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Nose Injuries

Topic Overview

Nose injuries often occur during play, sports, accidents, fights, and falls. Pain, swelling, and bruising are common, even with minor injuries. Home treatment can usually help relieve your symptoms.

It may be hard to tell if your nose is broken. Swelling can make your nose look crooked even if it is not broken. When the swelling goes down after a few days, it is easier to tell if your nose is really crooked. Most doctors prefer to check an injured nose soon after the swelling has gone down. Sometimes, testing may be needed, such as an X-ray or computed tomography (CT) scan of the head, if other facial injuries or fractures are suspected. See a picture of a broken nose .

Seriousness of a nose injury

Whether or not your nose is broken, a nose injury is more serious when:

  • You have a nosebleed that you can't stop. See how to stop a nosebleed .
  • The skin of your nose is cut or punctured, especially if you think your nose may be broken. This increases your risk of infection.
  • A blood clot forms in the tissue that separates the nostrils ( septum ). This can create a hole (perforation) in the septum or cause the bridge of the nose to collapse (saddle nose deformity).
  • You think the injury may have been caused by abuse. Physical abuse often causes bruises, burns, fractures, head injuries, and other injuries. If you suspect abuse, seek help. You can call a local child or adult protective services agency, the police, a spiritual adviser, or a health professional such as a doctor, nurse, or counselor.
  • You have persistent drainage from one or both nostrils. This may be caused by cerebrospinal fluid (CSF) draining from the brain into the nose (CSF rhinorrhea) and can occur after a head injury or after surgery on the nose or ears. There is a chance you may get a CSF infection, such as meningitis , which can affect the nervous system and be life-threatening.

Complications of a broken nose

Most broken noses heal without problems. When problems develop, they can include:

  • A change in the size or shape of the nose, or a crooked or bent nose. Multiple nose injuries, especially during childhood, increase the risk of damage to the tissues and structures in the nose. This can cause long-term problems.
  • Trouble breathing or nasal stuffiness.
  • An infection of the nose, sinuses , or bones in the face.
  • An abnormality in the tissue that separates the nostrils ( deviated nasal septum ).
  • A hole (perforation) in the septum.
  • Severe infection, such as meningitis or a brain abscess , or other CSF infection.

Treatment

Treatment of a simple fracture, when the bone is still in place, usually includes pain medicine and nasal decongestants. You may or may not need a nasal splint.

If your nose is broken and out of place, it may need to be set. Most doctors like to wait for any swelling to go down before setting a broken nose. Most swelling goes down after 2 or 3 days but may take as long as 7 to 14 days. After the nose is set, nasal packing may be inserted and a splint may be applied. You may be given antibiotics to help prevent infection if packing is used. Your doctor may want to recheck your nose and remove the packing in 2 to 3 days.

When you have a nose injury, it is important to look for other injuries to the head, face, and neck, such as a broken cheekbone, an eye injury, an injury to the mouth or teeth, or a cervical spine injury. If you think there are other injuries, use the topics in the Related Information section to evaluate these injuries.

Check your symptoms to decide if and when you should see a doctor.

Check Your Symptoms

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Home Treatment

First aid measures are important after a nose injury.

  • Stop a nosebleed . Crying can make a nosebleed worse. If your child has a nosebleed and is crying, speak to the child in a quiet, relaxed manner. This will help reduce the child's fear. For more information, see the topic Nosebleeds.
  • If you think that the nose is broken, do not try to put a crooked nose back in place. This may increase bleeding or deformity or cause further injury.

Measures to reduce pain, swelling, and bruising

  • Use ice. Cold will reduce pain and swelling. Apply an ice or cold pack immediately to prevent or minimize swelling. Apply the ice or cold pack for 10 to 20 minutes, 3 or more times a day. Always keep a cloth between your skin and the ice pack, and press firmly against all the curves of the affected area. Do not apply ice for longer than 20 minutes at a time, and do not fall asleep with the ice on your skin.
  • Keep your head elevated, even while you sleep. This will help reduce swelling.
  • Do not take aspirin for the first 48 hours. Aspirin prolongs the clotting time of blood and may cause more nose or facial bleeding. Also, do not give aspirin to anyone younger than 20 because of the risk of Reye syndrome , a rare but serious disease.
  • Do not smoke. Smoking slows healing because it decreases blood supply and delays tissue repair. For more information, see the topic Quitting Smoking.

Measures to relieve nasal stuffiness and promote sinus drainage

  • Drink plenty of fluids. Extra fluids help keep mucus thin and draining, which may help prevent blockage of the sinuses.
  • Try a nonprescription decongestant, such as Sudafed PE, or use saline nasal sprays or drops to relieve nasal stuffiness.
  • Use a humidifier to keep the air in your home moist. You may want to purchase a small humidifier to use in your bedroom while you sleep.
  • Inhale steam from a vaporizer, or take long, steamy showers. You may also try breathing the moist air from a bowl of hot water. Put a towel over your head and the bowl to trap the moist air.
Medicine you can buy without a prescription
Try a nonprescription medicine to help treat your fever or pain:

Talk to your child’s doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

Safety tips
Be sure to follow these safety tips when you use a nonprescription medicine:
  • Carefully read and follow all directions on the medicine bottle and box.
  • Do not take more than the recommended dose.
  • Do not take a medicine if you have had an allergic reaction to it in the past.
  • If you have been told to avoid a medicine, call your doctor before you take it.
  • If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to.
  • Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • Eye or vision changes develop.
  • A skin infection develops.
  • A sinus problem develops.
  • Symptoms do not improve with home treatment.
  • Symptoms become more severe or frequent.

Prevention

While not all nose injuries can be prevented, you can take steps to help reduce your risk of a nose injury.

  • Wear a helmet and face guard to protect your head, face, and mouth during sports activities in which facial injuries may occur.
  • Always use car safety seats and seat belts to prevent or reduce nose and facial injuries during a car accident.
  • Wear a face shield when you work with power tools or when you do an activity that might cause an object to fly into your face.

Reduce your child's risk of injury

You can take steps to help reduce your young child's risk of a nose injury.

  • Never leave your child unattended in a high place, such as on a tabletop; in a crib with the sides down; on elevated porches, decks, and landings; or even on a bed or sofa.
  • Do not leave your child alone in any infant seat or sitting toy, such as a swing or jumper. Use all of the safety straps provided.
  • Use stair gates to block stairways. Install gates at the top and bottom of the stairs, and use the gates properly.
  • Do not use baby walkers. Baby walkers have caused many injuries and are not safe even if the baby is watched closely.
  • Watch your child when he or she is outside. Uneven grass, sloping lawns, and hills may be difficult for your child to walk on.
  • Make your home safe from falls by removing hazards that might cause a fall, such as throw rugs.
  • Place your child in an approved child car seat when traveling in a car. Follow the manufacturer's directions for securing the seat in the car. Children should ride in the back seat for safety.
  • Have your children wear helmets when necessary, such as when they are passengers on a bike or are riding a tricycle or bicycle on their own.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • What are your main symptoms? How long have you had your symptoms?
  • How and when did an injury occur? How was it treated?
  • Have you had a nose injury in the past?
    • Was your injury checked by a doctor? What was the diagnosis?
    • How was your injury treated?
    • Do you have any continuing problems because of the previous injury?
  • What activities related to sports, work, or your lifestyle make your symptoms better or worse?
  • Do you think activities related to your job or hobbies caused your symptoms?
  • Was this injury intentionally caused by another person?
  • Was the use of alcohol or drugs involved in your injury?
  • What home treatment measures have you tried? Did they help?
  • What nonprescription medicines have you tried. Did they help?
  • Do you have any health risks?

Credits

By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer H. Michael O'Connor, MD - Emergency Medicine
Last Revised March 22, 2011

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