Broken Nose

Overview

A broken nose, also called a nasal fracture, is a break or crack in a bone in your nose — often the bone over the bridge of your nose.

Common causes of a broken nose include contact sports, physical fights, falls and motor vehicle accidents that result in injuries to the face.

A broken nose can cause pain, and it is common to get a nosebleed. You may have swelling and bruising around your nose and under your eyes. Your nose may look crooked, and you may have trouble breathing through it.

Treatment for a broken nose may include procedures that realign your nose. Surgery usually isn't necessary.

Symptoms

Signs and symptoms of a broken nose include:

1.Pain or tenderness, especially when touching your nose

2.Swelling of your nose and surrounding areas

3.Bleeding from your nose

4.Bruising around your nose or eyes

5.Crooked or misshapen nose

6.Difficulty breathing through your nose

7.Discharge of mucus from your nose

8.Feeling that one or both of your nasal passages are blocked

Causes

Common causes of a broken nose include:

1.Injury from contact sports, such as football or hockey

2.Physical fights

3.Motor vehicle accidents

4.Falls

A broken nose can even be caused by walking into a fixed object, such as a door or wall, or by rough, wrestling-type play.

Risk factors

Any activity that increases your risk of injuries to the face can increase your risk of a broken nose. Such activities may include:

1.Playing contact sports, such as football and hockey, especially without a helmet that has a face mask

2.Engaging in a physical fight

3.Riding a bicycle

4.Lifting weights, especially if you don't use a spotter

5.Riding in a motor vehicle, especially without a seat belt

Complications

Complications or injuries related to a broken nose may include:

1.Deviated septum. A nose fracture may cause a deviated septum. This condition occurs when the thin wall dividing the two sides of your nose (nasal septum) is displaced, narrowing your nasal passage. Medications, such as decongestants and antihistamines, can help you manage a deviated septum. Surgery is required to correct the condition.

2.Collection of blood. Sometimes, pools of clotted blood form in a broken nose, creating a condition called a septal hematoma. A septal hematoma can block one or both nostrils. It requires prompt surgical drainage to prevent cartilage damage.

3.Cartilage fracture. If your fracture is due to a forceful blow, such as from an automobile accident, you also may experience a cartilage fracture. If your injury is severe enough to warrant surgical treatment, the surgeon should address both your bone and cartilage injuries.

4.Neck injury. If a blow is strong enough to break your nose, it may also be strong enough to damage the bones in your neck. If you suspect a neck injury, seek medical care immediately.

When to see a doctor

Seek emergency medical attention if you experience a nose injury accompanied by:

1.A head or neck injury, which may be marked by severe headache, neck pain, vomiting or loss of consciousness

2.Difficulty breathing

3.Bleeding you can't stop

4.A noticeable change in the shape of your nose that isn't related to swelling, such as a crooked or twisted appearance

5.Clear, watery fluid draining from your nose

Prevention

You can help prevent a nose fracture with these guidelines:

1.Wear your seat belt when traveling in a motorized vehicle, and keep children restrained in age-appropriate child safety seats.

2.Wear the recommended safety equipment, such as a helmet with a face mask, when playing hockey, football or other contact sports.

3.Wear a helmet during bicycle or motorcycle rides.

Treatment

If you have a minor fracture that hasn't caused your nose to become crooked or otherwise misshapen, you may not need professional medical treatment. You may be fine just using ice on the area and taking over-the-counter pain medications.

Manual realignment

If the break has displaced the bones and cartilage in your nose, your health care provider may be able to manually realign them. This needs to be done within 14 days from when the fracture occurred, preferably sooner.

During this procedure, medication will numb your nose. In some cases, health care providers can push the nose back in place with their fingers. Sometimes, they may need to use special tools to help realign the broken bones and cartilage.

Your nose may be splinted with packing on the inside and a dressing on the outside. Sometimes, an internal splint is also necessary for a short time. If used, the packing usually needs to stay in for a week. The dressing may stay on for up to two weeks.

You may also be given a prescription for antibiotics to prevent infection from the bacteria that live in your nose.

Surgery

Severe breaks, multiple breaks or breaks that have gone untreated for more than 14 days may need surgery. Surgery can realign the bones and reshape your nose, if necessary.

If the break has damaged your nasal septum — the middle part of your nose that divides your nostril — your breathing may feel blocked or you may feel like you have a stuffy nose. Reconstructive surgery may be recommended.

Home remedies

If you think you may have broken your nose, take these steps to reduce pain and swelling:

1.Act quickly. When the break first occurs, breathe through your mouth and lean forward to reduce the amount of blood that drains into your throat.

2.Use ice. Apply ice packs or cold compresses immediately after the injury, and then at least four times a day for the first 24 to 48 hours to reduce swelling. Keep the ice or cold compress on for 10 to 15 minutes at a time. Wrap the ice in a washcloth to prevent frostbite. Try not to apply too much pressure, which can cause additional pain or damage to your nose.

3.Relieve pain. Take over-the-counter pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others), as necessary.

4.Keep your head up. Elevate your head — especially when sleeping — so as not to worsen swelling and throbbing.

5.Limit your activities. For the first two weeks after treatment, don't play any sports. Avoid contact sports for at least six weeks after your injury.

Can a broken nose heal on its own?

A broken nose can heal on its own in just a few weeks. But if your nose heals before a healthcare provider realigns it, then you could have permanent complications, such as permanent deformity or difficulty breathing. That's why it's important to seek medical care as soon as possible.

How serious is a nose fracture?

Serious nose injuries cause problems that need a health care provider's attention right away. For example, damage to the cartilage can cause a collection of blood to form inside the nose. If this blood is not drained right away, it can cause an abscess or a permanent deformity that blocks the nose.

Can a broken nose look normal again?

Yes. The goal of repairing the nose is to restore both form and function. The repair corrects the nasal fracture, straighten out the nose and make it look normal again. The repair also opens up the nasal airways, to get you breathing well again.