Has My Child Broken Their Nose? What Parents Should Do After a Nasal Injury
A football hits your child in the face. They fall from a scooter. Two children collide in the playground.
Within minutes, the nose can look swollen, bruised and surprisingly different from normal.
Parents understandably ask:
“Have they broken their nose?”
The difficulty is that immediately after an injury, swelling itself can make the nose appear crooked. It may therefore be impossible to know on the first day whether a nasal fracture requires treatment.
Fortunately, most childhood nasal injuries are uncomplicated.
University Hospitals Sussex notes that nasal injuries are common in children and that most bruising and swelling settles without further treatment. Nasal fractures are also less common in younger children because much of the developing nose is still cartilage rather than bone.
However, some important exceptions exist. Parents need to recognise significant head-injury symptoms, uncontrolled bleeding and especially swelling inside the nose that might represent a septal haematoma.
This guide explains what to check, what to do during the first few days and when paediatric ENT assessment may be needed.
What actually happens when a child hits their nose?
The upper part of the nose contains the nasal bones. Lower down, cartilage supports much of the nose.
Running through the centre is the nasal septum, which separates the two nostrils.
A blow to the nose can cause:
- soft-tissue bruising
- swelling
- nosebleed
- injury to the cartilage
- fracture of the nasal bones
- occasionally a collection of blood within the nasal septum.
A swollen nose does not automatically mean it is fractured.
Likewise, confirming whether a small fracture line exists is often less important than asking two practical questions:
What are the signs of a broken nose?
Possible signs include:
- pain and tenderness
- swelling
- bruising around the nose or eyes
- nosebleed
- a new crooked appearance
- persistent difficulty breathing through the nose.
NHS lists pain, swelling, bruising, nasal obstruction and a change in shape among the typical features of a broken nose.
Immediately after the injury, however, swelling can distort the appearance.
That is why the nose often needs to be judged again once the initial swelling subsides.
How long should I wait before judging whether the nose is crooked?
A useful reassessment point is around three to seven days after the injury.
The newly published August 2026 Alder Hey Children’s Hospital guidance advises families to look again once swelling has reduced, which may take around three days. A newly crooked or “wonky” nose or persistent breathing difficulty may indicate a fracture requiring ENT review.
Other NHS nasal-trauma pathways similarly arrange ENT reassessment around five to seven days after injury, when swelling makes the true nasal shape easier to assess.
A useful tip is to compare your child with a clear photograph taken before the accident.
Does my child need an X-ray?
Usually, no.
This surprises many parents.
For an uncomplicated isolated nasal injury, an X-ray generally does not determine whether the nose needs treatment.
Child-specific NHS guidance from University Hospitals Sussex states that an X-ray is not needed to determine whether the nose is broken.
The important clinical questions are usually whether:
- the nose has become visibly displaced
- nasal breathing is persistently impaired
- there is a septal haematoma
- another facial or head injury is suspected.
If there are signs of a more significant head or facial injury, imaging decisions are different and are based on clinical assessment.
What should I do immediately after the injury?
If your child is otherwise well and the injury appears minor:
Apply a cold pack wrapped in a cloth over the nose for short periods to reduce swelling.
Use age-appropriate pain relief such as paracetamol or ibuprofen if your child can normally take them.
Keep their head reasonably elevated during rest.
Alder Hey’s current paediatric guidance recommends a wrapped ice pack and appropriate analgesia during the early period after injury.
Do not try to push or straighten the nose yourself.
NHS specifically advises against attempting to straighten a nose that has changed shape.
What should I do if the nose is bleeding?
Nosebleeds are common after nasal trauma.
Sit your child upright and lean them slightly forwards, rather than tipping the head backwards.
Pinch the soft, fleshy part of the nose firmly.
Alder Hey advises maintaining pressure for around 10 minutes, while NHS general broken-nose guidance recommends sustained compression for up to around 15 minutes.
The exact minute is less important than applying continuous pressure without repeatedly releasing the nose to check.
If significant bleeding continues despite appropriate first aid, seek urgent medical assessment.
Should my child blow their nose after the injury?
It is sensible to avoid forceful nose blowing during the early healing period.
NHS guidance recommends avoiding picking or blowing the nose while a broken nose is healing.
Forceful blowing can restart bleeding and increase discomfort.
If dried blood is present around the nostrils, gently clean the outside rather than inserting cotton buds or other objects deeply inside the nose.
What is a septal haematoma?
This is the complication parents particularly need to understand.
The nasal septum contains cartilage covered by a thin lining. After trauma, blood can sometimes collect between these layers.
This is called a septal haematoma.
The child may develop:
- increasing nasal blockage
- blockage affecting both sides
- increasing pain
- soft or purple swelling visible inside the nose.
NHS broken-nose advice identifies a purple swelling inside the nose, particularly if it is painful or obstructs breathing, as an indication for urgent hospital assessment.
Do not leave a septal haematoma until the routine fracture clinic appointment. It needs prompt assessment because prolonged separation of the septal cartilage from its blood supply can damage the cartilage.
What if my child cannot breathe through their nose?
Some obstruction immediately after injury is expected because of swelling and clotted blood.
However, persistent or increasing blockage—particularly bilateral blockage associated with pain or swelling inside the nose—requires medical assessment.
A Gloucestershire NHS nasal-fracture pathway specifically advises urgent assessment when increasing pain and blockage in both nostrils is associated with septal swelling or fever.
What if the nose looks crooked?
Do not try to straighten it at home.
Wait for the initial swelling to reduce, unless there are urgent red flags.
If the nose remains clearly different from its pre-injury shape once swelling has settled, arrange ENT assessment promptly.
Timing matters because nasal bones begin healing relatively quickly.
Leeds Teaching Hospitals advises review within approximately two to three weeks if correction may be required, while several paediatric pathways aim to assess children considerably earlier once swelling has settled.
In children, any needed manipulation may require a general anaesthetic, depending on age and cooperation.
Does every broken nose need to be straightened?
No.
If the nose remains essentially the same shape and breathing is normal, many nasal fractures require no procedure.
The bones can simply heal naturally.
Barnsley NHS guidance similarly explains that most childhood nasal swelling resolves without significant deformity and only a minority need a procedure to straighten the nose.
Treatment therefore depends more on function and new deformity than on proving a fracture line exists.
What happens if ENT needs to straighten the nose?
If the nose has genuinely shifted position, an ENT surgeon may discuss a procedure called manipulation of nasal bones.
The aim is to improve the position of the recently displaced nasal bones before they heal in the altered position.
NHS notes that manipulation should generally occur before the bones fully set, typically within the first few weeks after injury.
In younger children, this may require general anaesthesia.
No procedure can guarantee that the nose will look exactly as it did before the injury, and this should be discussed as part of shared decision-making.
When can my child return to sport?
This depends on the injury's severity and the sport.
The priority is avoiding another blow while the nose is healing.
NHS advises avoiding strenuous exercise initially and avoiding sports where the face could be hit for several weeks after a broken nose.
Alder Hey’s current paediatric guidance recommends avoiding strenuous exercise and contact sports during early recovery.
For football, rugby, martial arts, hockey or similar contact activities, ask the treating clinician when return is appropriate.
What about symptoms of a head injury?
A blow strong enough to injure the nose can sometimes also injure the head.
Seek urgent assessment if your child develops concerning neurological symptoms such as unusual drowsiness, loss of consciousness, seizures, repeated vomiting or significant confusion.
NICE head-injury guidance includes specific criteria for urgent assessment and CT imaging in children, including reduced consciousness, post-traumatic seizure, neurological deficit and signs suggesting skull fracture.
Clear, watery fluid coming from the nose after substantial head trauma is particularly important because it can signal a skull-base injury rather than ordinary nasal mucus. NHS and NICE both treat this as an emergency warning sign.
Red flags: when should parents seek urgent help?
Take your child for urgent medical assessment if there is:
- a nosebleed that will not stop despite sustained pressure
- a large wound
- significant breathing difficulty
- purple or boggy swelling inside the nose
- increasing bilateral nasal obstruction and pain
- clear watery fluid draining from the nose after significant trauma
- severe headache
- eye pain, double vision or other visual change
- repeated vomiting
- collapse or loss of consciousness
- seizure
- unusual drowsiness, confusion or neurological symptoms.
NHS broken-nose guidance specifically highlights uncontrolled bleeding, possible septal haematoma, clear nasal fluid and neurological or visual symptoms as reasons for emergency assessment.
Call 999 for severe head injury symptoms, loss of consciousness, seizure, major uncontrolled bleeding, serious breathing difficulty or rapid deterioration.
When should my child see a paediatric ENT specialist?
Paediatric ENT review is particularly useful when:
- the nose remains newly crooked after swelling settles
- nasal breathing remains significantly obstructed
- there is concern about septal injury
- recurrent bleeding continues
- an emergency department recommends nasal-fracture follow-up
- a manipulation procedure may be required.
The assessment is usually time-sensitive because waiting too long may allow displaced nasal bones to heal in their new position.
Paediatric nasal injury assessment in London and Essex
Nasal injuries are particularly common during childhood sport, cycling, playground activities and accidental falls.
Most recover without an operation.
Mr Gaurav Kumar, Consultant ENT Surgeon, assesses children with nasal injuries, suspected fractures, persistent nasal obstruction and wider paediatric ENT concerns from London, East London, Romford, Ilford, Redbridge, Brentwood, Chelmsford and surrounding areas of Essex.
The priority is to identify the relatively small number of children who need urgent intervention or timely fracture assessment while avoiding unnecessary X-rays and procedures in uncomplicated injuries.
The key message for parents
Immediately after a nasal injury, swelling can make the nose look worse than it really is.
Use a cold pack, appropriate pain relief and manage any nosebleed with firm continuous pressure while leaning forwards.
Once swelling has started to settle after a few days, look again at the shape of the nose and compare it with older photographs.
If it remains newly crooked or breathing is persistently affected, arrange timely ENT assessment.
Most importantly, do not wait for swelling to settle if your child has a purple swelling inside the nose, worsening bilateral blockage, uncontrolled bleeding or concerning head-injury symptoms.
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