Your nose is home to many blood vessels. Because of this, and the fact that noses protrude from the face, noses are a target for trauma. Therefore, they are prone to bleeding.
While nose bleeds can be frightening, they’re common in both children and adults. In fact, most people have at least one nose bleed in their lives. Luckily, the vast majority of nose bleeds are manageable and do not require a trip to the doctor’s office.
Though a nose bleed is seldom a serious medical condition, recognizing what causes it, how to treat and prevent them, and when it’s appropriate to see a doctor can leave you feeling more prepared the next time you’re faced with one.
What Is a Nose Bleed?
Nose bleeds, also known by the medical term epistaxes, are when the blood vessels inside the nose bleed. Nose bleeds are classified into two groups: anterior nose bleeds, when the blood vessels at the front of your nose break, and posterior nose bleeds, which occur deeper within your nose.
Anterior nose bleeds are easy to treat at home. Plus, they’re the more frequent type of nose bleeding in children. Posterior nose bleeds, however, are more common in adults. Because the bleeding is further back in the nose, the bleeding may be heavier, which means they may be more serious and may require medical attention.
What Causes Nose Bleeds?
While there are many factors that can contribute to a nose bleed, most cases originate from the combination of dry nasal passages and some type of trauma—even trauma as innocuous as nose-picking.
Causes of anterior nose bleeds
Anterior nose bleeds can happen quickly after dry nasal membranes crack. You may be more susceptible to these types of nose bleeds in dry climates or in dry central heating when indoors during the winter. Other common causes include:
- Being hit in the nose
- Picking the inside of your nose
- Sinusitis (inflammation of the sinuses), or any illness that causes nasal irritation
- Frequent nose-blowing due to a cold, viral infection, or the flu
- Rapid temperature change in low-humidity climates
- High altitude
- A deviated septum, or the displacement of the wall between your nasal passages
- Use of illicit drugs like cocaine
Causes of posterior nose bleeds
Like an anterior nose bleed, blood may escape down your nose and out of your nostrils during a posterior nose bleed. However, blood also tends to travel down your throat because of how deep posterior nose bleeds occur in your nose. This development usually makes them more dangerous than anterior nose bleeds.
Causes of posterior nose bleeds include:
- Injuries to the nose or skull
- Excessive exposure to chemical irritants like ammonia
- Extended time in dry air
- Leukemia, hemophilia, and other blood diseases
- Nasal surgery
Other nose bleed causes
Anterior and posterior nose bleeds share many common causes stemming from trauma and irritation. General causes for both types of nose bleed also include:
- Persistent picking or scratching inside your nose
- A foreign object stuck in your nose
- Upper respiratory infections
- Repeated sneezing
How to Stop A Bloody Nose
Here’s a step-by-step guide on how to stop a bloody nose at home. This method is effective for most cases of occasional nose bleeds. If you are unable to stop a nose bleed on your own following these steps, if your nose bleed lasts more than 20-30 minutes, or if you taste blood in your throat, see your doctor as soon as you can.
- Sit upright, lean forward and tilt your head forward slightly: It’s important to avoid lying down with a nose bleed, as you may inhale blood and gag or swallow blood and upset your stomach. Keep your head higher than your heart to reduce your blood pressure, which will help slow further bleeding.
- Blow your nose gently: Do this to clear any blood clots. While this may make the bleeding intensify, that’s expected. If there is blood lingering in your mouth or throat, spit it out.
- Pinch the soft part of your nose (just above your nostrils) together with your thumb and index finger: Breathe through your mouth and continue to pinch for 10 minutes. Applying pressure to the source of bleeding helps to stop the blood flow.
- Repeat: Continue going through the steps until the bleeding has stopped. Once it has stopped, refrain from bending over for the next several hours and blowing or picking your nose. If you are unable to stop the bleeding after 20-30 minutes, see your doctor as soon as possible to determine the cause.
In addition to this method, you can also apply a cold compress to the bridge of your nose to help seal off the small blood vessels. Nasal sprays like oxymetazoline (Afrin) can act as short-term solutions for minor bleeding and congestion, but do not use them for more than a few days in a row, since they could lead to worse nose bleeds over time.
If the severity of your nose bleed necessitates a trip to the doctor’s office, treatments may include chemicals or tools that seal off the blood vessels in your nose. Your doctor might also use special nasal gauzes, sponges, or balloons to stop the bleeding, or employ hot water with special tools to soothe irritation and cleanse your nasal cavity.
How to Prevent Nose Bleeds
Since dryness and trauma are the cause of most nose bleeds, preventative measures work to combat both of those conditions. Some effective preventative measures are:
- Avoiding picking your nose: This includes blowing your nose too hard, or blowing it too often.
- Using a humidifier: This will offset the effects of dry air in your home.
- Keeping the lining of your nose moist: Apply a very thin layer of petroleum jelly or antibiotic ointment (Neosporin, bacitracin) with a cotton swab as needed when your nose feels dry, up to three times per day.
Risk Factors and Complications
Medications that contribute to drying your nose can put you at a greater risk for nose bleeds, like antihistamines or decongestants. Meanwhile, medications that interfere with blood clotting—like aspirin, ibuprofen or anticoagulants—don’t necessarily increase your chance of having a nose bleed, but they could influence your body’s ability to stop one quickly once it begins.
If you are taking any of these medications and experiencing nose bleeds, consult with your doctor before stopping them, so you can properly assess their benefits and risks. Children and adults over 65 are more likely to get nose bleeds, as well as those who are pregnant due to a shift in hormones.
Anxiety and stress are risk factors for nose bleeds, but their connection isn’t necessarily direct. Instead, these conditions may trigger behaviors that lead to nose bleeds, like picking your nose or blowing it more frequently.
Nose bleeds in children
Nose bleeds in children ages 3-10 are common, since nose picking can agitate dried out nasal membranes in the nose. Prevention for children relies on many of the same actions as nose bleed prevention for adults, but also includes trimming your child’s fingernails to discourage—or minimize the damage from—nose picking.
When to See a Doctor
Most nose bleeds are not serious; only approximately 10% require medical attention and treatment. If you experience a nose bleed that lasts longer than 20-30 minutes despite applying pressure, see a health care professional as it could indicate you have a posterior nose bleed.
If your nose bleed follows an injury like a car accident, seek emergency medical care, especially if you fear your nose is broken; this could be a sign of internal bleeding.
See your doctor if you experience chronic or frequent nose bleeds–or those that occur four or more times per week. They’ll help determine the cause of your nose bleeds, and help rule out if it points to an underlying health issue.
How K Health Can Help
If you have questions about your nose bleeds, talk to a doctor. Did you know you can get affordable primary care with the K Health app? Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.