Diagnosis

Your doctor may press gently on the outside of your nose and its surrounding areas. He or she may look inside your nasal passage to check for obstruction and further signs of broken bones. Your doctor may use anesthetics — either a nasal spray or local injections — to make you more comfortable during the exam.

X-rays and other imaging studies are usually unnecessary. However, your doctor may recommend a computerized tomography (CT) scan if the severity of your injuries makes a thorough physical exam impossible or if your doctor suspects you may have other injuries.

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. Your doctor may recommend simple self-care measures, such as using ice on the area and taking over-the-counter pain medications.

Fixing displacements and breaks

Your doctor may be able to realign your nose manually, or you may need surgery.

Manual realignment

If the break has displaced the bones and cartilage in your nose, your doctor 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, your doctor:

  • Administers medication by injection or nasal spray to ease discomfort
  • Opens your nostrils with a nasal speculum
  • Uses special instruments to help realign your broken bones and cartilage

Your doctor will also splint your nose using packing in your nose and a dressing on the outside. Sometimes, an internal splint is also necessary for a short time. The packing usually needs to stay in for a week. You'll also be given a prescription for antibiotics to prevent infection with the bacteria that may normally reside in your nose.

Surgery

Severe breaks, multiple breaks or breaks that have gone untreated for more than 14 days may not be candidates for manual realignment. In these cases, surgery to realign the bones and reshape your nose may be necessary.

If the break has damaged your nasal septum, causing obstruction or difficulty breathing, reconstructive surgery may be recommended. Surgery is typically performed on an outpatient basis.

Lifestyle and home remedies

If you think you may have broken your nose, take these steps to reduce pain and swelling before seeing your doctor:

  • Act quickly. When the break first occurs, breathe through your mouth and lean forward to reduce the amount of blood that drains into your throat.
  • Use ice. Apply ice packs or cold compresses immediately after the injury, and then at least four times a day for the first 24 to 48 hours to reduce swelling. Keep the ice or cold compress on for 10 to 15 minutes at a time. Wrap the ice in a washcloth to prevent frostbite. Try not to apply too much pressure, which can cause additional pain or damage to your nose.
  • Relieve pain. Take over-the-counter pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others), as necessary.
  • Keep your head up. Elevate your head — especially when sleeping — so as not to worsen swelling and throbbing.
  • Limit your activities. For the first two weeks after treatment, don't play any sports. Avoid contact sports for at least six weeks after your injury.

Preparing for your appointment

If your injury is severe, you'll need to seek immediate medical attention and won't have time to prepare for your appointment. But, if the injury to your nose is less severe — accompanied only by swelling and moderate pain — you may choose to wait before seeing your doctor. This allows time for the swelling to subside, so you and your doctor can better evaluate your injury.

However, it's best not to wait longer than three to five days before seeing your doctor if your signs and symptoms persist. And 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 efficiently through your nose even after the swelling subsides
  • You experience frequent, recurring nosebleeds
  • You're running a fever

When you make an appointment, you'll probably start by seeing your primary care doctor. However, he or she is likely to refer you to a doctor who specializes 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 from your doctor.

What you can do

  • Write down any symptoms you're experiencing, and let your doctor know 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 your doctor.

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

  • 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 material that I can take home? What websites do you recommend for additional information?

What to expect from your doctor

Your doctor 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 normal 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?
June 18, 2014
References
  1. Stone CK, et al., eds. Current Diagnosis & Treatments: Emergency Medicine. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://accessmedicine.mhmedical.com/content.aspx?bookid=385&Sectionid=40357238. Accessed April 14, 2014.
  2. Mayersak R. Facial trauma in adults. http://www.uptodate.com/home. Accessed April 14, 2014.
  3. Mendez DR, et al. Nasal trauma and fractures in children. http://www.uptodate.com/home. Accessed April 14, 2014.
  4. Fractures of the nose. The Merck Manuals: The Merck Manual for Health Care Professionals. http://www.merckmanuals.com/professional/injuries_poisoning/facial_trauma/fractures_of_the_nose.html. Accessed April 18, 2014.
  5. Doherty GM. eds. Current Diagnosis & Treatment: Surgery. 13th ed. New York, N.Y.: The McGraw-Hill Companies; 2010. http://accessmedicine.mhmedical.com/content.aspx?bookid=343&Sectionid=39702829. Accessed April 14, 2014.
  6. Nasal fractures. American Academy of Otolaryngology — Head and Neck Surgery. http://www.entnet.org/HealthInformation/Nasal-Fractures.cfm. Accessed April 24, 2014.
  7. Blum DJ (expert opinion). Mayo Clinic, Rochester, Minn. April 23, 2014.