Signs your nose may be broken
- Pain and tenderness, especially when touching the bridge.
- Swelling of the nose and around it.
- Bruising around the nose and under the eyes (“black eyes”).
- A nosebleed at the time of injury.
- A crooked, bent or flattened nose.
- Difficulty breathing through one or both nostrils.
- A crunching or grating sensation when the nose is touched.
Bruised or broken?
A bruised nose is painful and swollen but keeps its shape and you can breathe through both sides once the swelling settles. A broken nose more often looks crooked, crunches when touched or stays blocked on one side. Swelling in the first days can hide a deformity or make a straight nose look bent, which is why a check after 5 to 7 days is useful.
X-rays are rarely helpful for nose fractures; examination by an experienced clinician is more reliable. CT scans are used when other facial bones may be broken.
What to do straight away
- Sit up and lean forward to stop blood running down the throat.
- Pinch the soft part of the nose for 10 to 15 minutes without letting go; see how to stop a nosebleed.
- Apply an ice pack wrapped in a cloth for 10 to 15 minutes several times a day.
- Keep your head raised, including at night.
- Take paracetamol for pain; avoid blowing the nose for a few days.
- Do not try to straighten the nose yourself.
When to go to the emergency department
- A nosebleed that does not stop after 15 to 20 minutes of pressure.
- Clear, watery fluid dripping from the nose, which may be fluid from around the brain.
- Head injury with headache, drowsiness, vomiting or confusion.
- Difficulty breathing.
- Other facial injuries, double vision or difficulty opening the mouth.
- A swelling inside the nose blocking one or both nostrils.
Septal haematoma: a complication not to miss
Bleeding can collect between the septum, the wall dividing the nose, and its lining, forming a soft, swollen, often purple bulge that blocks the nostrils. If left untreated, it can become infected and destroy the septal cartilage, causing the bridge of the nose to collapse (saddle nose).
A septal haematoma needs to be drained urgently by an ENT doctor. It is more common in children, so any child with a blocked nose after injury should be examined.
The ENT review and resetting the nose
When the swelling has settled, usually after 5 to 7 days, an ENT specialist checks the shape of the nose and breathing. If the nose is crooked, the bones can be moved back into place under local or general anaesthetic, a procedure called manipulation under anaesthetic (MUA). This works best within about 2 weeks of injury in adults, and sooner in children, before the bones set.
If the nose heals crooked or breathing remains blocked, a septorhinoplasty can be done months later. See deviated septum.
Healing and recovery time
- Pain and swelling improve over 1 to 2 weeks.
- Bruising around the eyes fades in about 2 weeks.
- The bones are fairly stable after about 3 weeks and fully healed in about 6 weeks.
- Avoid contact sports for at least 6 weeks; protective face guards are available.
- Some swelling and stiffness of the nose can last for a few months.
Broken nose in children
Children’s noses are made mostly of cartilage and can be injured without obvious deformity. They are more prone to septal haematoma and their bones set faster, so they should be seen promptly. Injuries to the nose in childhood can occasionally affect nasal growth.
Breathing problems after a broken nose
Some people notice that one side of the nose stays blocked after a fracture, because the septum has been bent or the bones have narrowed the airway. This may only become obvious when the swelling has gone. Nasal steroid sprays and saline can help with swelling, but a persistent blockage is assessed by an ENT specialist. See stuffy nose.
Warning signs
- Clear fluid from the nose or a salty taste after a head injury.
- Swelling inside the nose.
- Persistent bleeding.
- Fever, increasing pain or redness, suggesting infection.
- Changes in vision or eye movement.
Key points to remember
- Pain, swelling, bruising, a crooked nose and blocked breathing suggest a fracture.
- Stop bleeding by leaning forward and pinching the soft part of the nose.
- Get an ENT check within a week; resetting works best within 2 weeks.
- Septal haematoma and clear fluid from the nose need urgent care.
Questions about broken noses
These answers are general information and do not replace an examination or individual medical advice.
Can a broken nose heal on its own?
Yes, if it is not displaced. A crooked nose may need to be reset within about 2 weeks.
Do I need an X-ray for a broken nose?
Usually not. Examination is more useful.
How long does a broken nose take to heal?
About 3 to 6 weeks for the bones; swelling can take longer.
Can you breathe with a broken nose?
Often yes, but breathing may be blocked on one or both sides.
Why do I have black eyes after hitting my nose?
Blood from the injury tracks under the skin around the eyes.
How should I sleep with a broken nose?
On your back with your head raised on pillows.
When can I play sport after a broken nose?
Contact sport is usually avoided for at least 6 weeks.
Sources
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.