Broken nose

Overview

A broken nose, also called a nasal fracture, is a crack or break in one of the bones in the nose. Typically, the bone at the bridge of your nose is the one that breaks.

Common causes of a broken nose include contact sports, physical fights and falls. Motor vehicle accidents that injure the face also may cause a nose to break.

A broken nose can be painful and often causes 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.

Most broken noses don't require surgery. Treatment often involves procedures to realign the nose to help it heal properly.

When to see a doctor

Seek emergency medical care if you experience a nose injury along with any of the following symptoms:

• A possible head or neck injury with symptoms such as a severe headache, neck pain, vomiting or loss of consciousness.
• Trouble breathing.
• Bleeding that won't stop.
• A noticeable change in the shape of your nose that doesn't seem to be caused by swelling, such as a crooked or twisted look.
• Clear, watery fluid draining from your nose.

Risk factors

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

• Playing sports such as soccer, basketball and baseball.
• Playing contact sports, such as football and hockey, especially without a helmet and face mask.
• Getting into a physical fight.
• Lifting weights without a spotter for safety.
• Riding a bicycle, especially without a helmet.
• Riding in a car without wearing a seat belt.
• Riding a motorcycle or an all-terrain vehicle.
• Riding an electric scooter.

Prevention

You can reduce the risk of a nose fracture by following these safety tips:

• Always wear a seat belt when riding in a car. Make sure children are in the right car seat or booster seat for their age and size.
• Wear proper safety equipment, such as a helmet and face mask, when playing hockey, football or other contact sports.
• Wear a helmet when riding a bicycle or motorcycle to protect your head and face in case of a fall or crash.

Treatment

If the fracture is minor and your nose isn't crooked or misshapen, you may not need medical treatment. In many cases, using ice to lessen swelling and taking pain medicine you can buy without a prescription is enough to help you heal.

Manual realignment

If the break has shifted the bones or cartilage in your nose, your healthcare professional may need to realign them. This procedure is called reduction. It needs to be done within 14 days of the injury, and preferably sooner for the best results.

To keep you comfortable during the procedure, you get numbing medicine. Typically, a healthcare professional can move the bones gently back into place by hand. Sometimes special tools may be needed to help realign the broken bones and cartilage.

After the procedure, your nose may need to be splinted to hold it in place while it heals. This can include:

• Packing inside the nose.
• A dressing or splint on the outside of the nose.
• An internal splint, which is left in place temporarily.

Typically, the packing used for splinting stays in for about one week. The external dressing may stay on for up to two weeks.

You also may be prescribed antibiotics to prevent infection, since the nose naturally has bacteria.

Surgery

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

The nasal septum is the middle part of your nose that divides your nostrils. If the injury damaged that area, you may feel like your nose is blocked or constantly stuffy. Surgery may be needed to reconstruct your nose to improve your breathing and correct the damage.

Preparing for your appointment

If your injury is serious, you won't have time to prepare for your appointment because you'll need to seek medical attention right away.

If the injury to your nose is less serious and you have only swelling and moderate pain, you may choose to wait before seeking care. This allows time for the swelling to lessen, making it easier to evaluate the injury.

If your symptoms don't start to improve, it's best to see a healthcare professional within 3 to 5 days of the injury. Get medical help right away if:

• The pain or swelling isn't getting better.
• Your nose looks misshapen or crooked after the swelling goes down.
• You can't breathe well through your nose, even after the swelling lessens.
• You have frequent nosebleeds.
• You develop a fever.

When you make an appointment, you typically start by seeing your primary healthcare professional. Depending on your injury, you may be referred to a specialist in conditions of the ear, nose and throat.

What you can do

• Write down any symptoms you're having and what you were doing at the time of the injury.
• Make a list of all medicines, vitamins and supplements you're taking.
• Bring a photo of yourself before the injury for comparison, if possible.
• Write down questions to ask.

Preparing a list of questions can help you make the most of your time with your healthcare professional. For a broken nose, here are some basic questions to ask:

• Do I need any tests, such as X-rays?
• How long will the swelling and bruising last?
• Will my nose look the same after it heals?
• Do I need surgery?
• Do I need to restrict my activity?
• What type of pain medicine can I take?
• Are there any brochures or other printed materials that I can take home? What websites do you recommend for more information?

What to expect from your doctor

Your healthcare professional may ask:

• How and when did your injury occur?
• Have your symptoms improved at all since the time of the injury?
• Is there clear nasal drainage?
• Does your nose look the same or different to you?
• Can you easily breathe through your nose?
• Do you take part in contact sports? If so, do you plan to return to participating in contact sports?