A broken nose is a common injury, usually caused by a blow to the face. Most broken noses heal naturally and can be managed at home.

The swelling should go down within a week, and the bruising should disappear after two weeks.

This page describes the signs of a broken nose and gives advice on what to do.

How do I know if I’ve broken my nose?

A broken nose will be painful, swollen and red. Other typical symptoms are:

• bruising around the eyes
• a nosebleed
• tenderness when you touch the nose
• a crunching or crackling sound when you touch the nose
• the nose looking deformed
• difficulty breathing out of the nose, as if something is blocking it

Most broken noses can be cared for at home, and medical treatment isn’t necessary, especially if the skin and septum (wall between the nostrils) are still intact.

Caring for your nose at home

You can usually manage your broken nose at home, following the below advice:

• Hold an ice pack (try frozen peas wrapped in a tea towel) to the nose for 15-20 minutes every one to two hours for the first couple of days.
• Prop your head up in bed by sleeping on a few pillows. This will reduce the swelling.
• Take over-the-counter painkillers such as ibuprofen to relieve the pain.
• If breathing through the nostril is difficult, use a nasal decongestant to help you breathe more easily (but don’t use this for more than five to seven days, as long-term use can make your congestion worse).
• If your nose is bleeding, hold your head forward to prevent blood trickling down your throat.

Don’t wear glasses until the swelling has gone down, and don’t attempt to straighten the nose yourself.

When to see your GP

Call your GP if:

• the pain gets worse or is not relieved by ordinary painkillers (your GP may be able to prescribe a stronger painkiller)
• the swelling doesn’t go down after a few days
• the swelling has gone down but you still can’t breathe through the nose
• the nose looks crooked
• you have nosebleeds that keep coming and going
• you have a fever

Look up your GP.

When to go to hospital

Go to your nearest accident and emergency department if:

• clear fluid is trickling from your nose or ears (this could indicate a serious head injury)
• you have a nosebleed that won’t stop
• you have a severe headache
• you have neck pain – especially if there is numbness or tingling in your arms
• your vision has been affected
• you keep fainting
• you can feel a boggy swelling (a blood clot) on your septum – if this blood isn’t drained, an abscess can form

Find your local hospital A&E.

Severely broken nose

If the bone is badly broken or the skin has broken, the nose will probably need medical treatment in hospital. An X-ray may be necessary, although in many cases it isn’t.

The doctor may be able to realign your nasal bones in their office, using special nasal instruments. However, this should be done within 14 days of the injury, otherwise treatment may not be possible. A local anaesthetic will be injected into your nose to numb it. Any broken skin will need stitches.

If your nose is bleeding continuously, a doctor will pack your nose with a soft gauze pad to stop the nosebleed. This will be removed by your doctor in two to three days. You musn’t try to remove it yourself.

If your nose has broken in a few places or become deformed, or if the inside structure of your nose has become damaged, you may need to have the bones surgically realigned. This will be done in hosppital using a general anaesthetic (you are put to sleep).

However, if you’re a boxer, footballer or other sportsman who is likely to break their nose again, it may not be worth having your deformed nose corrected. Speak to your doctor about this.

Follow-up

If you’ve severely broken your nose and received medical treatment for this, you’ll need to see a specialist for follow-up, to check the bones are healing in the correct position. You may see an ear, nose and throat doctor, and oral and maxillofacial surgeon, or a plastic surgeon.