Deviated septum symptoms

Overview

The nasal septum is the wall of bone and cartilage inside your nose that divides your nostrils into two separate passages. A deviated septum is when this wall is crooked or off-center, making one side of the nose smaller than the other. This can block airflow and make it harder to breathe through that side.

Yes, it is very common. Studies suggest that around 80% of people have some degree of septal deviation, but only those with a significant blockage develop noticeable symptoms.

Anyone can have a deviated septum. It may be present from birth, or it can develop after a nose injury. Symptoms often become more noticeable as you age or after an accident.

Symptoms

Common symptoms

• Nasal congestion on one side, often worse when you have a cold or allergies
• Difficulty breathing through the nose
• Frequent nosebleeds, especially on the more blocked side
• Noisy breathing during sleep (snoring or whistling)
• Recurring sinus infections (sinusitis)
• Facial pain or headache, often around the eyes or forehead
• Sleep problems, such as waking up tired or restless
• In some cases, reduced sense of smell

Symptoms in children

• Mouth breathing (especially during sleep)
• Loud snoring or noisy breathing
• Frequent ear infections or sinus infections

Symptoms in older adults

• Worsening of existing symptoms, like increased congestion
• More noticeable difficulty breathing during sleep
• Higher risk of sinus infections due to age-related changes in the immune system

Causes

Main causes

• Injury or trauma to the nose, such as from a fall, sports accident, or car crash
• Being born with a crooked nasal septum (congenital deviation)

Risk factors

• Playing contact sports without proper face protection
• History of facial injury or surgery
• Having a naturally narrow nasal passage
• Age — the septum can shift over time due to natural changes in cartilage

When to see a doctor

See a doctor urgently if:

• You have a high fever with nasal discharge that smells bad or is bloody
• You have intense facial pain, especially around the eyes or forehead
• You have trouble breathing that keeps getting worse

Book a routine appointment if:

• You have ongoing nasal congestion that affects your sleep or daily life
• You get sinus infections several times a year
• You snore loudly or wake up feeling very tired
• You have frequent nosebleeds without a clear cause

Diagnosis

A doctor can often diagnose a deviated septum by looking inside your nose with a light and a small instrument called a nasal speculum. They may also ask about your symptoms and any injuries to your nose.

Tests that may be done

• Nasal endoscopy — a thin, flexible tube with a camera is inserted into your nose to see the septum and inside passages more clearly
• CT scan — sometimes used if sinus infections are severe, to check for other problems like sinus blockages or polyps

What to expect at your appointment

The doctor will examine your nose while you sit in a chair. They may use a numbing spray to make the exam more comfortable. If they want a closer look, they might use a small camera. The process is usually quick and painless.

Treatment

Treatment for a deviated septum depends on how much your symptoms affect your life. Many people do not need any treatment. For mild symptoms, simple self-care can help. If symptoms are troublesome, medications and, in some cases, surgery are options.

Self-care at home

• Use a saline nasal spray or rinse to keep your nasal passages moist and clear
• Run a humidifier in your bedroom at night to add moisture to the air
• Elevate your head with an extra pillow when sleeping to help drainage
• Avoid things that can irritate your nose, like cigarette smoke, strong perfumes, or dust
• Try a nasal strip or dilator to help open your nostrils while sleeping

Medical treatments

If self-care is not enough, your doctor may suggest medications. These are usually available over the counter or by prescription. They include nasal sprays that reduce swelling (decongestants), sprays that control allergies (antihistamines), and steroid nasal sprays to ease inflammation. For sinus infections, antibiotics may be needed if bacteria are involved. Always talk to your doctor or pharmacist before starting any new medication.

When is surgery considered?

Surgery, called septoplasty, is an option when symptoms are severe and have not improved with medications. During septoplasty, a surgeon straightens the septum and repositions the cartilage. This is usually done through the nostrils, with no visible scars. Recovery takes a few weeks, and most people notice significantly better breathing afterwards.

Living with this condition

Living with a deviated septum often means managing mild symptoms with simple habits. Keep your nose clean and moist, and avoid triggers that make congestion worse. If you have trouble sleeping, try extra pillows or nasal strips. For sinus infections, make sure you finish any prescribed treatment.

Lifestyle tips

• Wear a face mask or use a saline rinse after being in dusty or smoky environments
• Stay hydrated by drinking plenty of water — this helps thin mucus
• Exercise regularly, as physical activity can help clear the nasal passages naturally
• Avoid blowing your nose too hard — it can irritate the inside of your nose

Diet and exercise

There is no special diet for a deviated septum, but a healthy, balanced diet supports your immune system and may reduce the frequency of sinus infections. Regular exercise like walking or jogging can improve airflow through your nose and help you breathe easier.

Mental health and emotional wellbeing

Persistent symptoms like trouble breathing, snoring, and poor sleep can be frustrating and affect your mood, energy, and ability to focus. This may lead to irritability or stress. It is important to talk to your doctor if these problems are bothering you, as treatment can often improve both your physical and mental well-being.

Prevention

It is not possible to prevent a deviated septum if you were born with one. However, you can reduce your risk of injury by wearing appropriate head and face protection during contact sports, cycling, or any activity where a nose injury is possible.

Vaccines

Vaccines are not directly related to preventing a deviated septum, but staying up to date with vaccines like the flu shot and pneumococcal vaccine may help prevent infections that could worsen your symptoms.

Screening programmes

There is no routine screening test for a deviated septum. It is usually discovered when a person sees a doctor for nasal symptoms or after a nose injury.

Complications

If left untreated

• Chronic or recurrent sinus infections
• Obstructive sleep apnea, where breathing stops and starts during sleep, leading to poor sleep quality
• Loud snoring that affects your partner's sleep
• Nasal obstruction that makes it hard to breathe, especially during exercise or sleep

Long-term outlook

For most people, a deviated septum does not cause serious health problems. Even when symptoms are bothersome, treatments like medications or surgery can greatly improve breathing and quality of life. Septoplasty has a high success rate, and most people are very satisfied with the results.

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