Broken nose: symptoms, treatment and when to get help

The NHS says symptoms of a broken nose include pain, swelling and bruising, a crunching or crackling sound when you touch your nose, difficulty breathing through the nose (it might feel blocked), and the nose changing shape, for example it is not as straight as before.

A broken nose may cause bruising under the eyes, which is often described as black eyes. You may also have a cut on the bridge of the nose, or a nosebleed.

Swelling can make it hard to judge the shape of the nose in the first days after an injury, which is why the NHS gives a timeline for when to seek help rather than relying on appearance alone.

The NHS says you can usually treat a broken nose yourself. It should start getting better within 3 days and be fully healed within 3 weeks.

• Hold an ice pack (or a bag of frozen peas) wrapped in a tea towel on your nose for up to 15 minutes, several times a day.

• Take paracetamol to relieve pain.

• Treat nosebleeds by sitting or standing upright and leaning forward; if possible, pinch your nose above the nostrils for up to 15 minutes.

• Keep your head upright when lying in bed by adding more pillows, which helps to reduce swelling.

• Treat minor cuts and grazes by stopping any bleeding, cleaning the wound and covering it with a plaster or dressing.

The NHS lists things to avoid after a broken nose.

• Do not try to straighten your nose yourself if it has changed shape; get help from NHS 111.

• Do not wear glasses until the swelling has gone down, unless you need them.

• Do not pick or blow your nose until it has healed.

• Do not do strenuous exercise for the first 2 weeks.

• Do not play sports for at least 6 weeks if there is a chance your face might be hit.

The NHS says to get help from NHS 111 if you think you have broken your nose and your nose is crooked after the injury, the swelling has not started to go down after 3 days, painkillers are not helping, you are still finding it difficult to breathe through your nose after the swelling has gone, you are having regular nosebleeds, or you have a very high temperature or feel hot, cold or shivery.

It says to call 999 or go to A&E if you have a broken nose and a nosebleed that will not stop, a large cut or open wound on the nose or face (or something in the wound, such as glass), clear watery fluid trickling from the nose (which could be a sign of a serious head injury), a severe headache with blurred or double vision, eye pain and double vision, neck pain or a stiff neck with numbness or tingling in the arms, a purple swelling inside the nose that may be painful or block breathing, or other signs of a severe head injury such as vomiting, collapsing or difficulty speaking.

Do not drive yourself to A&E. The NHS says to ask someone to drive you or call 999 and ask for an ambulance, and to bring any medicines you take.

A University Hospitals Sussex leaflet says doctors usually diagnose a broken nose by examining the nose and the area around it. X-rays are not usually required because nasal bones do not show clearly on standard X-rays. If imaging is needed, it is usually to check for other facial injuries, such as injuries to the eye sockets, cheekbones or jaw.

The same trust says staff will check that there is no bleeding or blood clot inside the nose, and that you can breathe through both nostrils. A swollen nasal septum (the wall between the nostrils) may need urgent treatment. Tell staff if you take blood-thinning medicines such as warfarin, apixaban or rivaroxaban, or if you lost consciousness, vomited or cannot remember the injury.

The NHS says a GP might prescribe stronger painkillers if paracetamol is not helping. If you have a severe broken nose or it has changed shape, you may be referred to a specialist in hospital for assessment and treatment.

If your nose has changed shape, a hospital doctor may be able to make it straighter using a procedure called manipulation. You might have to go home and wait for the swelling to go down first, but the NHS says the procedure should be done within 3 weeks of the break, before the bones start to set. It is done with local anaesthetic so your nose is numbed. It does not always make your nose look exactly as it was before, but it often helps.

If you have a large wound, the NHS says it will usually be cleaned and sealed with stitches or strips in hospital.

University Hospitals Sussex describes a typical hospital pathway: ice and simple painkillers such as paracetamol or ibuprofen, antibiotics if there is a cut or a drained blood clot, and an ENT follow-up appointment 5 to 7 days later once swelling has reduced, where the doctor decides whether the nose needs resetting with a minor procedure. If an operation is needed, it is usually done 1 to 2 weeks after the injury. Local arrangements vary, so follow the advice you are given.

Using the NHS timings, a broken nose should begin improving within 3 days and be fully healed within 3 weeks. The windows matter: if swelling has not begun to go down by day 3, or the nose is crooked, NHS 111 should be contacted, and any manipulation should happen within 3 weeks, before the bones set.

On the NHS, a broken nose is usually assessed through NHS 111, a GP or an urgent treatment centre, with referral to a hospital ENT or other specialist team if the nose has changed shape or breathing is affected. Some people choose private ENT consultation for assessment. The key point is timing: any realignment procedure needs to take place within about 3 weeks of the injury, so do not wait to seek advice if the nose looks crooked.