5 Signs You Have a Deviated Septum (and When to See a Specialist)

Have a deviated septum? The five most common signs are trouble breathing through your nose, frequent nosebleeds, one side feeling more blocked than the other, a visibly crooked nose, and nasal sprays that stop working. Here Dr. Hootan Zandifar explains each sign and when treatment is worth considering.

What Is the Nasal Septum?

The nasal septum is the middle wall of the nose — made of cartilage and bone — that divides it into a right and a left side, running all the way to the back where the two sides meet. When that cartilage and bone is crooked to one side or the other, it is called a deviated septum. It is extremely common: as Dr. Zandifar notes, roughly 95 out of 100 people have some degree of a crooked septum. The real question isn’t whether you have one — it’s whether it’s causing symptoms that warrant treatment.

5 Signs You May Have a Deviated Septum That Needs Treatment

1. You can’t breathe through your nose. The most common complaint — difficulty breathing through either side that over-the-counter medications don’t fix. On exam there is often a significant deviation that may require surgery.

2. Frequent nosebleeds. As air moves through the nose and passes the crooked portion of the septum, it dries that area out, making it more prone to bleeding. Recurring nosebleeds can therefore be a sign of a deviation.

3. One side is more blocked than the other. If the wall is crooked toward the right, the right side is more obstructed; if toward the left, the left side. Consistent one-sided blockage strongly suggests a deviated septum.

4. A visible deviation of the nose. The septum forms the midline of the nose. If the midline appears shifted to one side — or, viewed from the base, the central wall is clearly crooked — the deviation may be significant enough to need correction.

5. Nasal medications stop working. If you keep using medication for nasal obstruction and it doesn’t improve, that points to an anatomical obstruction (the shape of the nose inside) rather than allergy-related swelling.

How a Deviated Septum Is Diagnosed

An accurate diagnosis requires an in-person exam. A specialist uses a nasal endoscope to see all the way to the back of the nose and evaluate whether the deviation is significant enough to benefit from surgery (septoplasty). As a double board-certified ENT and facial plastic surgeon, Dr. Hootan Zandifar evaluates both the airway and the appearance of the nose — so treatment restores comfortable breathing while keeping the nose looking natural.

Related: Deviated Septum Repair & Rhinoplasty · Call 424-349-6008 to schedule a consultation.