Why is my nose always blocked on one side?

The 3 most common reasons for a blocked nose are:

1. Rhinitis (sensitive nose) - this can be allergic (if your nose reacts to a protein in the environment, e.g. dust mites, cat or dog furs, pollens etc) or non allergic (if your nose reacts to temperature changes, perfumes, cigarette smoke etc). Common symptoms include blocked nose, clear runny nose, sneezing, itchy eyes and nose as well as postnasal drip.

The main reason for the blocked nose (which is usually both sides but can be worse on one side) is due to enlarged turbinates (medically known as inferior turbinate hypertrophy. The turbinates are sausage-like structures at the side walls of the nose that warm and humidify the air that you breathe in. Treatment usually involves the use of nasal steroid sprays and antihistamines/decongestants. In patients with persistent blocked nose after a good trial of medications, turbinate reduction procedures can be considered.

These include radiofrequency or coblation of the turbinates (which is less aggressive in turbinate reduction but can be done in the clinic under local anaesthesia) and inferior turbinoplasty (which is more aggressive in turbinate reduction but is done under general anaesthesia)

2. Deviated nasal septum - the nasal septum is bony cartilaginous structure that divides the nasal cavity into a right and left side. In most people, it is mildly crooked or bent to one side. If the bent is significant, then one side of your nose may be blocked. It is quite likely that you may have this problem if your blocked nose is just one sided and is worse during a flu. This can be corrected with a minimally invasive surgery called septoplasty (no cuts on the outside of the nose/face). The reason for a deviated septum can be genetic or due to trauma.

3. Sinusitis - this refers to infection of the sinuses. Typical symptoms include coloured or thick nose mucous, pain in the face, blocked nose, postnasal drip and loss of or reduced sense of smell. Treatment includes a course of oral antibiotics, nasal steroid sprays and nose wash (salt water wash). In some cases, nasal polyps (usually benign inflammatory growths that forms from the lining of the nose and sinuses) can occur.

There are many other causes of a blocked nose such as tumours, foreign bodies, systemic disorders etc but these are much less common. I would suggest that you visit an ENT Specialist for an assessment. This will include a nasoendoscopy (nose scope done under local anaesthesia) which is relatively painless and takes minutes to perform.

Hope this helps and all the best!

The most common cause of a persistent blocked nose on one side would be that the nasal bone or septum is deviated internally to that side. The external nose may not look crooked. Usually, a very bad block results if the nose bone is crooked very near the entrance to the nose.

Sometimes, there may be polyps or tumors in the nose, so it is important that you see an ENT doctor if this does not resolve. A simple flexible nose scope in clinic will be able to exclude that quickly in less than 5 minutes, and will not be uncomfortable.

Another cause that is easily missed is a collapsed or weak nasal valve on that side of the nose. So when one breathes in, the soft lower part of the nose gets sucked in a little. As that is the area of an important nasal valve area, you may feel blocked on that side even if the nose bone is straight and there are no internal obstructions.

Kind regards,

Dr Lynne Lim

Thanks for your enquiry about the left nasal blockage that has been troubling you for so long.

Ideally, you would need a proper examination of the inside of your nose with a flexible nasal endoscope to check if the main central bone in your nose might be crooked or deviated (deviated nasal septum). This is a safe, short and painless procedure we do very frequently at our clinic.

We also need to make sure that there are no growths or tumours hiding inside your left nasalnpassage which could explain the persistent left-sided blocked nose. We would check both sides of your nose as well as the back of your nose too.

Sometimes, constant trails of thick mucus can irritate the nose and lead to inflammation and swelling of the soft tissue which could block your nose.

When you come down with the flu, this makes the situation even worse if you already have a narrow left nasal passage as the flu usually tends to lead to more mucus secretions being produced and swelling of soft tissue.

Hope the above helps.