Sore in Nose: Why It Happens and How to Heal It

What a sore inside the nose usually is

The front part of the nostril, just inside the opening, is called the nasal vestibule. It is lined with skin and small hairs, not the moist lining deeper inside. This is where most sores form, because it is the part you touch, wipe and blow. Sores here can feel like a small pimple, a raw patch, a crack, or a scab that keeps reforming.

A sore higher up or toward the back of the nose sits on the mucous membrane. It is less often caused by picking and more often by dry air, nasal sprays, a nosebleed site or, less commonly, an inflammatory disease or growth.

Common causes of a sore in the nose

Dryness and irritation

Dry winter air, central heating, air conditioning and high altitude dry out the nasal lining. It cracks, forms crusts, and the crusts tear when they come away. Repeated nose blowing during a runny nose or allergy season rubs the skin raw. The sore is usually small, tender and crusted, and often bleeds a little when you blow your nose.

Picking and scratching

Picking off crusts reopens the wound and pushes bacteria into it. This is the most common reason a sore in the nose "won't heal": it heals overnight, gets picked or blown open, and starts again. Many people do it without noticing, including during sleep.

Nasal vestibulitis and nasal boils

Nasal vestibulitis is a bacterial infection, usually with Staphylococcus aureus, of the skin and hair follicles just inside the nostril. It causes redness, crusting and soreness at the nostril opening. A deeper infection of one hair follicle forms a nasal furuncle, a painful, red, swollen lump that may come to a yellow head. Plucking nose hairs and picking are common triggers.

Cold sores

The herpes simplex virus can cause blisters on or just inside the nostril, not only on the lips. A cold sore starts with tingling or burning, then forms a cluster of small fluid-filled blisters that crust over within a few days and heal in 7 to 10 days. It tends to come back in the same spot after a cold, sun exposure, stress or a period.

Impetigo

Impetigo is a contagious skin infection that is common in children. It often starts around the nostrils as red sores that ooze and form golden, honey-colored crusts. It can spread to the lips and face.

Nasal sprays and allergies

Steroid nasal sprays can dry and irritate the septum, especially if you aim them at the middle of the nose. Decongestant sprays used for more than a few days, and allergic rhinitis with constant rubbing, also cause raw patches. Aiming the spray toward the outer wall of the nostril (toward the ear on the same side) reduces this.

Less common but important causes

• MRSA or recurrent staph: some people carry staph bacteria in the nose. This causes repeated boils or crusting that keeps returning. A swab can confirm it, and a doctor may prescribe an antibiotic ointment to clear carriage.
• Skin cancer: a basal cell carcinoma or squamous cell carcinoma can appear on the outside of the nose or at the nostril rim as a sore that bleeds, crusts, seems to heal, then reopens. It is painless more often than not. This matters most for a "sore on the outside of the nose not healing".
• Cocaine or other snorted drugs: these damage the lining and can cause ulcers, crusting and eventually a hole in the septum.
• Autoimmune and inflammatory disease: granulomatosis with polyangiitis, lupus and sarcoidosis can cause persistent crusting, bleeding and ulcers inside the nose, often with sinus, lung, kidney or joint problems.
• Nasal tumors: rare growths inside the nose can cause a one-sided blocked nose, bleeding and a sore that does not heal.
• Foreign body: in a young child, a smelly discharge from one nostril with soreness suggests something has been pushed up the nose.

How to tell the causes apart

Why a sore in the nose keeps coming back

A recurring sore in the nose usually has one of these explanations:

1. The same habit keeps reopening it: picking, rubbing, or blowing hard.
2. The air stays dry: the lining cannot heal in a heated or air-conditioned room without moisture.
3. Staph carriage: bacteria living in the nose re-infect hair follicles.
4. Herpes simplex: cold sores recur in the same place because the virus stays dormant in a nearby nerve.
5. A nasal spray is hitting the same patch of the septum each day.
6. An underlying condition such as a growth or autoimmune disease, which is why a sore that keeps returning for weeks needs to be seen.

When to worry about a sore in the nose

Most nose sores are minor. Get it checked if:

• it has not healed after 3 to 4 weeks despite leaving it alone
• it bleeds on its own, grows, or forms a raised, shiny or crusted bump
• you also have a blocked nose on one side, repeated nosebleeds or bloody crusts
• there is redness and swelling on the outside of the nose, or fever

The area between the corners of the mouth and the bridge of the nose drains through veins that connect with the cavernous sinus near the brain. That is why a spreading infection of the nose with eye swelling or severe headache is treated as an emergency, and why you should never squeeze a boil inside the nose.

What the doctor will do

A primary care doctor or ear, nose and throat (ENT) specialist will ask how long the sore has been there, whether it comes back, about picking, nasal sprays, cold sores and drug use. They will look inside the nostril with a light and a small speculum and may use a thin camera (nasal endoscopy) to see further back. Tests may include a swab for bacteria or herpes virus, blood tests if an inflammatory disease is suspected, and a biopsy of any sore that does not heal or looks abnormal.

How to heal a sore in your nose

Home care

• Leave it alone: do not pick crusts or pluck nose hairs. Trim nails, and wear thin cotton gloves at night if you pick in your sleep.
• Keep it moist: apply a thin layer of petroleum jelly or a saline nasal gel just inside the nostril with a clean cotton swab 2 to 3 times a day.
• Saline spray: use a saline spray several times a day to soften crusts and keep the lining moist.
• Humidify: run a humidifier in your bedroom in dry weather.
• Blow gently: one nostril at a time, with soft tissues.
• Warm compress: for a small, tender pimple at the nostril, a warm damp cloth for 10 minutes 3 times a day helps it settle. Do not squeeze it.
• Pain relief: acetaminophen (paracetamol) or ibuprofen, following the label dose.

Medical treatment

• Antibiotic ointment such as mupirocin for nasal vestibulitis, impetigo or staph carriage, prescribed by a doctor. Over-the-counter antibiotic ointments help mild cases.
• Oral antibiotics for a nasal boil, spreading redness or fever.
• Antiviral tablets or cream for frequent or severe cold sores. Starting at the first tingle works best.
• Changing nasal spray technique or pausing a spray that is causing irritation.
• Biopsy and specialist treatment for any sore that turns out to be a skin cancer or part of an inflammatory disease.

Preventing nose sores

• Keep indoor air moist in winter and use saline spray or petroleum jelly if your nose tends to dry out.
• Trim nose hairs with rounded scissors instead of plucking them.
• Wash your hands before touching your nose and avoid picking.
• Use sunscreen and lip balm with SPF if sun triggers cold sores.
• Aim nasal sprays away from the septum.

Frequently asked questions

Why do I have a sore in my nose that won't heal?

The most common reason is that it keeps being reopened by picking, blowing or dry air. Staph infection and recurring cold sores are next. If it has not healed after 3 to 4 weeks of leaving it alone and keeping it moist, see a doctor, because skin cancer and inflammatory diseases can look like a stubborn scab.

What is a sore inside my nose?

Usually it is a small crack, scab or infected hair follicle in the skin just inside the nostril, called the nasal vestibule. Dry air, nose blowing and picking cause most of them. Nasal vestibulitis, a mild staph infection of that skin, is also common and responds to antibiotic ointment.

How long does a sore in the nose take to heal?

A simple crack or scab heals in about 5 to 7 days if you stop picking and keep it moist. Nasal vestibulitis and cold sores take 7 to 14 days. A sore lasting several weeks is not typical and should be examined.

Can I put Vaseline on a sore in my nose?

Yes. A thin layer of petroleum jelly applied just inside the nostril with a cotton swab keeps the area moist and helps it heal. Do not push it high into the nose. Saline gel is an alternative if you prefer something water-based.

Is a sore in the nose a cold sore?

Sometimes. A cold sore starts with tingling, then forms a cluster of tiny blisters that crust over, and it tends to return in the same place. A single tender bump or crust without blisters is more likely to be an infected hair follicle or dryness.

Can a sore in the nose be cancer?

Rarely. Skin cancers usually appear on the outside of the nose or the nostril rim as a sore that bleeds, crusts and reopens over weeks. Cancers inside the nose are very rare and often also cause a one-sided blockage or bleeding. Any non-healing sore deserves a check.