Nasal Septal Hematoma: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Nasal Septal Hematoma?
An ear, nose, and throat doctor, also called an ENT or otolaryngologist, treats a nasal septal hematoma. A plastic surgeon, a doctor who repairs and reshapes parts of the body, may help too. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is a nasal septal hematoma?
A nasal septal hematoma is a collection of blood within the septum of the nose. The septum is the part of the nose between the nostrils. An injury disrupts the blood vessels, so fluid and blood may collect under the lining.
It is a rare but serious complication of nasal or facial injury. Most nasal injuries do not need immediate treatment, but an injury that causes a septal hematoma is an exception.
Symptoms
Symptoms may include:
- Trouble breathing through the nose, or nasal congestion.
- Painful swelling of the nasal septum.
- A change in the shape of the nose.
- Fever.
A blocked nose is the most common symptom. The problem usually shows up within the first 24 to 72 hours after an injury. In many cases the symptoms are not specific to this problem.
Causes and who gets it
A septal hematoma can be caused by a broken nose, an injury to the soft tissue of the area, surgery, or taking blood-thinning medicines. Injuries can come from sports, falls, assault, road accidents, or work. Even a minor injury can lead to a nasal septal hematoma, especially in children.
The problem is more common in children because their septa are thicker and have a more flexible lining. Rarely, it can happen without an injury in people with bleeding problems or who take blood-thinning drugs.
How doctors diagnose it
Your provider will look into your nose to see if there is swelling of the tissue between the nostrils. The provider will touch the area with an applicator or a cotton swab. If there is a hematoma, the area will be soft and able to be pressed down. The nasal septum is normally thin and rigid.
Doctors usually diagnose a septal hematoma from the exam alone. A CT or MRI scan is rarely considered, and only if the exam does not give a clear answer.
Treatment
A nasal septal hematoma should be drained urgently to avoid complications. Your provider will make a small cut to drain the blood. Gauze or cotton will be placed inside the nose after the blood is removed. Doctors may also drain it with a needle.
The procedure is done under local anesthesia. General anesthesia might be needed in nervous adults and in children. Several days of nasal packing prevents the blood from building up again. Ideally, treatment happens within a few hours of the injury. Antibiotics should follow drainage if an abscess is noted.
You should heal fully if the injury is treated quickly. With prompt drainage, the outcomes are good in most people.
When to see a doctor
This is an urgent condition, and a doctor who specializes in the ear, nose, and throat should see you right away. Contact your provider for any nasal injury that causes nasal congestion or pain. A septal hematoma should be suspected with any facial injury. If a hematoma stays for a long time, it may become infected and will be painful. You may develop an abscess and fever.
Call 911 or go to the emergency room if the injury also caused a head or spine injury, or bleeding that will not stop.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. After a nose injury with swelling, get urgent care first. A direct primary care or concierge doctor can then help with follow-up and coordinate care with an ENT doctor.
Common questions
Is a nasal septal hematoma urgent?
Yes, it is an urgent condition that needs quick medical care. It should be drained urgently to avoid complications.
What happens if a nasal septal hematoma is not treated?
An untreated septal hematoma may lead to a hole in the area separating the nostrils, called a septal perforation. The area may also collapse, which causes a deformity of the outer nose called a saddle nose deformity. Blood left in place may also become infected.
How is a nasal septal hematoma treated?
It is treated by draining the blood through a small cut. Gauze or cotton is then placed inside the nose. The procedure is done under local anesthesia.
Who gets a nasal septal hematoma most often?
It is more common in children because their septa are thicker and have a more flexible lining. Even a minor injury can lead to one, especially in children.
How can complications be prevented?
Recognizing and treating the problem early can prevent complications and allow the septum to heal. Treatment ideally happens within a few hours of the injury.
Sources
- MedlinePlus - Nasal septal hematoma
- StatPearls (NCBI Bookshelf) - Nasal Septal Hematoma (Archived)
- American Academy of Family Physicians - Swollen Masses in the Nose
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
