Open Wound of the Nose

First aid for an open wound on the nose

1. Wash your hands. Then stop any bleeding by pressing a clean cloth on the wound for 10 minutes without lifting to check. For bleeding from inside the nose, sit up, lean forward and pinch the soft part of the nose firmly for 10 to 15 minutes.
2. Rinse the wound under cool running tap water for a few minutes. Use mild soap around it, not in it. Gently remove dirt or grit.
3. Avoid harsh antiseptics. Hydrogen peroxide, iodine and rubbing alcohol damage healing tissue and are not needed for clean minor wounds.
4. Keep it moist with a thin layer of petroleum jelly. Moist wounds heal faster and scar less than wounds left to dry out and scab.
5. Cover it with a small bandage or a hydrocolloid patch if it is likely to be rubbed or dirtied. Change it daily or when it gets wet.
6. Ice for 10 to 15 minutes at a time wrapped in a cloth reduces swelling after a blow.

For pain, use acetaminophen (paracetamol) or ibuprofen at the label dose. Ibuprofen and aspirin can make bleeding a little worse in the first day, so acetaminophen is often a better first choice.

Does it need stitches?

The nose is in the middle of your face, so a well-repaired wound matters for appearance. Get a cut checked the same day if:

• it is deeper than the skin, gapes open, or the edges do not come together easily
• it is longer than about 1 cm (0.5 in)
• it crosses the rim of the nostril or the edge where skin meets the lip
• it is a flap, a puncture or a bite

Facial wounds are best closed within 24 hours. Options include fine stitches (removed after about 5 days), skin glue or adhesive strips. Bites are cleaned thoroughly and often treated with antibiotics. A doctor will also check for a broken nose, which causes swelling, crookedness and nosebleeds, and for a septal hematoma, a collection of blood inside the nose that must be drained quickly to prevent cartilage damage.

Common types of nose wounds

Cuts and scrapes from injury

Falls, sports and fights are the usual causes. Because the nose has a rich blood supply, even small cuts bleed a lot but also heal well. Look out for a facial laceration that extends to the eyelids or lips, which may need a specialist repair.

Open wound on the bridge of the nose

Wounds on the bridge are often pressure sores from glasses, sunglasses, goggles, masks or CPAP machines. To treat them:

• take the pressure off: adjust nose pads, switch to frames that sit higher, or add silicone pads
• clean gently and apply petroleum jelly twice a day
• use a thin hydrocolloid dressing under a mask to cushion the skin
• have a CPAP mask refitted, as a different size or a nasal pillow style may avoid the bridge altogether

Open wound inside the nose

Sores inside the nostril come from picking, dry air, nose blowing, nasal sprays and occasionally infection. Small cracks often scab, itch, and get picked again, which keeps the cycle going. Nasal vestibulitis is an infection of the skin just inside the nostril, usually from staph bacteria, causing a painful, red, crusted opening. Cold sores (herpes simplex) can also appear on or in the nose as a cluster of tingling blisters.

Bites

Animal bites to the face carry a high infection risk and occasionally rabies risk. Always see a doctor for a bite to the nose, even if it looks small.

Why an open wound on the nose won't heal

Most minor nose wounds heal in 1 to 2 weeks. A wound that won't heal usually has one of these causes:

The nose is one of the most common sites for basal cell carcinoma, the most common skin cancer. It often looks like a small sore or pimple that bleeds, crusts, seems to heal and then breaks down again. It grows slowly and is very treatable, but it needs a biopsy to confirm. Any nose sore lasting more than 4 to 6 weeks should be examined.

Signs of infection

• Redness spreading out from the wound
• Increasing pain, swelling or warmth after the first 2 days
• Pus or a honey-colored crust
• Red streaks spreading from the area, or fever

The skin of the central face drains toward veins near the brain, so infection here is taken seriously. Cellulitis of the nose or face needs prompt antibiotics. Signs such as swelling around the eye, double vision or severe headache need emergency care.

Helping your nose heal with less scarring

• Keep the wound moist with petroleum jelly until the skin has closed.
• Do not pick scabs.
• After the skin has closed, protect it from the sun with SPF 30+ sunscreen or a bandage for at least 6 months, as UV light darkens new scars.
• Silicone gel or sheets can flatten raised scars once healed.
• Gentle massage of a healed scar for a few minutes daily can soften it.
• If a scar is raised, thick or tight after a few months, a dermatologist can treat it with steroid injections, lasers or minor revision surgery.

Frequently asked questions

How do I treat an open wound on the bridge of my nose?

Clean it with water, apply petroleum jelly and cover it if it gets rubbed. Most sores on the bridge come from glasses or masks, so remove or adjust whatever is pressing on it. Hydrocolloid patches cushion the skin. See a doctor if it is not healing after 2 to 3 weeks.

Why won't the open wound on my nose heal?

Common reasons are repeated picking or rubbing, infection, dry air and pressure from glasses or masks. Diabetes and smoking also slow healing. A sore that repeatedly scabs, bleeds and returns over more than 4 to 6 weeks may be a skin cancer such as basal cell carcinoma and should be checked.

What should I put on an open wound inside my nose?

A thin layer of petroleum jelly or saline nasal gel, applied with a clean finger or cotton swab twice a day, keeps the area moist so it heals. A humidifier helps in dry weather. If the area is very red, crusted or painful, see a doctor, as you may need a prescription antibiotic ointment.

Is it bad to pick an open wound in your nose?

Yes. Picking reopens the wound, adds bacteria from your fingers and can cause nasal vestibulitis or a boil in the nose. It also causes repeated nosebleeds. Keep nails short, use petroleum jelly to soften crusts, and cover the area at night if you pick in your sleep.

When should I see a doctor for a cut on my nose?

See a doctor the same day for cuts that gape, are deep, longer than about 1 cm, cross the nostril rim, or come from a bite. Go urgently if your nose looks crooked, you cannot breathe through one side, or the wound shows signs of infection.