- Diagnostic Guidelines for Blood Pressure Screening Techniques What are the Symptoms for High Blood Pressure?
- What To Do When You Get a Nosebleed
- Nosebleed Do’s and Don’ts
- When to Go to the Emergency Room
- Why Come to Michigan for Treatment?
- Make an Appointment
- Nosebleed for No Reason? Here Are Some Possible Causes
- 2. Dry Air
- 3. Blood-Thinning Medications
- 4. Nose Picking or Scratching
- How to Stop a Bloody Nose at Home
- When to Get Help for Nosebleeds
- Can Stress Trigger Nosebleeds?
- What Is Alcoholic Nose? (Rhinophyma)
- The Stigma Of Addiction And Alcoholic Nose
- Nosebleed Do’s and Don’ts
- Nosebleed (Epistaxis)
Diagnostic Guidelines for Blood Pressure Screening Techniques
What are the Symptoms for High Blood Pressure?
What are the Symptoms for High Blood Pressure?
The AHA continues to call hypertension (high blood pressure) the “silent killer.” There are no concrete symptoms for high blood pressure. Headaches, dizziness, and nosebleeds (epistaxis) are not usually caused by high blood pressure, unless the patient is in hypertensive crisis (systolic 180 or greater and/or diastolic 120 or greater). In this case, you should call 911. Facial flushing may occur with high blood pressure, but high blood pressure is not the cause of facial flushing. Factors such as spicy foods, sun exposure, cold weather, hot drinks, medical conditions, and exercise are more of the cause of facial flushing. Although dizziness is not the cause of high blood pressure, it may be a side effect of some blood pressure medications. In addition to extreme blood pressure readings, severe headaches and nosebleeds, patients may also experience severe anxiety and shortness of breath. Again, it must be stressed that if your patient is in hypertensive crisis (systolic 180 or greater and/or diastolic 120 or greater) they must receive emergency care immediately – call 911.
One in seven Americans will develop a nosebleed (epistaxis) at least once in their lives. While nosebleeds are common and usually harmless, the sudden onset of a bloody nose can be startling and frightening. The most common causes for nosebleeds are dry climate, heated indoor air during winter months, steroid nasal sprays or direct injury to the nose. More intense and frequent nosebleeds may occur in people who take anticoagulation medication.
Fortunately, there are some easy steps you can take to prevent and treat most nosebleeds on your own at home.
What To Do When You Get a Nosebleed
View our video for step-by-step instructions on what to do when you get a bloody nose and tips for preventing nosebleeds in the future.
If your nosebleeds occur more than three to four times per week, or six or more times in a month despite following these tips, please contact your health care provider. Patients who take anticoagulation medication and experience frequent and/or more severe nosebleeds should call 734-936-8051 for an urgent appointment.
Nosebleed Do’s and Don’ts
(Note: the following instructions are intended for adult and adolescent use only.)
Nosebleeds are rarely dangerous and can be easily managed at home if you know what to do and when to seek help.
- Remain calm.
- Lean forward. If there is blood in your mouth, spit it out; do not swallow it.
- Apply 3 sprays of decongestant nose spray, such as Afrin, into the side that is bleeding.
- Pinch the soft part of your nose shut.
- Pinch the nose for 10 minutes. Use a clock to keep track of time. Resist the urge to peek after a few minutes to see if your nose has stopped bleeding.
- After 10 minutes, let go of your nose. If it is still bleeding, soak a cotton ball with the nose spray. Place the cotton ball into the bleeding nostril and pinch for 10 minutes. Again, use a clock to time it.
- Once bleeding has stopped, do not blow your nose for 2 days.
- Check your blood pressure, if possible. High blood pressure can cause nosebleeds.
- Do not pack the nose with tissues or other household items like tampons. This can make the bleeding worse.
- Do not tilt your head back or lie flat. This may cause you to choke on blood. Blood in the stomach can make you sick to your stomach and cause vomiting
- Do not lift anything heavy, like groceries or perform physical activities or household chores such as vacuuming. Do not pick up young children and babies. It can take up to two full weeks to heal after a nosebleed.
When to Go to the Emergency Room
Nosebleeds are a nuisance but rarely an emergency. There are some situations, however, when nosebleeds require immediate medical attention:
- Bleeding that does not stop in 30 minutes.
- Bleeding that is very heavy, pouring down the back of your throat and out the front of your nose.
- Bleeding with other symptoms, like very high blood pressure, light-headedness, chest pain and/or rapid heart rate that may require treatment.
Why Come to Michigan for Treatment?
- We have expertise in treating all forms of nosebleeds, including those caused by hereditary conditions.
- We treat more than 84,000 patients every year.
- We take a multidisciplinary, step-by-step approach that takes you – as a whole person – into account.
- If you need us for surgery, know that we perform more than 7,000 surgeries every year. And, when it comes to surgery, experience counts.
Make an Appointment
To make an appointment, please call 734-936-8051. If you take anticoagulation medication and experience frequent/more severe nosebleeds, call us for an urgent appointment.
Nosebleed for No Reason? Here Are Some Possible Causes
Colds, allergies, and frequent nose-blowing can also irritate the lining of your nose, resulting in a nosebleed.
2. Dry Air
Dry air from indoor heating or outdoor cold can dry the lining of the nose, causing it to crack and bleed. Using a humidifier while sleeping can help relieve dryness, and nasal sprays are helpful for moistening the nostrils.
3. Blood-Thinning Medications
Anticoagulant (blood-thinning) medications, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDS) used to treat pain can all cause nosebleeds. Because blood clotting is a necessary step in preventing or stopping a nosebleed, any medication that changes the blood’s ability to clot can cause a bloody nose — or make one harder to stop. Examples include anticoagulants like Coumadin or Jantoven (warfarin), the anti-platelet medication Plavix (clopidogrel bisulfate), over-the-counter drugs like aspirin, and prescription or over-the-counter NSAIDS like naproxen.
Many people with the heart condition atrial fibrillation (AFib), an irregular heartbeat, take anticoagulant medication to prevent blood clots from forming. And if you’ve had a heart attack, your doctor may have recommended a daily aspirin to help prevent a recurrence. Blood clots can lead to a stroke or heart attack if they travel through the blood and reach the brain or heart, but the anticoagulant medications commonly used to prevent clots carry an increased risk of bleeding.
4. Nose Picking or Scratching
Accidental injury to the blood vessels in the nostril from nose picking can cause a nosebleed. This is common in children, but also in adults who are prone to itching or scratching inside their noses.
How to Stop a Bloody Nose at Home
- While sitting and leaning forward, use direct pressure to stop bleeding by pinching your nostrils shut for at least 10 minutes, breathing through your mouth.
- Alternatively, you can make a nose-pinching device using tongue depressors and tape.
- If bleeding starts again, use a nasal decongestant spray (such as Afrin, Dristan, or Vicks Sinex) to constrict the blood vessels of your nose, and again apply direct pressure to stop bleeding.
To prevent another bloody nose, use saline and topical ointments to moisturize inside your nose, but only once bleeding has stopped. And avoid picking or scratching your nose.
When to Get Help for Nosebleeds
Although most nosebleeds can be treated at home, some are severe and require medical attention. Kevin Campbell, MD, a cardiologist at Wake Heart and Vascular Associates in Raleigh, North Carolina, says “Nosebleeds are rarely life-threatening. But under certain circumstances, such as if you’re taking blood thinners like aspirin or warfarin, nosebleeds can be quite concerning and require medical care.” In such cases, your healthcare provider may need to adjust the dose of blood-thinning medication, he says.
Having more than one nosebleed a week is also a sign that you should talk to your doctor. “If nosebleeds are recurrent — whether or not you’re on blood-thinning medications — it’s reasonable to seek help from your primary care physician,” says Dr. Campbell. He adds that recurrent nosebleeds may point to other, more significant medical conditions.
“You should certainly seek medical attention in an emergency room if your nosebleed lasts longer than a few minutes, or if you’re unable to stop the bleeding with direct manual pressure,” Campbell says.
RHD is a major public health concern in the developing nations with a mean prevalence of 2.1/1000 among school going children (5–15 years of age) and contributing to 6.6% of cardiovascular admissions. Recurrent attacks of acute rheumatic fever are more common in the adolescent and younger age groups, while RHD shows its peak prevalence between 25 and 40 years. RHD has a female preponderance of about two times as in males. Even though the disease is very rare in developed countries, they do encounter atypical presentations of the disease. The modified Jones criteria for diagnosis of rheumatic fever effectively diagnose the condition in most cases but varied presentations might lead to undiagnosed/misdiagnosed cases. In the original Jones criteria (1944), the minor criteria included epistaxis, abdominal pain, and pulmonary findings which were later removed due to the lack of specificity of these symptoms.
Epistaxis is a usual presentation in emergencies, ear nose throat/otorhinolaryngology and medicine outpatient settings. About 60% of the population experience nose bleed at least once in their lifetime, of which only 6–10% seek medical care. As found in a German study, the hospitalized patients were just 6% from children less than 15 years. The common causes being trauma (nose picking, facial injury), hypertension, bleeding diathesis, dry climate, and idiopathic causes, to site a few. Recurrent episodes call for further examination to look for causes including polyps or nasopharyngeal diseases like juvenile angiofibroma especially in children. Bleeding could be anterior from the Kiesselbach’s plexus of vessels or posterior from the branches of the sphenopalatine artery or the woodruffs plexus. Epistaxis can be controlled in most of the cases by pinching the nose and applying pressure.
There is a 4% probability of developing epistaxis in a patient with acute rheumatic fever which increases to 9% in those who had recurrence of RHD. The probable pathogenesis of this presentation can be attributed to the increased susceptibility of the capillaries owing to rheumatic heart associated vasculitis and fibrinoid degeneration of the fibrous tissue which prevents effective platelet aggregation and hemostasis.
The key in unlocking this atypical presentation was the collapsing pulse and widened pulse pressure which called for further detailed examination and investigations. As defined by the World Heart Federation for echocardiographic diagnosis of RHD in individuals less than 20 years, the involvement of both the mitral and aortic valve gave the diagnosis.
The involvement of heart valves shows varied pattern. The most commonly involved is the mitral valve, followed by aortic and rarely tricuspid and pulmonary valves. As observed in a study on the pattern of valvular involvement, combined lesions are found in more than 55% of the cases where combination of mitral stenosis and regurgitation with AR is the commonest. About 20% of the cases show mitral and AR, as seen in our case. Chronic AR causes gradual left ventricular volume overload that leads to left ventricular enlargement and eccentric hypertrophy. Pure single valve lesion is less frequent, mitral stenosis being the commonest.
This case report is significant as it shows a male with RHD at an early age with initial presentation as epistaxis, which is infrequent and not among the diagnostic criteria. This patient had multivalvular disease without any cardinal symptoms of the cardiovascular system, which was peculiar. It is possible that such atypical presentations are being missed or undiagnosed and remain “subclinical” in the population of both developing as well as developed countries. They can present with cardiac failure later, as it would be undetected in the initial stages especially when any cardiac symptomatology is absent. Clinicians should be aware of such presentations and appropriate prophylaxis and treatment should be initiated.
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The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
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Can Stress Trigger Nosebleeds?
Although not usually dangerous, a nosebleed can be a stressful situation all by itself. There are steps you can take to reduce the anxiety surrounding a nosebleed when it happens.
No matter what’s causing your nosebleed, the first-line treatment method is the same:
- Sit up straight.
- Tilt your head slightly forward.
- Pinch your nose shut as you breathe in and out slowly through your mouth. You may need to pinch your nose shut for a full 10 minutes before the blood flow slows or stops.
When you get a nosebleed that you attribute to stress:
- Try to relax your breathing.
- Pay attention to the length of each breath and the rise and fall of your chest as you wait for the bleeding to stop.
- Remove yourself from any stressful circumstances while you treat your nosebleed.
- Seek out a quiet or secluded area. People tend to react strongly at the sight of blood, even when it’s just a nosebleed, so removing yourself from any excitement is ideal. Calming your thoughts and emotions will be easier when you’re by yourself or with one person you trust.
Once the flow of blood slows down, drink some water and get hydrated. If you can, go to an area with a humidifier or air that hasn’t been dried out with forced heating.
Nosebleed prevention and stress relief techniques | Prevention
You can incorporate stress relief techniques into your daily life to make stress and anxiety less of a factor.
Yoga has been studied as a treatment for high blood pressure and anxiety. Practicing yoga poses such as Child’s Pose and Mountain Pose might help you feel more balanced and calm.
In stressful moments, you may also try a “body scan” exercise to feel more connected to your body and relaxed. To do this, envision the different muscle groups in your body, then relax them, one at a time, as you breathe in deeply. This exercise can make you feel more present and aware of things other than your anxiety.
You can work to prevent stress-related nosebleeds by adopting healthy habits that contribute to a more balanced inner life. The following can all help reduce stress levels:
- Stay hydrated.
- Reduce your caffeine intake.
- Participate in regular cardiovascular exercise.
- Spend time outside in nature.
Take a look at the foods you tend to eat. See if there are things in your diet that may be causing your nosebleeds. There’s research to suggest that certain foods, like chocolate and citrus fruits, seem to bring on nosebleeds.
Sleeping in a room with a humidifier and avoiding allergy triggers can also work to prevent nosebleeds.
What Is Alcoholic Nose? (Rhinophyma)
Since everyone has different levels of sensitivity to alcohol, those suffering from rosacea will have to test and build their own boundaries to avoid severe flare-ups of alcoholic nose. A recent survey of rosacea patients found that 90 percent of responders found that limiting their alcohol consumption helps greatly to reduce sudden outbreaks.
The Stigma Of Addiction And Alcoholic Nose
Although alcoholic nose has nothing to do with drinking, the general public still widely associates this condition with alcohol abuse. Due to this close association, those that suffer from rhinophyma often feel self-conscious not just because of their appearance, but because others might assume that they’re an alcoholic. This assumption brings up a much larger issue surrounding the addiction community – the stigma surrounding those suffering from this heartbreaking disease.
People who have rhinophyma are so scared of being labeled as an alcoholic that some report avoiding social activities or going out on a regular basis. In doing so, the stigma of addiction continues to thrive. This stigma results in prejudice, avoidance, rejection, and discrimination against people who have an addiction because others are unwilling to show compassion to those different from them. Unfortunately, the shame of addiction often prevents those with alcoholism from reaching out for help.
The reality is, there are more than 15 million Americans suffering from an alcohol use disorder according to the National Institute on Alcohol Abuse and Alcoholism. Of this population, less than eight percent will receive treatment. To get more people suffering from alcoholism the help they desperately need, the stigma surrounding addiction must be broken.
People can start deconstructing the stigma of addiction by:
- Learning about the disease
- Talking about addiction with others
- Breaking down misconceptions about addiction
- Recognizing fact-based warning signs of alcohol abuse
- Speaking up when someone is mistreated because of their addiction
- Offering compassionate support to those struggling
- Avoiding hurtful labels like “addict” and “drunk”
The misconception that rhinophyma equals alcoholism is an outdated stereotype that can breed negative self-esteem and social anxiety. It can also prevent those actually suffering from alcoholism from getting the help they need.
Despite being widely considered a symptom of alcoholism, rhinophyma had nothing to do with alcohol consumption. This misguided and popular thought process perpetuates the stigma of addiction and prevents those suffering from alcoholism from seeking help.
Nosebleed Do’s and Don’ts
All it takes is a soccer ball to the face, or maybe just a little dry air. Then, suddenly, you have a bloody nose.
Nosebleeds can be annoying and sometimes scary, especially if you have a bleeding disorder. But they’re seldom cause for alarm. With many tiny, delicate blood vessels, the nasal membranes are easily irritated. Allergies, certain medications and dry air can all aggravate those membranes and lead to nosebleeds.
Most of the time, nosebleeds don’t require emergency medical attention and can be treated at home. However, you should seek medical care if you have a prolonged nosebleed—one that lasts for several hours and that does not respond to pressure or other home remedies—or frequent smaller nosebleeds that stop easily but return for weeks, or if you vomit blood or have signs of anemia.
Here are a few tips on what to do if you have a nosebleed.
- Pinch the bridge of the nose and lean forward slightly, holding pressure for a minimum of 10 minutes. You can use nose clamps to apply pressure, but you shouldn’t leave a clamp on for more than 10 minutes.
- Time the nosebleed and record the information to share with your care provider.
- Talk to your medical care team about the best products for preventing nosebleeds. Options include saline sprays, creams or gels that prevent the breakdown of clots, and lubricating creams and ointments.
- Avoid secondhand smoke and other triggers, such as allergens, or hot, dry air. If dry air seems to be a trigger, you can counteract it by using a humidifier.
- Rest after a nosebleed to avoid a recurrence. You should avoid vigorous activities like sports, running, and other activities that cause your blood pressure to increase.
- Lie flat or recline during a nosebleed. Blood could run down your throat; swallowing blood can upset your stomach and cause vomiting.
- Pick or vigorously blow your nose. Both can irritate the delicate nasal passage. Blowing your nose during a nosebleed can make the bleeding worse or cause bleeding to restart after it’s stopped.
- Bend over for a long period of time.
- Eat warm and spicy food—which can cause blood vessels to dilate—on the day of a nosebleed.
Random nosebleeds are always a nuisance, except maybe if you want to be Carrie for Halloween and don’t have time to buy fake blood. Otherwise, nosebleeds have zero benefits and many drawbacks, including stained clothing and feeling nervous that something is wrong with your health. Luckily, random nosebleeds are usually not a big deal and have totally harmless causes. Here are the various reasons why your nose might suddenly do its best impression of The Shining’s elevator scene.
1. The weather is as cold and dry as a smooth martini.
In areas of the United States that really experience winter, December through March is “nosebleed season,” Erich Voigt, M.D., clinical associate professor in the Department of Otolaryngology–Head and Neck Surgery at NYU Langone Health, tells SELF. During this time, the air is colder and dryer, he explains, and many people use heating systems in their homes. “This combination will make the nose very dry, which allows little cracks to develop in its membranes,” Dr. Voigt says.
This is a problem because your nose has a ton of blood vessels (they help moisturize and filter the air you breathe), Dr. Voigt says. Tiny cracks in your nose’s membranes can injure these blood vessels, making blood gush from your nose at what seems like random times.
If you suspect this is your issue, Dr. Voigt recommends getting a humidifier. You can also help keep the lining of your nose moist with petroleum jelly, antibiotic ointments, or saline nasal spray, says the Mayo Clinic.
2. You’ve been “scratching” your nose a lot lately.
This is another common reason behind nosebleeds, Riddhi Patel, M.D., an otolaryngologist at Northwestern Medicine Central DuPage Hospital in Winfield, Illinois, tells SELF. Picking or scratching at the inside of your nose is an easy way to wind up with a bleeding cut.
This is, Dr. Voigt notes, more common in little kids, but it does happen in adults sometimes. You’ve been warned.
3. Your yearly cold has made its appearance.
When you have an infection, your body releases histamine, a chemical that causes your blood vessels to dilate. This makes it easier for your immune system to get infection-fighting substances to the site of the illness. If that happens to be your nose, the tissues and blood vessels there can become inflamed. The resulting swelling can lead to congestion that makes you look back wistfully on all the times you took breathing easily for granted. As an added bonus, congestion sometimes comes with a runny nose.
Blowing your nose in response to congestion and runniness can irritate its lining enough for small cracks to form. “Someone who is blowing their nose a lot can force the blood right out of those small vessels from the pressure,” Dr. Voigt says.
On a related note, if you have cold symptoms that don’t go away after 10 days or that start to get better then come back with a vengeance, your cold may have progressed into a sinus infection, which happens when the cavities around your nasal passages get swollen. Usually, a sinus infection will clear up on its own, and in the meantime, you can treat symptoms with things like decongestants and nasal sprays with corticosteroids to reduce inflammation. If your sinus infection is really making your life hell, though, see your doctor, who may prescribe antibiotics if your case is extreme.
4. Your allergies are acting up.
Allergies can lead to a bloody nose the same way colds can. If you come into contact with an allergen, your body releases histamine that can cause the symptoms of an allergic reaction, including your nasal tissues getting congested and your nose running. If any of your nose’s blood vessels become irritated and exposed in the process, voilà, bloody nose.
5. You’ve been taking a medication that causes blood thinning.
There are two categories of blood thinners, according to the U.S. National Library of Medicine: anticoagulants, like heparin or warfarin, which slow your body’s clot-making process, and antiplatelet drugs, like aspirin, which make it harder for platelets to clump together and form a clot to stop bleeding. If you’ve recently been taking either kind, any injury to your nose’s blood vessels might cause bleeding when it otherwise wouldn’t or bleed more than you’d expect, Dr. Voigt says.
6. Something is wrong with your nasal septum.
Your nasal septum is the wall of bone and cartilage separating your right and left nostrils. If yours is deviated, meaning it leans to the left or right, one side of it can be more exposed to airflow than it usually would be, according to the Mayo Clinic. This can dry it out and make it more likely to bleed. Some people don’t even realize they have a deviated septum because the curvature is so slight, but others are aware because it’s tough to breathe properly. In that case, a doctor can likely fix the issue with surgery.
A nosebleed occurs when blood vessels lining the nose get injured and bleed.
What is a nosebleed?
Simply put, a nosebleed is the loss of blood from the tissue that lines the inside of your nose.
Nosebleeds (also called epistaxis) are common. Some 60% of people will have at least one nosebleed in their lifetime. The location of the nose in the middle of the face and the large number of blood vessels close to the surface in the lining of your nose make it an easy target for injury and nosebleeds.
Are nosebleeds serious?
Although seeing blood coming out of your noise can be alarming, most nosebleeds are not serious and can be managed at home. Some, however, should be checked by your doctor. For instance, if you have frequent nosebleeds, see your doctor. This could be an early sign of other medical problems that needs to be investigated. A few nosebleeds start in the back of the nose. These nosebleeds usually involve large blood vessels, result in heavy bleeding and can be dangerous. You will need medical attention for this type of bleed, especially if the bleeding occurs after an injury and the bleeding hasn’t stopped after 20 minutes of applying direct pressure to your nose. (Read on to learn the steps for how to stop a nosebleed.)
Are there different kinds of nosebleeds?
Yes. Nosebleeds are described by the site of the bleed. There are two main types and one is more serious than the other.
An anterior nosebleed starts in the front of the nose on the lower part of the wall that separates the two sides of the nose (called the septum). Capillaries and small blood vessels in this front area of the nose are fragile and can easily break and bleed. This is the most common type of nosebleed and is usually not serious. These nosebleeds are more common in children and are usually able to be treated at home.
A posterior nosebleed occurs deep inside the nose. This nosebleed is caused by a bleed in larger blood vessels in the back part of the nose near the throat. This can be a more serious nosebleed than an anterior nosebleed. It can result in heavy bleeding, which may flow down the back of the throat. You may need medical attention right away for this type of nosebleed. This type of nosebleed is more common in adults.
Who gets nosebleeds?
Anyone can get a nosebleed. Most people will have at least one in their lifetime. However, there are people who are more likely to have a nosebleed. They include:
- Children between ages two and 10. Dry air, colds, allergies and sticking fingers and objects into their nose make children more prone to nosebleeds.
- Adults between ages 45 and 65. Blood may take longer to clot in mid-life and older adults. They are also more likely to be taking blood thinning drugs (such as daily aspirin use), have high blood pressure, atherosclerosis (hardening of the walls of arteries) or a bleeding disorder.
- Pregnant women. Blood vessels in the nose expand while pregnant, which puts more pressure on the delicate blood vessels in the lining of the nose.
- People who take blood-thinning drugs, such as aspirin or warfarin.
- People who have blood clotting disorders, such as hemophilia or von Willebrand disease.
What causes nosebleeds?
Nosebleeds have many causes. Fortunately, most are not serious.
The most common cause of nosebleeds is dry air. Dry air can be caused by hot, low-humidity climates or heated indoor air. Both environments cause the nasal membrane (the delicate tissue inside your nose) to dry out and become crusty or cracked and more likely to bleed when rubbed or picked or when blowing your nose.
Other common causes of nosebleeds include:
- Nose picking.
- Colds (upper respiratory infections) and sinusitis, especially episodes that cause repeated sneezing, coughing and nose blowing.
- Blowing your nose with force.
- Inserting an object into your nose.
- Injury to the nose and/or face.
- Allergic and non-allergic rhinitis (inflammation of the nasal lining).
- Blood-thinning drugs (aspirin, non-steroidal anti-inflammatory drugs, warfarin, and others).
- Cocaine and other drugs inhaled through the nose.
- Chemical irritants (chemicals in cleaning supplies, chemical fumes at the workplace, other strong odors).
- High altitudes. The air is thinner (lack of oxygen) and drier as the altitude increases.
- Deviated septum (an abnormal shape of the wall that separates the two sides of the nose).
- Frequent use of nasal sprays and medications to treat itchy, runny or stuffy nose. These medications – antihistamines and decongestants – can dry out the nasal membranes.
Other, less common causes of nosebleeds include:
- Alcohol use.
- Bleeding disorders, such as hemophilia or von Willebrand disease or leukemia.
- High blood pressure.
- Facial and nasal surgery.
- Nasal tumors.
- Nasal polyps.
- Immune thrombocytopenia.
- Hereditary hemorrhagic telangiectasia.
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