21 Aug 2023

Broken Nose (Nasal Fracture) – Advice, Recovery & Red Flags

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Understanding your injury

You have injured your nose. This is called a nasal fracture (a broken nose).
The nose is made of bone and cartilage. A direct blow can cause swelling, bruising and sometimes a shift in position. This can affect how your nose looks or how easily you can breathe through it.

Today we have:

  • Assessed your injury
  • Checked for a nasal septal haematoma (a blood collection inside the nose that needs urgent treatment
  • Managed bleeding
  • Possibly gently realigned (reduced) the nose if needed

Even if the nose has been straightened, swelling can make it look uneven for several days.

It is normal to have:

  • Swelling for 3–7 days
  • Bruising around the nose and under the eyes
  • Mild bleeding or blood-stained mucus for 24–48 hours
  • Nasal blockage
  • Mild headache or facial tenderness

Swelling usually improves over 1–2 weeks.
Breathing should gradually improve as swelling settles.

Sometimes you will have (these are not emergencies):

  • Ongoing blockage on one side after swelling settles (if the septum is no longer central)
  • Visible deformity once swelling has reduced (even ‘set’ nasal fractures can ‘settle back’ and not be cosmetically ideal)
  • Persistent pain beyond 2 weeks

If these occur, see your GP within 5–7 days for review. You may need referral to an Ear, Nose and Throat specialist.

  • Rest
  • Keep your head elevated (including when sleeping)
  • Apply ice packs for 10–15 minutes every 1–2 hours while awake
  • Avoid blowing your nose
  • Avoid heavy lifting or straining
  • Avoid alcohol for 24 hours

For pain:

  • Use paracetamol
  • Avoid ibuprofen for the first 24 hours if there was significant bleeding

If your nose starts bleeding:

  • Sit upright
  • Lean forward
  • Pinch the soft part of the nose firmly for 10 minutes
  • Do not check before 10 minutes
  • Avoid contact sport for at least 4–6 weeks
  • Avoid situations where your nose could be knocked
  • Do not attempt to straighten the nose yourself
  • Avoid nose blowing for at least 3–5 days

If swelling hides a deformity, reassessment is usually done at 5–7 days, once swelling reduces but before the bone fully sets.

You may return to light non-contact activity once:

  • Pain is controlled
  • No active bleeding
  • Vision is normal
  • You feel steady and comfortable

For contact or collision sport (including equestrian competition):

  • Wait at least 4–6 weeks
  • Ensure no nasal blockage affecting breathing
  • Ensure no ongoing tenderness
  • Consider protective face equipment where appropriate

If there was any head impact or concern for concussion, follow concussion return-to-ride guidance separately.

Call 000 or go to the nearest Emergency Department if:

  • You develop fever and increasing facial pain
  • The nose becomes rapidly more swollen or very painful inside
  • You develop increasing blockage on one side
  • There is persistent bleeding that does not stop after 20 minutes of pressure
  • You have clear watery fluid dripping from the nose
  • You develop worsening headache, vomiting, or confusion
  • You notice double vision or difficulty moving your eyes
  • See your GP within 5–7 days for reassessment
  • Earlier review if breathing worsens
  • ENT referral may be needed if deformity or obstruction persists

In Australia – Healthdirect: 1800 022 222
Or, call or visit your local GP or Emergency Department.

NB: This advice is based on Australian emergency and sports medicine guidance and is believed to be accurate at the time of publishing, if It is not intended for use outside the specifically stated use, and only by people explicitly directed to follow it by the doctor representing DeployED at an event, who has assessed the person concerned. Consequently, DeployED disclaims any liability arising from the improper or unintended use of this information. This information is provided in good faith.
DeployED Discharge Advice v1.1
Review due: February 2027
Annual clinical review cycle

Follow Dr Stuart McLay:

Emergency Physician

Dr Stuart McLay is passionate about the delivery of exceptional care, everywhere. He is the founder of DeployED, a Fellow of the Australasian College of Emergency Medicine (FACEM - an Emergency Physician), a Core trainee of the College for Intensive Care Medicine, and a Mass Gathering Medicine / Expedition Medicine enthusiast. He's also a husband to 1, and father to 3, and a great annoyance to many.