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Why Is One Nostril Always Blocked? An ENT in Gangnam, Seoul Explains

Answered by Dr. Kim Yoo Suk, MD · Board-certified otolaryngologist · Former professor, Yonsei & Ajou University · Consultations in English

First, is it really always the same side?

Everyone has a nasal cycle: the turbinates, the soft ridges inside each side of the nose, take turns swelling and shrinking every few hours. Most people never notice it, but when the lining is inflamed from a cold or allergy, the cycle becomes obvious and blockage seems to move from side to side, especially when lying down.

Blockage that stays on one fixed side for weeks or months is different. It usually means something structural or localized is narrowing that passage.

Common causes of a one-sided blocked nose

• Deviated septum: the dividing wall bends toward one side, narrowing it. The opposite turbinate often enlarges to fill the extra space.
• Turbinate hypertrophy: chronically enlarged turbinates, as seen in hypertrophic rhinitis, can be worse on one side.
• Nasal polyps: usually on both sides, but can be uneven.
• One-sided sinusitis: including sinusitis from an upper tooth or dental implant.
• Nasal valve collapse: the side wall near the nostril caves in when you breathe in.
• Old injury: a previous broken nose can leave a twisted septum or bone.
• Foreign body: mainly in children, often with a foul-smelling discharge from one side.
• Tumors: uncommon, but benign growths such as inverted papilloma, or rarely cancers, typically affect one side.

Red flags that need prompt evaluation

See an ENT soon if one-sided blockage comes with nosebleeds, bloody discharge, facial numbness or swelling, a change in vision, loosening of upper teeth, or a one-sided ear fullness that does not go away. These features do not mean cancer, but they should be checked with an endoscope rather than treated with sprays alone.

What we do at Gangnam Yonsei ENT

A blocked nostril is one of the most common reasons people visit our nose clinic, and it is a core area for Dr. Kim Yoo Suk, whose subspecialty as a former Yonsei and Ajou professor was rhinology. The key test is a nasal endoscopy, which takes a few minutes and shows the septum, turbinates, sinus openings, and back of the nose. A decongestant may be applied to see how much of the blockage shrinks, which separates swollen lining from fixed structure.

If the cause is not clear, or surgery is being considered, a sinus CT scan gives a three-dimensional view. Treatment follows the cause:

• Swollen lining: steroid sprays, allergy treatment, saline irrigation
• Fixed septal deviation: septoplasty
• Persistent turbinate enlargement: turbinate reduction
• Polyps or sinus disease: medication first, then endoscopic surgery if needed

Functional nasal surgery at our clinic is performed under local anesthesia, and many patients go home the same day.

Try this before your visit

Note whether the blockage is worse at night, after alcohol, or during allergy season, and whether you use decongestant sprays. Bring any prior scans. Consultations are in English; see our location and hours, or read whether you can get hooked on nasal sprays and whether a deviated septum is dangerous.

Related questions

Why does my nose block on the side I lie on?

Gravity increases blood flow to the lower side of the nose when you lie down, so the turbinates on that side swell. This is normal, but it becomes very noticeable when the nose is already inflamed or narrowed by a septal deviation.

Can a one-sided blocked nose be a tumor?

It is possible but uncommon. Most one-sided blockage is due to septal deviation or turbinate swelling. Bleeding, numbness, facial swelling, or symptoms that steadily worsen deserve prompt endoscopy so that a growth can be excluded.

Will a nasal spray fix a one-sided blockage?

Steroid sprays help when the cause is swollen lining from allergy or rhinitis. They cannot straighten a bent septum or remove a polyp. If sprays used correctly for several weeks do not help, a structural cause is more likely.

This answer is general medical information written and reviewed by an ENT specialist. It is not a diagnosis. Please see a doctor for an examination. In an emergency in Korea, call 119.