Medicines for Broken nose

What it is

A broken nose (nasal fracture) is a break or crack in the bone or cartilage of the nose. It is one of the most common facial injuries, and usually happens from a knock or blow to the nose — for example during sports, falls, fights, or accidents. The symptoms of a broken nose can include: pain and tenderness; swelling of the nose and around the eyes; bruising, including sometimes bruising around the eyes ("black eyes"); a nosebleed; a blocked or stuffy nose, or difficulty breathing through the nose; a crunching or crackling sound or feeling; and, in some cases, the nose looking crooked, bent, or out of shape (though swelling can make this hard to judge at first). Because the nose swells quickly after an injury, it can be difficult to tell straight away whether it is broken or how bent it is, and the swelling often needs to settle (over several days) before the shape can be properly assessed. Many broken noses are not serious and heal on their own without specific treatment, with self-care to manage pain, swelling, and any bleeding. Treatment is mainly needed if the nose is noticeably bent or out of shape, or if breathing through the nose is affected — in which case the nose may be realigned (straightened), usually best done within a couple of weeks of the injury before it starts to heal in position. It is important to be aware of certain features that need more urgent attention — such as heavy or persistent bleeding, difficulty breathing, a clear fluid draining from the nose, severe pain, a change in vision, or a collection of blood in the nasal septum (which needs prompt treatment) — as well as signs of a more serious head or facial injury. The key messages are that many broken noses heal well with self-care, that assessment is worthwhile (especially if the nose looks bent or breathing is affected, or for concerning features), and that realignment, if needed, is best done within a couple of weeks.

How it is treated

Many broken noses heal well with simple self-care, and treatment is mainly needed if the nose is bent or breathing is affected, or for concerning features. Initial self-care after a nose injury includes: managing any nosebleed (sitting up and leaning forward, and pinching the soft part of the nose); applying ice or a cold pack (wrapped) to reduce swelling; taking simple pain relief; and keeping the head up, including when sleeping, to help reduce swelling. Because swelling makes it hard to judge the shape at first, it is often best to wait a few days for the swelling to settle before assessing whether the nose is bent. Many broken noses need no specific treatment and simply heal, and if the nose is not bent and breathing is normal, self-care may be all that is required. Assessment (by a GP or, if needed, an ENT specialist) is worthwhile particularly if the nose looks crooked or out of shape once the swelling settles, or if breathing through the nose is affected — in which case the nose can be realigned (manipulated back into position), which is usually best done within around one to two weeks of the injury, before the bones start to set in the wrong position; if the nose has already healed crooked or breathing remains a problem, an operation to straighten the nose may be considered later. It is important to seek more urgent attention for certain features: heavy or persistent bleeding that will not stop; difficulty breathing; a clear watery fluid draining from the nose (which could indicate a more serious injury); severe pain, or pain and swelling that are worsening; a change in vision or the eyes; signs of a more serious head injury (such as confusion, drowsiness, vomiting, or loss of consciousness); or a swelling inside the nose on the septum (a septal haematoma — a collection of blood that needs prompt drainage to prevent complications). The reassuring messages are that most broken noses are not serious and heal well with self-care, that assessment is worthwhile especially if the nose is bent or breathing is affected (with realignment best done within a couple of weeks), and that certain features need more urgent medical attention.