sinusitis that lasts longer than four to six weeks may require four to six weeks of antibiotics.

If you cannot figure out what is causing your nose woes, you might consider seeing your doctor. You will most likely find other patients with similar symptoms in his waiting room-sneezing and blowing their nose and wondering, "Do I have sinusitis, allergy or a common cold?"

Dr. Robert Overholt has been in private practice for more than 30 years. He is the host of the television program "The Dr. Bob Show" airing weekly in 13 million homes on the GoodLife Television Network. If you have a question for Dr. Bob, write "The Dr. Bob Show" at 6700 Baum Drive, Suite 1, Knoxville, TN 37919 or send your e-mail to letters@drbobshow.com.