Health Library Nose InjuriesFrom Healthwise

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 health professionals prefer to evaluate 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 an illustration 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 cannot 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 suspect 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 advisor, 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.
• Difficulty 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, eye injury, or injury to the mouth or teeth, or a cervical spine injury. If you suspect other injuries, use the topics in the Related Information section to evaluate these injuries.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a health professional.

• A person is not breathing or is unconscious. After calling 911 or other emergency services, see the topic Dealing With Emergencies.
• Moderate to severe difficulty breathing:
  • In children
  • In adults and older children
• Signs of shock:
  • In children
  • In adults and older children
• A serious head injury
• Sudden partial or complete vision loss

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

When you have a nose injury, it is important to look for other injuries. If you have any of the following symptoms, evaluate those symptoms first.

• Bleeding from cut skin on the nose: Go to the topic Cuts.
• A head injury or symptoms of a head injury: Go to the topic Head Injury, Age 4 and Older or Head Injury, Age 3 and Younger.
• A neck or spine injury: Go to the topic Neck Problems and Injuries.
• An eye injury or cuts around the eye: Go to the topic Eye Injuries.
• A facial injury: Go to the topic Facial Injuries.
• A mouth or dental injury: Go to the topic Mouth and Dental Injuries.
• An object in the nose: Go to the topic Objects in the Nose.

	Yes	Do you have difficulty breathing, talking, or swallowing after a nose injury?
When to See a Doctor See significance of difficulty breathing if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have mild difficulty breathing? Yes Does your baby age 3 months or younger have any difficulty breathing through the nose, even from nasal stuffiness? Call your health professional today if you answer "Yes" to the following question. Yes Do you have mild difficulty breathing through your nose, but you are able to breathe through your mouth without difficulty? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Does your nose look swollen, crooked, or different than normal after an injury?
When to See a Doctor See significance of a nose looking swollen, crooked, or different than normal if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have a cut or puncture in the skin on your nose? Yes Can you see bone or pieces of bone in your wound, inside your nose, or sticking out of your wound? Yes Have you had an ongoing clear drainage from one or both nostrils? Call your health professional today if you answer "Yes" to the following question. Yes Does your nose look crooked or different than normal (not just swollen), but the skin on your nose is not cut or punctured? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Does your nose look moderately swollen after 72 hours of home treatment? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Have you had any eye or vision changes after an injury to your nose?
When to See a Doctor See significance of eye or vision changes if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Have you had any eye or vision changes after an injury to your nose? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have a nosebleed after an injury to your nose or face? See how to stop a nosebleed.
When to See a Doctor See significance of a nosebleed if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Are you having a moderate to severe nosebleed? Call your health professional today if you answer "Yes" to any of the following questions. Yes Have you had more than 4 episodes of a mild nosebleed in the past 24 hours? Yes Have you been unable to stop a mild nosebleed after applying pressure for 30 minutes? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have pain after a nose injury?
When to See a Doctor See significance of pain if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you have severe pain? Call your health professional today if you answer "Yes" to the following question. Yes Do you have moderate pain that is getting worse? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Do you continue to have moderate pain after 48 hours of home treatment? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to the following question. Yes Do you have mild pain after 1 week of home treatment? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have bruising around your nose or eyes?
When to See a Doctor See significance of bruising if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have bruising around your eyes, but you have not had a direct injury to your eyes or forehead? Yes Do you have bruising behind one or both ears, but you have not had a direct injury to your forehead or ears? Yes Do you have any clear drainage from your nose after an injury? Call your health professional today if you answer "Yes" to the following question. Yes Did a lot of bruising develop within 30 minutes after a nose injury? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you think you have a sinus infection after a nose injury?
When to See a Doctor See significance of sinus infection if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Note: If you need information on how to take a temperature, see the topic Body Temperature. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have a fever of 101 °F (38 °C) or higher? Yes Do you think that you have a mild fever, but you are unable to measure your temperature? Yes Do you have diabetes? Yes Do you have a disease or take a medicine that causes problems with your immune system? Call your health professional today if you answer "Yes" to the following question. Yes Do you have symptoms of a sinus infection but do not have a fever? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Do you have moderate sinus pain after 48 hours of home treatment? Yes Do you have mild sinus pain with yellow or green nasal discharge after 72 hours of home treatment? Yes Have you had yellow nasal discharge for longer than 1 week, but you do not have other symptoms? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to the following question. Yes Have you had nasal stuffiness for longer than 2 weeks, but you do not have other symptoms? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you think you have a skin infection after an injury to the nose?
When to See a Doctor See significance of a skin infection if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have symptoms of a skin infection around one or both eyes? Yes Do you have diabetes? Yes Do you have a disease or take a medicine that causes problems with your immune system? Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have increased pain, swelling, redness, or warmth around your nose? Yes Do you have pus in or around your nose? Yes Do you have a fever? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Have you had swollen glands (lymph nodes) in your neck or behind your ears for 24 hours or longer? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you think a nose injury may have been caused by abuse?
When to See a Doctor See significance of abuse if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you have a nose injury because someone hurt you? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you know or think you need a tetanus shot?
When to See a Doctor See significance of getting a tetanus shot if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Note: If you need a tetanus shot, call your doctor to arrange for the shot as soon as possible. Your need for a tetanus shot depends on the seriousness of your wound and your tetanus shot history. Your doctor may be able to tell you over the telephone if you need a tetanus shot. Call your health professional today if you answer "Yes" to any of the following questions. Yes Were you cut by something clean and your last tetanus shot was longer than 10 years ago? Note: Something is clean if it does not have dirt, soil, spit, or feces on it. Examples include a broken water glass, a kitchen knife, or sewing scissors. Yes Were you cut by something dirty and your last tetanus shot was longer than 5 years ago? Note: Something is dirty if it has dirt, soil, spit, or feces on it. Examples include a garden tool, a dirty nail, or a piece of glass that has been buried in the dirt. Yes Are you not sure if you were cut by something clean or dirty and your last tetanus shot was longer than 5 years ago? Yes Are you not sure when you had your last tetanus shot? Yes Did you not get the first series of tetanus shots (primary vaccination series)? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.

Other Symptoms to Watch For

Do you have any of the following symptoms?

• A puncture, scrape, burn, or bite to the nose: Go to the topic Puncture Wounds, Scrapes, Burns, or Animal and Human Bites.
• A nosebleed not caused by the injury: Go to the topic Nosebleeds.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

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 suspect 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.
• For the first 48 hours, avoid things that might increase swelling, such as hot showers, hot tubs or hot packs, or drinking alcohol.
• After 48 to 72 hours, if swelling is gone, apply warmth to the area that hurts. You can use a hot water bottle, warm towel, or a heating pad set on low. To avoid burning your skin, do not apply anything that is uncomfortably warm.
• Do not smoke. Smoking slows healing because it decreases blood supply and delays tissue repair. For more information, see the topic Quitting Tobacco Use.

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.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment:

• Eye or vision changes develop.
• Fever, headache, dizziness, facial numbness, difficulty in tasting food, or vomiting with blood develops.
• Clear drainage from one or both nostrils develops.
• A skin infection develops.
• A sinus problem develops.
• Symptoms do not improve with home treatment.
• Symptoms become more severe or frequent.

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.

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

You can help your health professional 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 evaluated by a health professional? 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? Be sure to include any nonprescription medicines you have taken. Did they help?
• Do you have any health risks?

• Animal and Human Bites
• Body Piercing Problems
• Burns
• Child Abuse and Neglect
• Cuts
• Dealing With Emergencies
• Eye Injuries
• Facial Injuries
• Facial Problems, Noninjury
• Head Injury, Age 3 and Younger
• Head Injury, Age 4 and Older
• Mouth and Dental Injuries
• Nosebleeds
• Objects in the Nose
• Puncture Wounds
• Scrapes
• Shock
• Sinusitis

Author:	Jan Nissl, RN, BS	Last Updated: April 20, 2007
Medical Review:	William M. Green, MD - Emergency Medicine Charles M. Myer, III, MD - Otolaryngology
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