Broken nose

Usually a doctor can tell your nose is broken from the way your nose looks.

You probably won't need an X-ray of your broken nose unless your doctor thinks another bone in your face is broken.

Most broken noses can be managed at home. To reduce swelling, hold an icepack against your nose for 15 minutes, once an hour, for the first few days. Make sure there is a cloth between the ice and your skin, so you don't damage your skin.

The swelling will usually go down after a week, and the bruising will go in about two weeks.

You should see your GP if:

• the pain gets worse, or doesn't get better with simple painkillers like paracetamol
• the swelling has gone down, but you still find it hard to breathe through your nose
• your nose looks crooked
• the swelling hasn't gone down after a few days
• you have nosebleeds that keep coming and going
• you have a high temperature.

If your nose is severely broken, you may need to get it straightened (realigned) by an otolaryngologist – previously called an ear, nose, and throat (ENT) specialist. It's best to do this within two weeks of the injury. You might need to wait till there is less swelling before your doctor can decide if your nose needs to be straightened.

Usually, you will be given a local anaesthetic that can numb your nose for two to four hours before straightening. If you are unhappy with either how you are breathing or the shape of your nose, ACC might cover the cost of private surgery. Talk to your doctor about this.

When you have your broken nose straightened, you will have a local anaesthetic, which numbs your nose for two to four hours.

Afterwards, it is best to get someone to drive you home – or to wait two hours before you drive.

When you are home:

• take two paracetamol tablets (Panadol or Paracare), or paracetamol with codeine (Panadeine) every four hours to control the pain. Don't take any more than eight tablets in one day
• don't drink alcohol or take any recreational drugs for 24 hours, as these may react badly with the local anaesthetic
• rest for the next 24 hours. Don't try any heavy lifting or hard physical work for the next two days.

If the pain continues, or if you become hot and feverish with a nasty green nose discharge, phone your doctor or surgeon. 

Over the next few days you should:

• be careful at times when you may bump your nose, such as when you have small children or animals on your knee, or when you are in bed at night
• just dab your nose gently – don't wipe it vigorously or blow it hard
• keep your mouth open if you sneeze
• keep any plaster on your nose dry and stay out of the sun to avoid overheating. (Try to keep the plaster in place for at least one week)
• gently sniff warm, salty water from your cupped hand if crusts form inside your nose, to soften them. Don't pick your nose.

You should also avoid contact sport for the next four weeks as your nose heals.