A bruised nose, medically termed a nasal contusion, results from trauma that causes small blood vessels beneath the skin to tear and leak blood into the surrounding soft tissue or bone area. This internal bleeding leads to the visible discoloration and swelling commonly associated with a bruise. While the appearance can be alarming, a minor nasal contusion that does not involve a fracture or other serious complications can often be successfully managed with self-care at home. This guidance focuses on the steps you can take to promote healing for a simple bruise.
Immediate Steps for Bruising
The initial focus following a nasal injury is to minimize swelling and internal bleeding using the RICE protocol: Rest, Ice, Compression, and Elevation. Immediate rest prevents further damage to the injured area. You should avoid strenuous activity and actions that cause blood to rush to the head, such as bending over.
Ice application is the most effective way to address acute swelling and pain in the first 48 to 72 hours. Apply a cold pack or ice wrapped in a thin towel to the nose for about 10 to 20 minutes at a time, repeating this every one to two hours while awake. The cold works by constricting the blood vessels, which slows the flow of blood and minimizes the leakage that causes the bruise to spread.
Compression is generally not recommended for the nose, but you should avoid blowing your nose for at least 48 hours to prevent re-bleeding or increased swelling. For elevation, keep your head raised above the level of your heart, especially when sleeping, by propping yourself up with pillows. This uses gravity to help drain excess fluid from the area, which reduces swelling.
Ongoing Care and Symptom Management
After the first two to three days, your care strategy shifts toward managing residual pain and helping the body reabsorb the pooled blood. Acetaminophen is the preferred over-the-counter medication for pain relief because it does not interfere with the blood clotting process. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can increase the risk of bleeding, so they should be used with caution, if at all, following an acute injury.
Once the initial swelling has subsided, typically after 48 to 72 hours, you can introduce gentle heat therapy to the bruised area. Applying a warm compress for 15 to 20 minutes several times a day will dilate the blood vessels, increasing circulation to the area. This enhanced blood flow helps carry away the broken-down blood cells, which accelerates the fading of the bruise.
A bruise progresses through predictable color changes as the body metabolizes the leaked hemoglobin. It appears reddish-pink, quickly turning blue or black, then shifting to green, and finally to a yellow or brown tint before resolving completely, usually over two weeks. Patience is important during this phase, and gentle heat aids the final stages of discoloration resolution.
When to Seek Medical Attention
While most bruised noses heal without intervention, some symptoms indicate a serious underlying injury requiring immediate medical evaluation. One warning sign is any noticeable change in the shape of the nose after the initial swelling subsides, which can signal a nasal fracture. Severe difficulty breathing through the nostrils that persists after the initial swelling could indicate a septal hematoma, a collection of blood that needs draining.
Seek medical care immediately if you experience persistent or heavy bleeding that does not stop after applying pressure for 10 to 15 minutes. The drainage of any clear, watery fluid from the nose may indicate a leak of cerebrospinal fluid from the brain cavity. Other symptoms, such as severe, unrelenting pain, vision changes, dizziness, vomiting, or a loss of consciousness, necessitate an emergency visit.
If you develop swelling or a bump on the septum, the thin wall between the nostrils, see a doctor immediately. If the bruise remains painful or has not significantly faded after two weeks, a medical professional should assess the injury to rule out complications. A doctor can determine if the bruise is isolated or if further damage, such as a deviated septum or fracture, needs specific treatment.