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.

When to see a doctor

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

• A head or neck injury, which may be marked by severe headache, neck pain, vomiting or loss of consciousness
• Difficulty breathing
• Bleeding you can't stop
• A noticeable change in the shape of your nose that isn't related to swelling, such as a crooked or twisted appearance
• Clear, watery fluid draining from your nose

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:

• Playing contact sports, such as football and hockey, especially without a helmet that has a face mask
• Engaging in a physical fight
• Riding a bicycle
• Lifting weights, especially if you don't use a spotter
• Riding in a motor vehicle, especially without a seat belt

Prevention

You can help prevent a nose fracture with these guidelines:

• Wear your seat belt when traveling in a motorized vehicle, and keep children restrained in age-appropriate child safety seats.
• Wear the recommended safety equipment, such as a helmet with a face mask, when playing hockey, football or other contact sports.
• 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.

Preparing for your appointment

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

If the injury to your nose is less severe — accompanied only by swelling and moderate pain — you may choose to wait before seeking care. This allows time for the swelling to subside, making it easier to evaluate your injury.

However, it's best not to wait longer than 3 to 5 days before seeing your health care provider if your signs and symptoms persist. During this waiting period, get medical attention if:

• The pain or swelling doesn't progressively improve
• Your nose looks misshapen or crooked after the swelling recedes
• You can't breathe well through your nose even after the swelling subsides
• You experience frequent, recurring nosebleeds
• You're running a fever

When you make an appointment, you may start by seeing your primary care provider. He or she may refer you to a specialist in disorders of the ear, nose and throat.

Here's some information to help you get ready for your appointment, and to know what to expect.

What you can do

• Write down any symptoms you're experiencing and what you were doing at the time of the injury.
• Make a list of all medications, 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 health care provider. 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?
• Do I need surgery?
• Do I need to restrict my activity?
• What type of pain medication can I take?
• Are there any brochures or other printed materials that I can take home? What websites do you recommend for additional information?

What to expect from your doctor

Your health care provider may ask:

• How and when did your injury occur?
• Have your symptoms improved at all since the time of the injury?
• Does your nose look the same or different to you?
• Can you easily breathe through your nose?
• Do you participate in contact sports? If so, how long do you plan on participating in this sport?