What to know about a broken nose
A broken nose, or nasal fracture, is when a bone in the nose becomes cracked or broken. There may also be damage to the connective tissue, or cartilage, inside the nose.
A broken nose can result from an impact to the face, potentially from a fall, violence, contact sport, or accident. Being able to recognize a broken nose can help ensure that a person or child receives appropriate treatment.
In this article, we explain how to recognize a broken nose and when to see a doctor. We also cover diagnosis, self-care, medical treatments, recovery, causes, risk factors, and prevention tips.
How to recognize a broken nose
A broken nose may appear crooked or misshapen.
The signs and symptoms of a broken nose are similar in adults and children.
They typically include pain, swelling, redness, and bruising around the nose. A person may also have cuts or scrapes on the face and bruising around the eyes.
Other symptoms that can help people identify a broken nose include:
- a runny nose
- the sensation of having a blocked nose
- difficulty breathing through the nose
- a crunching noise when touching the nose
- a crooked or misshapen nose
When to see a doctor
An adult or child with a suspected broken nose should see a doctor if:
- the swelling persists for several days
- the nose is misshapen or crooked
- the pain is severe or persistent
- it is difficult to breathe through the nose once the swelling goes down
- nosebleeds occur regularly
- fever or chills occur
It is important to call 911 or go to the nearest emergency department if:
- there is severe or persistent bleeding
- it becomes difficult to breathe
- there is a large open wound on the face
- there is broken glass or other debris inside the nose
Immediate medical attention is necessary if an adult or child has signs of a head injury, such as:
- clear, watery fluid coming out of the nose
- a severe headache
- blurred vision
- loss of consciousness
- difficulty speaking or moving
- confusion or memory loss
A doctor can usually diagnose a broken nose by carrying out a visual inspection and a physical examination of the person's face. They may:
- ask about symptoms and how the injury occurred
- look for swelling, bruising, and bleeding
- press gently on the nose and surrounding areas
- check the inside of the nasal passage
The doctor may apply an anesthetic to numb the affected area if a person is experiencing pain or discomfort during the examination.
Further investigations might sometimes be necessary. A doctor may order a CT scan or an X-ray to check for other injuries or complications.
During a nosebleed, leaning forward is the safest practice.
People can often treat a broken nose at home if the injury is not serious or causing other problems. However, a person should not attempt to realign their nose themselves if it is misshapen or crooked.
To manage a broken nose at home:
- Treat nosebleeds by sitting down and leaning forward to prevent the blood from entering the throat.
- Apply an ice pack to the injury for 15 to 20 minutes, several times a day.
- Take over-the-counter (OTC) pain relievers, such as acetaminophen or ibuprofen, to relieve pain and swelling.
- Treat minor wounds by cleaning them and covering them with a dressing.
- Elevate the head while lying down to reduce swelling.
- Avoid picking or blowing the nose.
People with large cuts or gashes on their face should see a healthcare professional, as stitches or a medical dressing may be necessary to close and protect the wound while it heals.
For people with more severe pain and swelling, a doctor can prescribe stronger pain relievers if OTC medications are not effective.
People with severe injuries or damage to the nose may require manual realignment or surgery. We discuss these medical treatments below:
A person with a misshapen or crooked nose may require a doctor to realign the bones manually. This procedure should restore the appearance of the nose and resolve any difficulties in breathing through it.
When performing a manual realignment on a person with a broken nose, a doctor may:
- use an anesthetic nasal spray or administer an injection to numb the affected area
- use a speculum and other medical tools to realign the broken bones and damaged cartilage
- pack the nose and place a dressing on the outside to keep the bones and cartilage in place
- prescribe antibiotics to prevent infection
If it has been more than 2 weeks since the injury occurred, manual realignment is usually no longer an option, and a doctor may recommend surgery to repair the nose instead.
A doctor may recommend surgery to individuals with a broken nose if the injury:
- is severe
- involves multiple broken bones
- involves damage to the nasal septum or is affecting breathing
For some people with a misshapen or crooked nose, a doctor may be able to realign the bones manually without surgery. However, manual realignment is usually only an option if the injury occurred less than 2 weeks ago.
It may sometimes be necessary for a person to wait for 2 to 3 months following the injury before undergoing surgery. This period of waiting allows the swelling to go down and the bones to heal before a surgeon attempts to restore the original appearance of the nose.
Nasal fractures typically begin to heal within a few days, but it may take a week or so for the pain and swelling to go away completely. While recovering from a broken nose, it is advisable to avoid activities that could further damage it, such as playing contact sports.
If there are complications, recovery may take longer. Complications arising from a broken nose can include:
- A deviated septum, which is where the thin wall between the nostrils moves out of alignment. A person may require surgery to fix a deviated septum, particularly if it is affecting breathing through the nose.
- Cartilage damage. Depending on the severity of this damage, a person may require surgery.
- Septal hematoma, where pools of clotted blood block the nostrils. It is important for people to seek prompt medical treatment for this condition.
Nasal deformities that arise from a broken nose are usually permanent if a person does not receive corrective treatment.
Forceful impacts to a person's face can result in a broken nose. According to a small study from 2013, common causes of a broken nose include:
- accidents, such as motor vehicle collisions
- sporting injuries
Children generally have a higher risk than adults of injuries from falls.
Image credit: Marco Antonio Torres, 2006.
A broken nose can happen to anyone, but certain activities and factors can increase a person's risk. These include:
- doing contact sports, such as football or boxing
- participating in activities where falls or collisions are possible, such as skiing or riding a bicycle
- engaging in physical fights
- traveling in a motor vehicle, especially without a seat belt
- living with domestic violence
Broken noses are also more common in children and older adults, as these individuals often have a lower bone mass and are more at risk of falls.
It is not always possible to prevent a broken nose. However, a person can take certain steps to reduce their risk. These include:
- wearing protective clothing and a helmet when playing contact sports and engaging in activities with a risk of falls or collisions, such as skiing, horse riding, and using a bicycle or motorcycle
- wearing a seat belt at all times when traveling in a motor vehicle
- wearing suitable shoes to prevent falls
- using walking sticks or other mobility aids if unsteady when moving about
Parents and caregivers may wish to take extra precautions to safeguard children against falls and other accidents. These precautions can include:
- installing stair gates and other safety aids in the home
- removing rugs and other fall hazards
- ensuring that children wear appropriate and well-fitting shoes
- discouraging children from running or playing on slippery or uneven surfaces
- encouraging children to play on soft surfaces, such as grass
Broken noses are a common injury that can result from any forceful impact to the face. While it can be painful and distressing, a person can often treat a broken nose with simple home care, such as ice packs and OTC pain relievers.
People should seek medical treatment for a misshapen nose or if their symptoms are severe or do not improve after a few days.
It is important to seek immediate medical attention if a broken nose leads to breathing difficulties or heavy bleeding or if there are signs of a head injury.
Reconstructive surgery is an option for people who are not happy with the appearance of their nose following the break or for those who continue to experience breathing difficulties after it heals.