Deviated Septum
A deviated septum occurs when your septum, the cartilage and bone that separates your nasal cavity, is off-center. Some people are born with a deviated septum. For others, a nose injury causes it. A badly deviated septum may cause breathing problems, congestion and headaches. Surgery called septoplasty can repair a deviated septum.
What Is a Deviated Septum?
A deviated septum is when the bone and cartilage that divides your nasal cavity and/or nostrils is off-center. Your nasal septum is the tissue that separates the right and left sides of your nasal cavity. A perfectly straight nasal septum creates two equally-sized nasal cavities. Air flows freely through both.
But about 8 out of 10 people — so, most of us — have a nasal septum that’s a little off-center. Lots of people don’t realize it because they don’t have symptoms.
If you have a more pronounced deviation, though, air may have a harder time flowing through your nose. This can make it harder to breathe. It may make you more likely to have nosebleeds and other issues.
Deviated septum causes
You can be born with a nasal septum deviation. A difficult delivery can injure your nasal septum. As your nose grows, your septum also grows and can sometimes lean more toward one side. This is the most common deviated septum cause.
Other causes include an injury, like a broken nose.
Symptoms of a deviated nasal septum
A severely deviated septum may make your nose look off-center. If it’s not noticeable when you’re looking straight on in the mirror, take a picture of the underside of your nose. If your nostrils are uneven or different sizes, you may have a deviated septum.
Other deviated septum symptoms may include:
- Difficulty breathing out of your nostrils (usually worse on one side).
- Facial pain.
- Headaches.
- Loss of smell.
- Nasal congestion.
- Noisy breathing.
- Nosebleeds.
- Snoring.
Minor nasal septum deviation may not cause any issues at all. But a severely deviated septum can cause problems like:
- Chronic sinusitis.
- Dry mouth.
- Nasal congestion.
- Sleep apnea.
- Long-lasting or frequent ear infections (in children).
Activities or events that lead to a nose injury increase your risk. Examples include:
- Car accidents.
- Contact sports.
- Falls.
- Fights.
- Inhaling addictive substances through your nose (like cocaine).
You can’t avoid all risks. But you can take precautions, like wearing a seatbelt. You can wear protective gear (like a midface mask and helmet) when playing contact sports.
How doctors diagnose this condition
A healthcare provider will examine your nose using a nasal speculum. This handheld instrument gently spreads your nostrils open so your provider can see the inside of your nose. They’ll look at your septum to see if it affects the size of your nasal passages.
You may also need tests that show tissue deeper inside your nose, including:
- CT scan.
- Nasal endoscopy.
How do healthcare providers treat a deviated septum?
Most people don’t need deviated septum treatment because they have little to no symptoms. You can treat mild symptoms with medication. But if a deviated nasal septum keeps you from breathing properly, you might need surgery.
Medications
Mild septal deviation may cause occasional symptoms. They may not show up until you get sick. You can treat these symptoms with over-the-counter (OTC) medications, including:
- Antihistamines.
- Nasal steroid sprays.
- Nasal decongestants.
But don’t use nasal decongestant sprays for more than three days in a row. It could cause rebound congestion.
Deviated septum surgery
The only way to fix a deviated septum is with septoplasty. This surgery may be an option if you have breathing problems or other bothersome symptoms. During a septoplasty, a surgeon reshapes your septum.
If your child needs surgery, their surgeon may wait to do a septoplasty until their nose finishes growing. Usually, this happens in a child’s mid-teens.
Sometimes, a septoplasty happens alongside a rhinoplasty. This surgery reshapes your nose. It may help if you’re unsatisfied with how your nose looks.
Talk to a provider if your symptoms interfere with breathing, disrupt your sleep or have a negative impact on other aspects of your life.
If you think you have a broken nose, go to your nearest emergency room (ER).
What can I expect if I have a deviated septum?
Usually, having a deviated septum doesn’t affect your quality of life. An untreated deviated symptom may not cause issues at all. You may be able to manage mild symptoms with over-the-counter medications.
But the only way to fix, or cure, a nasal deviated septum is with surgery. If you have symptoms that interfere with your quality of life, ask your healthcare provider if surgery is an option.
FAQ
In most cases, you can’t tell if you have a deviated septum just by feeling it. But people with severe nasal deviation might be able to tell that their septum is off-center.
You might be able to tell by taking the deviated septum self-test:
- Using your finger, hold one of your nostrils closed.
- Breathe in and notice the airflow. Be mindful about how easy or difficult it is to breathe through that nostril.
- Now, hold your other nostril closed and repeat the exercise.
- If you have trouble breathing through one or both nostrils, you could have a deviated septum.
This test can be helpful. But the only surefire way to know if you have a deviated septum is to get a diagnosis from a healthcare provider.
You shouldn’t try to push your septum back into place under any circumstances. If a traumatic event like a car crash injures your nose, head to your nearest emergency room right away.
It’s possible. As you grow, individual body parts, like your nasal septum, can change. With age, a slightly deviated septum can become more off-center.
References
- Alghamdi FS, Albogami D, Alsurayhi AS, et al. Nasal Septal Deviation: A Comprehensive Narrative Review (https://pmc.ncbi.nlm.nih.gov/articles/PMC9736816/). Cureus. 2022 Nov;14(11):e31317. Accessed 8/18/2025.
- Lee S, Fernandez J, Mirjalili SA, Kirkpatrick J. Pediatric paranasal sinuses-Development, growth, pathology, & functional endoscopic sinus surgery (https://pubmed.ncbi.nlm.nih.gov/35437820/). Clin Anat. 2022 Sep;35(6):745-761. Accessed 8/18/2025.
- Malpani SN, Deshmukh P. Deviated Nasal Septum a Risk Factor for the Occurrence of Chronic Rhinosinusitis (https://pubmed.ncbi.nlm.nih.gov/36381736/). Cureus. 2022 Oct;14(10):e30261. Accessed 8/18/2025.
- Papadopoulou AM, Chrysikos D, Samolis A, Tsakotos G, Troupis T. Anatomical Variations of the Nasal Cavities and Paranasal Sinuses: A Systematic Review (https://pubmed.ncbi.nlm.nih.gov/33614330/). Cureus. 2021 Jan;13(1):e12727. Accessed 8/18/2025.
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