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What are the symptoms of skull and face fractures?

Written by Bellaire ER Medical TeamUpdated July 4, 2026

Skull and facial fractures cause focused pain or a felt step-off at the injured bone, rapid swelling and bruising, and sometimes visible deformity such as a flattened cheek, crooked nose, or teeth that no longer meet. Warning signs of a deeper injury include double vision, facial numbness, clear fluid from the nose or ears, and bruising around both eyes or behind the ear.

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What a Fracture Feels and Looks Like

The most common symptoms are focused pain and tenderness directly over the injured bone, sometimes with a step-off: an edge or dent you can feel where the bone has shifted. Swelling and bruising usually appear quickly. Because facial bones are close to the surface, a fracture may also produce a visible change in shape: a flattened cheekbone, a crooked or shifted nose, or a sunken eye. If the jaw or the bones around the teeth are involved, the teeth may no longer meet correctly when you bite down.

Symptoms That Reveal a Deeper Problem

Certain symptoms matter more than the pain itself because they point to injury of the structures the bone protects:

  • Double or blurred vision, or trouble moving the eye: suggests an eye-socket (orbital) fracture trapping the muscles that move the eye
  • Numbness of the cheek, upper lip, gums, or forehead: a facial nerve running through the bone has been injured
  • Bleeding from the ear, or a nosebleed that will not stop: can accompany a fracture at the base of the skull
  • Thin, clear fluid draining from the nose or ears: may be cerebrospinal fluid leaking, a sign the fracture reaches the space around the brain

Bruising Patterns That Are Warning Signs

Two specific bruising patterns are classic signs of a skull-base fracture and should never be ignored: bruising around both eyes (“raccoon eyes”) and bruising behind the ear (Battle’s sign). These often appear hours after the injury, so their absence right away does not rule out a fracture.

Overlap With Brain-Injury Symptoms

Because the force that breaks head bone can also shake the brain, fracture symptoms frequently arrive alongside concussion or brain-injury signs: headache, confusion, drowsiness, nausea, or vomiting. These symptoms can develop or worsen in the hours after the injury, which is why symptoms that seemed minor at first still deserve attention if they progress.

For a complete guide, see our skull and face fractures page. Bellaire ER is open 24/7 at 5302 Bellaire Blvd with on-site CT and X-ray to identify what is behind your symptoms. Walk in any time, or call (713) 660-0001.