What Is a Deviated Septum?
Published on April 29, 2025
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If you find it harder to breathe through one nostril than the other, you might have a deviated septum, a condition in which the thin wall that separates the left and right side of your nose is off-center.
Deviated septums are very common, says Peter Filip, MD, an assistant professor in the department of otorhinolaryngology and head and neck surgery at Rush University Medical Center in Chicago. Up to 80 percent of people have some degree of septal deviation, though some aren't aware of it. Deviated septums usually aren't problematic, but they can cause issues for some people and affect quality of life, Dr. Filip says.
Deviated Septum, Defined
The nasal septum, a thin layer of cartilage and bone in the middle of the nasal cavity, separates the left and right sides of your nose. It’s what creates your two nostrils. A deviated septum is a septum that's off-center. Sometimes, the deviation can restrict airflow in one or both sides of the nose, making breathing more difficult.
Causes of a Deviated Septum
Many people are born with deviated septums, says Bradley Marple, MD, a professor and the chair of otolaryngology–head and neck surgery at the University of Texas Southwestern Medical Center in Dallas. This might be the result of a difficult birth, connective tissue disorder such as Ehlers-Danlos syndrome, or the septum simply leaning more to one side over time as the nose grows. "In other words, they just grow that way," Dr. Marple says.
Nasal trauma is another common cause of septum displacement. "Most of us, whether we remember or not, get hit in the nose at some point," Filip says. Injury or trauma from contact sports, falls, rough play like wrestling, or car accidents can cause a deviated septum.
What Are the Symptoms of a Deviated Septum?
One of the most common signs of septal deviation is difficulty breathing through the nose, says R. Peter Manes, MD, a rhinologist and endoscopic skull base surgeon at Yale Medicine in New Haven, Connecticut.
"If it deviates to one side, it will limit airflow to that side," Dr. Manes says. "If it is more S-shaped, with part going to one side and part going to the other, it may restrict airflow on both sides." Nasal congestion in one or both sides of the nose is also common, Filip notes.
Other symptoms of a deviated septum include:
- Headaches
- Pain in the face
- Noisy breathing
- Nosebleeds
- Chronic sinus inflammation (sinusitis)
- Snoring
- Sleep apnea
Is a Deviated Septum Serious?
Deviated septums aren't dangerous but can affect quality of life, says Marianella Paz-Lansberg, MD, an otolaryngologist at Boston Medical Center. "Reduced airflow can affect exercise capacity, worsen snoring, and lead to frequent nosebleeds," she says.
How Is a Deviated Septum Diagnosed?
A primary care doctor may be able to diagnose severe nasal septum deviation with a physical exam, Filip says. But to properly diagnose and evaluate a deviated septum, an otorhinolaryngologist (also known as an ear, nose, and throat doctor, or ENT) must use a small camera called an endoscope, he says.
"A primary care doctor can only see the very front of the septum and does not have a camera to see the inside of the nose," he says. "This lack of instrumentation is a major limitation as they can only diagnose a very bad septal deviation in the front of the nose but would miss anything even a little farther back."
A nasal endoscopy gives the doctor a clear look at the nasal cavity, indicating how badly the septum is deviated and whether there are other causes of congestion, such as polyps, allergic swelling, or a sinus infection, Filip says. In some cases, a doctor may use a computed tomography (CT) scan, as well, he adds.
Treatment for a Deviated Septum
Most deviated septums don't require treatment because they don't cause any symptoms. If you do have symptoms, medication or corrective surgery can help.
Medications
Mild cases of deviated septum that cause occasional symptoms may benefit from nonsurgical treatments. These consist of over-the-counter medications, such as decongestants, nasal steroid sprays, and antihistamines. They can help reduce congestion and inflammation, making breathing easier.
- Decongestants Over-the-counter decongestants can decrease inflammation and excess mucus, helping to counteract blockage, says Linda Lee, MD, a facial plastic and reconstructive surgery physician at Mass Eye and Ear in Boston. "While the decongestants do not treat the deviated septum directly, they can help to open the nasal airway around the deviated septum to help improve airflow," she says. Be careful not to use nasal decongestants that include oxymetazoline (such as Afrin) for more than three days, as doing so can create dependency, causing a "rebound effect" and increased congestion when you stop using them, she warns. It's safe to use oral decongestants for longer, Dr. Lee says, but they have not been studied for long-term use and may cause unwanted side effects, so speak with your doctor about how long you can take them.
- Nasal Steroid Sprays Prescription nasal steroid sprays like fluticasone (Flonase) can clear the airways by reducing mucus and alleviating swelling in the turbinates, the tiny structures in the nose that cleanse and humidify air traveling to the lungs, Lee says. Unlike sprays with oxymetazoline, nasal steroid sprays are safer to use for extended periods, Lee notes. They work much more slowly and may take up to six to eight weeks to produce optimal results. "Don't give up on them without a real trial period — consistency is key," she says, adding that these sprays can have minor side effects, such as dryness in the nose or increased bloody noses. "Because these sprays target the turbinates (not the septum), direct them away from the septum for best results," she says.
- Antihistamines Antihistamines may also be helpful to alleviate symptoms, particularly if you have allergies alongside nasal septum deviation, Lee says. These medications work by blocking histamines, chemicals the immune system releases in response to allergy triggers that can cause symptoms like runny nose, itching, and inflammation. Many people experience nasal obstruction from their deviated septum and congestion from allergies or turbinate hypertrophy (enlargement), Lee says. "It's important to identify both and treat in multiple ways if needed," she says. Your doctor might suggest using a prescription antihistamine spray such as azelastine in addition to a nasal steroid, or independently, she adds.
Procedures
Doctors typically only recommend deviated septum surgery when a patient has severe symptoms, Manes says.
"I always tell people to consider how much their symptoms bother them, and if that amount of bother is enough to undergo a surgery," Manes says. "For some people, it is, and for some people, it is not. It is a very personal decision."
Deviated septum correction options include:
- Septoplasty This minimally invasive, outpatient procedure involves removing or reshaping deviated portions of the septum to reposition it and improve airflow. Septoplasty may involve adding or removing cartilage and bone.
- Septorhinoplasty For more severe deviations or when additional nasal issues need to be addressed, a doctor may recommend a septorhinoplasty, Dr. Paz-Lansberg says. This more complex procedure straightens the septum and changes the nose's shape.
- Turbinate Reduction Another option is turbinate reduction, which may be performed alone or alongside a septoplasty, Lee says. "It does not address the septum directly but reduces the size of the turbinate, which is next to the septum, to allow more room for nasal airflow," she says.
Are There Any Complications Related to a Deviated Septum?
Although nasal septum deviation can interfere with quality of life, most cases don’t cause health complications, Paz-Lansberg says. But chronic nasal congestion may prevent the sinuses from draining properly, which may contribute to infection, Lee notes.
Additionally, research suggests that individuals with chronic congestion from a deviated septum are at increased risk of developing obstructive sleep apnea.
"If patients feel chronic, severe nasal obstruction, especially single-sided, a doctor's visit with a full intranasal examination is recommended to hear about treatment options," Lee says. You should also see a doctor if you experience frequent nosebleeds or recurring sinus infections.
The Takeaway
- Many people with nasal septum deviation don’t realize they have it because they don't have any symptoms.
- If you’re experiencing symptoms like nasal blockage or breathing difficulties, see your doctor for a diagnosis and treatment.
- Usually, it's possible to address symptoms without surgery, but your doctor can help you choose the best option for your needs.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
- Deviated Septum. Mayo Clinic. September 14, 2021.
- Deviated Septum. Cleveland Clinic. July 3, 2023.
- Deviated Septum. Johns Hopkins Medicine.
- Diagnosing Deviated Septum. NYU Langone. September 14, 2021.
- Deviated Septum: Diagnosis & Treatment. Mayo Clinic. September 14, 2021.
- ENT-How to Use Nasal Steroid Spray. National Health Service Northern Care Alliance. September 2024.
- Steroid Nasal Spray. National Health Service. June 15, 2023.
- Farzam K et al. Antihistamines. National Library of Medicine. July 10, 2023.
- Sarikaya PZ et al. Relationship Between Nasal Septal Deviation Angles and Turbinates: A Computed Tomography Study. Cureus. February 21, 2023.
- Azelastine (Nasal Route). Mayo Clinic. March 1, 2025.
- McCallum K. What Is a Deviated Septum and When Is Surgery Needed to Fix It? Houston Methodist. September 28, 2022.
- Septoplasty. Cleveland Clinic. September 19, 2022.
- Septoplasty and Septorhinoplasty. National Health Service. December 7, 2022.
- Turbinate Reduction. Cleveland Clinic. April 19, 2022.
- Yeom SW et al. Association Between Septal Deviation and OSA Diagnoses: A Nationwide 9-Year Follow-Up Cohort Study. Journal of Clinical Sleep Medicine. October 1, 2021.
Meet Our Experts
Jessica Lee, MD
Medical Reviewer
Jessica Lee, MD, practices general otolaryngology at Charleston ENT and Allergy in South Carolina. After several years in clinical and surgical practice, Dr. Lee wanted to learn more about the impact of nutrition, activity, and sleep on general health and ear, nose, and throat health, so she pursued additional training in integrative, lifestyle, and functional medicine topics and became board-certified in lifestyle medicine in 2021.
Her practice centers on first addressing the lifestyle causes of disease and chronic illness, with the understanding and ability to use medical and surgical care for more acute concerns. She is also the co-founder and director of the Keto Hope Foundation, a nonprofit dedicated to helping families use the ketogenic diet as medical treatment for epilepsy
Lee enjoys cooking, strength training, reading, and spending time with friends and family.
Her practice centers on first addressing the lifestyle causes of disease and chronic illness, with the understanding and ability to use medical and surgical care for more acute concerns. She is also the co-founder and director of the Keto Hope Foundation, a nonprofit dedicated to helping families use the ketogenic diet as medical treatment for epilepsy
Kate Daniel
Author
Kate Daniel is a journalist specializing in health and wellness. Previously, she was a reporter for Whidbey News Group in Washington, where she earned four regional awards for her work. Daniel has written for various outlets, including HealthDay, Nice News, and Giddy.