Broken or Bruised Nose, No X-Ray

Based on your exam today, you have swelling and a bruise (contusion) in your nose. You likely have pain, swelling, and nasal stuffiness. You may also have bleeding from the nose. By tomorrow, you may have bruising around your eyes. A minor break (fracture) of the bone or cartilage may also have occurred. This generally isn’t serious. It is treated the same way as a bruise. A nose bruise will heal in about 1 to 2 weeks. A minor break will heal in about 3 to 4 weeks.

If your nose looks crooked after the swelling goes down, then you likely have a break. A broken bone that changes the shape of the nose or causes trouble breathing may need to be treated by a surgeon. This might be an ENT or plastic surgeon. He or she can straighten the bones in your nose. A nose break isn’t treated until the swelling goes down, so the surgeon can see whether the nose is back into position. For a break with bones out of place, surgery to put the bones back into place (reduction) should be done 6 to 10 days after the injury. In children, it should be done 3 to 7 days after the injury. After that time, the bones become harder to move back into position.

Home care

  • You can keep doing most daily activities, but be careful when doing them. Try not to lift anything heavy unless your doctor says it's OK.

  • To ease pain and swelling, put a cold pack on your nose for 15 to 20 minutes at a time. Do this every 2 hours the first day. Then reduce to 3 to 4 times a day for the next 2 days. After that, use it as needed. You can make your own cold pack by using ice in a bag or a bag of frozen peas. Be sure to wrap the cold source in a thin towel. Don't put it directly on your skin.

  • Tell your doctor if you are taking aspirin or blood thinners (warfarin). These medicines make it more likely that your nose will bleed. Your dose may need to be changed.

  • To control pain, use medicine as recommended by the healthcare provider. You may be told to use over-the-counter ibuprofen or naproxen. If you have ulcers or bleeding problems talk with your healthcare provider before using these medicines.

  • Don’t drink alcohol or hot liquids for the next 2 days. These can dilate blood vessels in your nose and cause bleeding.

  • Don’t blow your nose for the first 2 days. After that, do so gently to prevent bleeding.

  • Don’t play contact sports for the next 6 weeks or until your doctor says it's OK to return. 

Note about concussion

Because the injury was to your head, it is possible that you could have a mild brain injury (concussion). Symptoms of concussion can show up later. For this reason, be alert for symptoms of a concussion. Seek emergency medical care if any of these develop over the next hours to days:

  • Headache

  • Nausea or vomiting

  • Dizziness

  • Sensitivity to light or noise

  • Unusual sleepiness or grogginess

  • Trouble falling asleep

  • Personality changes

  • Vision changes

  • Memory loss

  • Confusion

  • Trouble walking or clumsiness

  • Loss of consciousness (even for a short time)

  • Inability to be awakened

Follow-up care

Follow up with your healthcare provider, or as advised. If you were referred to a surgeon, make that appointment soon. Be sure to see a surgeon if your nose looks crooked after the swelling goes down or if it’s still hard to breathe through one or both sides of your nose. If you have trouble getting an appointment, call your regular doctor.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

  • Bleeding from your nose even after you have pinched your nostrils together for 15 minutes

  • Swelling, pain, or redness on your face that gets worse

  • Fever of 100.4ºF (38ºC) or higher, or as directed by your healthcare provider

  • Chills

  • Unable to breathe from both sides of the nose after swelling goes down

  • Sinus pain

Call 911

Call 911 for any of the following:

  • Trouble breathing or shortness of breath

  • Severe or worsening headache or dizziness

  • Seizure

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