Broken nose

A broken nose, or a nasal fracture, is a crack or break in the two nasal bones that form the bridge of your nose. When you break your nose there may also be damage to the cartilage that supports it, and the thin wall that separates your nostrils may have been bent out of place (deviated septum).

A broken nose often heals itself within three weeks, but may need surgery to reshape it or repair any serious damage.

The most common causes of a broken nose include injury during contact sports, physical fights, falling over, traffic accidents and walking into objects like a door.

The most common symptoms of a broken nose are pain and swelling in your nose. You might also notice bruising around your eyes or a cut on the bridge of your nose.

Other symptoms can include:

• Blocked nose – this can be in one or both nasal passages
• Crunching or cracking when you touch your nose
• Nosebleed
• Visible changes in the shape of your nose

Seek medical help straight away if you also have symptoms that might suggest a severe head injury, such as:

• Double vision or pain in your eyes
• Pain in your head or neck
• Watery liquid trickling from your nostril
• A constant nosebleed
• A severe headache
• Difficulty speaking or passing out

You should also call 999 or go to A&E if you have a broken nose and a large wound with something still in it, like glass, or a blood clot in the skin between your nostrils.

You can usually treat a broken nose by yourself. The swelling should start to go down after three days and be fully healed in three weeks. You should see your GP if your symptoms don't improve or if:

• Painkillers aren’t helping
• You’re having breathing difficulties
• Your nose is bent out of shape once the swelling goes down

Your GP can tell if your nose is broken by assessing your symptoms and gently examining your nose. They may press on the outside of your nose and surrounding areas of the nose, your GP may also look inside your nasal passage during your appointment. They'll usually only arrange for an X-ray if they suspect you’ve injured other parts of your face.

If your GP thinks you may need treatment to straighten your nose, they may refer you to a specialist in ear, nose and throat surgery.

A broken nose should feel a bit better in about three days. Things you can do to help include:

• Holding an ice pack to your nose for 15 minutes, several times a day
• Sleeping as upright as possible by propping up pillows to reduce swelling
• Taking over-the-counter painkillers (paracetamol or ibuprofen)
• If you have a nosebleed, stay upright and lean forward, then pinch your nose above the nostrils

Many people find their nose heals in about three weeks without medical treatment.

If you have a large wound, it will usually be cleaned and closed up with stitches or strips. If your nose won’t stop bleeding, you may need to have a soft gauze pad in your nose for a few days.

If your nose is bent out of shape, you may have a procedure called manipulation – usually no later than two weeks after your injury. This will only be performed once your swelling has started to go down. Manipulation may not make your nose look exactly as it was before, but it often helps. It's mostly a quick procedure done under local anaesthetic, so you don't feel any pain. During your manipulation, your doctor will open your nostrils with an instrument called a nasal speculum. After this, your doctor will realign your broken nasal bones and cartilage using their fingers or special forceps.

If you have damaged cartilage or a deviated septum that affects your breathing, you may need another operation at a later date.

Your doctor may suggest surgery to repair your broken nose if you’ve suffered severe or multiple breaks, or if you’re not suitable for manipulation. If the break has damaged your nasal septum and is causing obstruction or breathing difficulties, reconstructive surgery may be recommended.

How to prevent a broken nose

Some of the ways you can prevent a broken nose are:

• Wearing appropriate and protective equipment when partaking in activities and contact sports such as cycling and kickboxing
• Wearing your seat belt every time you travel and keeping children in age-appropriate safety seats
• Wearing a helmet when riding a motorbike

How do I know if my nose is broken?

The most common symptoms of a broken nose are pain and swelling, you might also have bruising around your eyes or a cut on the bridge of your nose. Other symptoms can include:

• Blocked nasal passages
• Crunching or cracking when you touch your nose
• Nosebleed
• Changes to your nose shape

Will a broken nose heal on its own?

A broken nose will often heal by itself and you probably won’t need to go to hospital. The swelling should start to go down after three days and the fracture should be fully healed in three weeks.

Can complications occur with a broken nose?

There are some other complications and injuries that may occur as a result of your broken nose. These include:

Deviated septum

A broken nose may cause a deviated septum. This is when the wall that separates the two nasal passages becomes displaced. A deviated septum will cause a narrowing in your nasal passage. Medication can manage the condition, however, surgery will be required to correct it.

Septal haematoma

Blood clots may pool in the nose after it has been broken and block one or both nostrils. This condition is called a septal haematoma and may cause cartilage damage unless the blood is surgically drained quickly.

Cartilage fracture

In some cases where the nasal bones have broken due to a forceful blow, the cartilage in your nose may also be fractured.

Can I straighten my nose without surgery?

In a lot of cases, surgery isn’t necessary to straighten a broken nose. You may have a procedure called manipulation.

It’s a quick procedure that’s performed under general anaesthetic and involves your doctor realigning the broken nasal bones and cartilage with their fingers or special forceps.

Manipulation can only be performed once the swelling has gone down. It doesn't have to be right away, but it's more likely to be successful if carried out within two to three weeks of your injury. The procedure may not make your nose look the same as it was before, but many find it helpful.

What should I avoid with a broken nose?

You should avoid trying to straighten your nose yourself. If it has changed shape and you’d like it straightened, you should see your GP. If you wear glasses, you should try to avoid wearing these until your swelling has gone down. You should also refrain from picking or blowing your nose until it's healed.

In the first two weeks of breaking your nose, you should avoid any strenuous exercise. If you play contact sports where your face may be hit, you’ll need to stop playing for at least six weeks.

How painful is a broken nose?

A broken nose can cause you pain, swelling and bruising around your nose and under your eyes.