Nosebleeds are very common. In fact, 1 in 7 people living in the United States will have at least one nosebleed at some point during their life. Although it might seem scary while it’s happening, a nosebleed isn’t usually dangerous. Read on for more information about why a nosebleed happens, how to treat it, and ways to prevent it.
- What is a nosebleed?
- What causes a nosebleed?
- What do I do if my nose is bleeding?
- What happens if my nose doesn’t stop bleeding?
- What if I get nosebleeds a lot?
- Is there anything I can do to prevent a nosebleed?
- Nosebleed (Epistaxis)
- How to Prevent Nosebleeds
- How harmful is it to pick your nose?
- How are nosebleeds treated?
- Can nosebleeds be prevented?
- Nose Picking and Five Other Causes of Nosebleeds
- Direct Causes of Nosebleeds
- Other Possible Causes of Nosebleeds
- Health Conditions Tied to Nosebleeds
What is a nosebleed?
A nosebleed (also called “epistaxis”) is exactly what it sounds like – bleeding from the nose. The most common type of nosebleed is called an anterior nosebleed, which means that the blood is coming from the front of the nose. An anterior nosebleed occurs when tiny blood vessels inside your nose break and bleed.
Another type of nosebleed is called a posterior nosebleed, which means that the blood is coming from the back of the nose. The blood from this type of nosebleed will go down a person’s throat instead of out of the nostrils. Posterior nosebleeds are much more common in adults or in someone who experiences an injury to the nose or face. It’s more likely that you would need to see a health care provider for this type of nosebleed.
What causes a nosebleed?
There are many things that may cause a nosebleed (such as an injury to your nose), but the most common causes are dry air, allergies, colds, sinusitis, some types of nose drops, and nose picking.
When the air around you is dry (either from low humidity or heated indoor air) the membranes inside your nose can become very dry. This can cause an itchy crust to develop, and if you scratch or pick at it, it can cause bleeding. Your nasal membranes can also become irritated from allergies, colds, or sinusitis. Blowing your nose over and over again can cause bleeding as well.
What do I do if my nose is bleeding?
If your nose is bleeding, try your best to stay calm, and follow these steps:
- Get something to catch the blood, such as tissues, paper towel, or a damp cloth.
- Make sure to sit up (lying down can cause the blood to drip down the throat) and lean forward. Sitting up with your body tilted forward lowers the pressure in your nose and helps prevent you from swallowing blood, which can bother your stomach.
- Gently blow your nose to get rid of clots, and then pinch your nostrils shut with your thumb and index finger. Breathe through your mouth. Do this for 5 minutes (10-15 minutes for adults). If your nose is still bleeding after 5 minutes, keep holding this position for another 10 minutes.
After your nosebleed has stopped, don’t do anything that would cause you to strain. Make sure that you don’t blow or pick your nose for about 24 hours.
What happens if my nose doesn’t stop bleeding?
Most nosebleeds will stop either on their own or by following the steps above.
You should get emergency care if:
- The bleeding doesn’t stop after 20 minutes
- Your nose is bleeding after an injury (such as a car accident)
- You’re having trouble breathing
What if I get nosebleeds a lot?
If you have frequent nosebleeds such as more than once a week, talk with your health care provider. He or she will ask you if other members of your family have a lot of nosebleeds or a bleeding problem and may want you to have a blood test to check for anemia and clotting problems. Treatment depends on the cause (injury, allergies, infections, clotting problems etc.).
Is there anything I can do to prevent a nosebleed?
Yes. Things you can do to help prevent nosebleeds include the following:
- If you have a cold or allergies, or whenever you need to blow your nose, make sure you do it gently.
- Avoid picking your nose, even if it itches.
- Wear the proper protective sports equipment when playing sports to avoid a nose injury.
- Use a humidifier in your room to help keep the air moist in the winter.
If you’re concerned about nosebleeds, here’s a tip on how to bring it up with your provider: “I get nosebleeds a lot, is there anything I can do?”
How do I stop a nosebleed?
Follow these steps to stop a nosebleed:
- Sit upright and lean your body and your head slightly forward. This will keep the blood from running down your throat, which can cause nausea, vomiting, and diarrhea. (Do NOT lay flat or put your head between your legs.)
- Breathe through your mouth.
- Use a tissue or damp washcloth to catch the blood.
- Use your thumb and index finger to pinch together the soft part of your nose. Make sure to pinch the soft part of the nose against the hard bony ridge that forms the bridge of the nose. Squeezing at or above the bony part of the nose will not put pressure where it can help stop the bleeding.
- Keep pinching your nose continuously for at least 5 minutes (timed by clock) before checking if the bleeding has stopped. If your nose is still bleeding, continue squeezing the nose for another 10 minutes.
- If you’d like, apply an ice pack to the bridge of your nose to further help constrict blood vessels (which will slow the bleeding) and provide comfort. This is not a necessary step, but you can try this if you want.
- You can spray an over-the-counter decongestant spray, such as oxymetazoline (Afrin®, Dristan®, Neo-Synephrine®, Vicks Sinex®, others) into the bleeding side of the nose and then apply pressure to the nose as described above. WARNING: These topical decongestant sprays should not be used over a long period of time. Doing so can actually cause an increase in the chance of a nosebleed.
- After the bleeding stops, DO NOT bend over, strain and/or lift anything heavy. DO NOT blow or rub your nose for several days.
When should I go to the emergency room if I have a nosebleed?
Call your doctor immediately or have someone drive you to the nearest emergency room or call 911 if:
- You cannot stop the bleeding after more than 15 to 20 minutes of applying direct pressure on your nose as described in the steps above.
- The bleeding is rapid or the blood loss is large (more than a cup).
- You are having difficulty breathing.
- You have vomited because you’ve swallowed a large amount of blood.
- Your nosebleed has followed a blow to your head or serious injury (fall, car accident, smash to your face or nose).
Call your doctor soon if:
- You get nosebleeds often.
- You have symptoms of anemia (feeling weak or faint, tired, cold, short of breath, pale skin).
- You have a child under two years of age who has had a nosebleed.
- You are taking blood thinning drugs (such as aspirin or warfarin) or have a blood clotting disorder and the bleeding won’t stop.
- You get a nosebleed that seems to have occurred with the start of a new medication.
- You get nosebleeds as well as notice unusual bruising all over your body. This combination may indicate a more serious condition such as a blood clotting disorder (hemophilia or von Willebrand disease), leukemia or nasal tumor and will need to be checked by your doctor.)
What should I expect when I go to my doctor with a nosebleed?
The doctor will ask you questions about your nosebleed including:
- Length (in minutes) of your nosebleed.
- Approximate amount of blood that was lost.
- How often you get nosebleeds.
- Did the nosebleed involve one or both nostrils.
Your doctor will also ask about medications you are taking – including over-the-counter blood thinning drugs, such as aspirin, and drugs for colds and allergies. They will also ask if there is a family history of blood disorders and ask about your use of alcohol or any illegal drug use in which the drug was sniffed up your nose.
Next, your doctor will examine your nose to determine the source of the bleed and what may have caused it. They will use a small speculum to hold the nostril open and use various light sources or an endoscope (lighted scope) to see inside your nasal passages. Your doctor may use topical medications to anesthetize (numb) the lining of the nose and to constrict blood vessels. The doctor is also likely to remove clots and crusts from inside your nose. This can be unpleasant but is not painful. Your blood pressure and pulse will likely be taken. Occasionally, x-rays or CT scan or blood tests may be ordered to check for bleeding disorders, blood vessel abnormalities or nasal tumors.
What are the treatments for nosebleeds?
Treatments depend on the cause and could include:
- Nasal packing. Gauze, special nasal sponges or foam or an inflatable latex balloon is inserted into your nose to create pressure at the site of the bleed. The material is often left in place for 24 to 48 hours before being removed by a healthcare professional.
- Cauterization. This procedure involves applying a chemical substance (silver nitrate) or heat energy (electrocautery) to seal the bleeding blood vessel. A local anesthetic is sprayed in the nostril first to numb the inside of your nose.
- Medication adjustments/new prescriptions. Reducing or stopping the amount of blood thinning medications can be helpful. In addition, medications for controlling blood pressure may be necessary. Tranexamic (Lystedaâ), a medication to help blood clot, may be prescribed.
- Foreign body removal if this is the cause of the nose bleed.
- Surgical repair of a broken nose or correction of a deviated septum if this is the cause of the nosebleed.
- Ligation. In this procedure, the culprit blood vessel is tied off to stop the bleeding.
How to Prevent Nosebleeds
You can’t always prevent nosebleeds from happening, but there are certain things you can do to help lower your chances of getting them:
- Keep the inside of your nose moist. Dryness can cause nosebleeds. Use a cotton swab to gently smear a thin layer petroleum jelly in your nostrils three times a day, including before you go to sleep. You can also use an antibiotic ointment like Bacitracin or Polysporin.
- Use a saline nasal product. Spraying it in your nostrils helps keep the inside of your nose moist.
- Use a humidifier. Your nostrils might be dry because the air in your house is dry.
- Don’t smoke. Smoking can irritate the inside of your nose and dry it out.
- Don’t pick your nose. Also, don’t blow or rub it too hard. If your child is getting nosebleeds, keep his fingernails short and discourage him from picking his nose.
- Don’t use cold and allergy medications too often. These can dry out your nose. In some cases, certain medications can cause nosebleeds or make them worse. You may need to discuss your medications with your doctor. But keep taking them unless your doctor tells you to stop.
- Larger text sizeLarge text sizeRegular text size
Nosebleeds are usually harmless and easily controlled, but they can look scary. Try not to worry — most nosebleeds are easy to stop.
How Can I Stop a Nosebleed?
Try these simple tips to stop a nosebleed:
- Get some tissues or a damp cloth to catch the blood.
- Sit up or stand.
- Tilt your head forward and pinch your nostrils together just below the bony center part of your nose. Applying pressure helps stop the blood flow and the nosebleed will usually stop with 10 minutes of steady pressure. Don’t stop applying pressure to keep checking if the bleeding has stopped.
If you get a nosebleed, don’t blow your nose. This can cause more bleeding. Also, don’t tilt your head back. This common practice will cause blood to run into your throat. This can make you cough or choke, and if you swallow a lot of blood, you might vomit.
If you’ve tried the steps above twice and the bleeding continues after the second attempt, you’ll need to see your school nurse or a doctor.
After you’ve stopped the initial nosebleed, don’t lift heavy objects or do other activities that cause you to strain, and try not to blow your nose for 24 hours.
Now that your nosebleed is over, let’s take a look at what a nosebleed is and what can cause it.
Different Kinds of Nosebleeds
The most common kind of nosebleed is an anterior nosebleed, which comes from the front of the nose. Capillaries, or very small blood vessels, that are inside the nose may break and bleed, causing this type of nosebleed.
Another kind of nosebleed is a posterior nosebleed, which comes from the deepest part of the nose. Blood from a posterior nosebleed flows down the back of the throat even if the person is sitting or standing. Teens rarely have posterior nosebleeds. They’re more common in older people, people who have high blood pressure, and people who have had nose or face injuries.
What Causes Nosebleeds?
The most common cause of anterior nosebleeds is dry air. A dry climate or heated indoor air irritates and dries out nasal membranes, causing crusts that may itch and then bleed when scratched or picked. Colds may also irritate the lining of the nose. Bleeding may happen after repeated nose-blowing. When you combine a cold with dry winter air, you have the perfect formula for nosebleeds.
Allergies can also cause problems, and a doctor may prescribe medicine such as antihistamines or decongestants to control an itchy, runny, or stuffy nose. The medicine can also dry out the nasal membranes and contribute to nosebleeds.
An injury to the nose may cause bleeding and isn’t usually cause for alarm. If you ever have a facial injury, use the tips outlined earlier to stop the nosebleed. If you can’t stop the bleeding after 10 minutes or you are concerned about other facial injuries, see a medical professional right away.
Nosebleeds are rarely cause for alarm, but frequent nosebleeds might indicate a more serious problem. If you get nosebleeds more than once a week, you should see your doctor. Most cases of frequent nosebleeds are easily treated. Sometimes tiny blood vessels inside the nose become irritated and don’t heal. This happens more frequently in teens who have ongoing allergies or frequent colds. A doctor may have a solution if you have this problem.
If your doctor rules out a sinus infection, allergies, or irritated blood vessels, he or she may order other tests to see why you’re getting frequent nosebleeds. Rarely, a bleeding disorder or abnormally formed blood vessels could be a possibility.
Cocaine (or other drugs that are snorted through the nose) can also cause nosebleeds. If you suspect a friend is using cocaine, try talking about it and get help from a trusted adult.
Can I Prevent Nosebleeds?
- When you blow your nose (especially when you have a cold), do so gently into a soft tissue. Don’t blow forcefully or pick your nose.
- Your doctor may recommend a cool-mist humidifier to moisten your indoor air.
- Keep the inside of your nose moist with saline (saltwater) nasal spray or gel, or dab petroleum jelly or antibiotic ointment gently around the opening of the nostrils.
- Wear protective athletic equipment when playing sports that could cause injury to the nose.
An occasional nosebleed may make you worry, but there’s no need to panic — now you know what to do!
Reviewed by: Michelle P. Tellado, MD Date reviewed: September 2019
How harmful is it to pick your nose?
Let’s be honest: Most of us pick our noses sometimes. But, depending on how you pick your nose and how often you do it, you could be hurting yourself – in some cases, doing significant damage.
“When nose-picking becomes habitual, that’s when a problem can begin,” says Bradley Otto, MD, the director of rhinology at The Ohio State University Wexner Medical Center.
“It doesn’t take much of a scratch to the surface of your nose to make you bleed pretty significantly. If you have long fingernails or you’re a little bit rough, you can scrape that lining and cause scabbing that then may allow bacteria from the nasal skin to collect there.”
When a scab forms there, it’s tempting to pick the scab, starting a cycle of introducing more bacteria into your nose and removing more mucosa (the lining of the inner nasal cavity).
“Every time you pick that scab off, you pull away a little bit of the lining of the nose,” Otto says. “In rare cases, people can develop a perforation between their nostrils from digging away at the septum over time.”
How to stop the nose-picking cycle
Many habitual nose-pickers do it because their noses are just too dry. Frequent picking doesn’t fix the dryness.
These people often can improve by hydrating their noses, Otto says. Saline sprays can be helpful in some cases. Be careful using saline nasal sprays excessively, though – in some cases they can dry out your nose even more when you use too much of the spray, washing away your mucus with the saline.
“A natural oil can rehydrate the nose, instead,” Otto says. “One of my favorites is coconut oil, because it’s natural, it smells good, and it’s not so thick and greasy that it blocks off the airway or gets rubbed all over their nostrils.”
Otto recommends washing your hands, then dabbing a small amount on the inside lining of the nostril to lightly coat it. No need to do this forever – just enough times that the nose can hydrate better and the nose-picking cycle can stop.
Others who habitually pick their noses may have problems beyond nasal dryness.
Those who have septal deviations, making air flow through just one nostril, could benefit from surgery. And frequent nosebleeds and/or infections in the nose could signify other problems, so it’s important to see your doctor if you’re suffering from either.
Is it harmful to eat your boogers?
Politeness tells us that we won’t win points with co-workers by nose-picking or booger-eating during a meeting, for example.
But in private?
“In a way, I’d say you’re already doing it,” Otto says. “We make about a quart of mucus a day, and most of it we swallow.”
The mucus in your nose travels from the sinuses to the nasal cavity, where it catches particles that you inhale through your nose. Then that mucus heads to your stomach.
You may sometimes see headlines touting booger-eating as a way to boost the immune system. But because boogers are made from the same ingredients as the mucus we swallow every day, Otto says eating boogers doesn’t matter much to your immune system.
“Swallowing mucus is how your immune system learns how to deal with the things that end up in your nose,” Otto says. “And it’s how we protect our lungs – trapping those things in the air in mucus.”
How are nosebleeds treated?
A child with a nosebleed may be very frightened or distressed about it. Try to comfort and reassure your children that nosebleeds are very common and lots of other kids get them. It doesn’t mean they are ill, and they will get better very soon.
To treat a nosebleed:
- Lean forward and firmly pinch the nose below the bridge (the bony part), for 10 minutes non-stop.
- Then let go and see if the bleeding has stopped.
- Don’t tilt your head backwards as the blood may go down your throat into your stomach — this can make you feel sick.
- Breathe through your mouth and spit out any blood that enters your mouth.
- You can put an ice pack on your forehead and the back of your neck and suck on ice cubes.
When the bleeding has stopped:
- try not to pick or blow your nose, even if it feels uncomfortable, as this may cause another nosebleed
- avoid any strenuous activity, such as playing sports, for 24 hours after the bleeding has stopped
- don’t pack the nostrils with tissues or cotton wool
If bleeding starts again, repeat the advice above.
If a nosebleed is very heavy and does not stop after 15 minutes of non-stop pressure, you need to go to your nearest emergency department. It may be necessary for a doctor or nurse to pack your nose with dressings to stop the bleeding.
If you have a facial injury that means you cannot put pressure on your nose to stop the bleeding, visit your nearest emergency department for further treatment.
If your child has an object up their nose, don’t try to remove the object yourself. Take your child to your doctor or an emergency department.
If the object falls back into the throat and you or your child start to choke, call an ambulance on triple zero (000). If the object contains chemicals (like a button battery) or is a bean (which can swell) you should go to the Emergency Department.
Can nosebleeds be prevented?
If your nosebleeds persist and become a problem, you may need treatment, such as surgery to cauterise (burn) the blood vessels in the nose. Talk to your doctor about your options.
After you have had a nosebleed, try not to pick your nose. Instead, blow it gently. Prevent the inside of your nose from drying out by using a humidifier or putting a small amount of lubricant cream like Vaseline or paw paw ointment inside your nose.
Drinking plenty of fluids and eating fibre will prevent constipation, so you won’t strain on the toiled which may start another nosebleed.
Additional treatments that may be used in hospital include:
- electrocautery – an electric current running through a wire is used to cauterise the blood vessel where the bleeding is coming from
- blood transfusions – a procedure to replace the blood you’ve lost
- tranexamic acid – medication that can reduce bleeding by helping your blood to clot
- packing under anaesthetic – your nose is carefully packed with gauze while you are unconscious from general anaesthetic
- ligation – an operation using small instruments to tie off bleeding blood vessels in the back of your nose
Once your nose has stopped bleeding, you should follow the advice below to reduce the risk of your nose bleeding again and to stop you picking up an infection:
- avoid blowing or picking your nose, heavy lifting, strenuous exercise, lying flat, and drinking alcohol or hot drinks for 24 hours
- don’t remove any crusts that form inside your nose – these may be unpleasant, but they’re a useful part of the healing process
- if you need to sneeze, try to sneeze with your mouth open to reduce the pressure in your nose
- avoid people with coughs and colds
If you see a GP or a hospital doctor about your nosebleed, they may give you a prescription for an antiseptic nasal cream once the bleeding stops. This should be applied to the inside of your nostrils several times a day for up to two weeks to help prevent further bleeding.
If your nose does start to bleed again, follow the first aid advice above and seek medical advice if the bleeding doesn’t stop.
Nose Picking and Five Other Causes of Nosebleeds
You’re on the train commuting to work, school, maybe even a sporting event, when all of a sudden your nose starts dripping. You attempt to stop it only to realize that your nose is actually bleeding, and doesn’t appear to be stopping any time soon. After using anything in sight – tissues, napkins, newspapers – to stop the nosebleed, your mind starts to wonder: Why is this happening to me?
Nosebleeds can be a frightening experience, but they are usually harmless, and easily treated. There are many causes for nosebleeds, and some are more obvious than others.
Direct Causes of Nosebleeds
Some of the more obvious causes for nosebleeds are classified as “local factors,” these include:
- Nose picking. Anything inserted into the nostrils can cause irritation that can lead to bleeding, even your fingers! “You get nosebleeds because a blood vessel inside your nose breaks,” said Marc Leavey, MD, of Lutherville Personal Physicians in Lutherville, MD. “The most common cause is picking your nose, because this erodes the vessel.”
- Trauma. A high impact blow to your nose can cause instant bleeding. Bleeding is almost guaranteed if the force is great enough to cause a fracture, but even less severe contact can cause a nosebleed. So stay away from those bar fights and contact sports!
Other Possible Causes of Nosebleeds
Blunt trauma and nose-picking are often avoidable causes of nosebleeds, but not all factors are within your control, and some can be serious:
- Tumors. One of the prolonged symptoms of a nasal and sinus tumor, whether benign of cancerous, is frequent and persistent nosebleeds. While an isolated nosebleed can be normal, tumors represent one reason to go see a doctor if your nosebleeds occur frequently.
- Weather. This cause is mostly out of your control, but the level of humidity, extreme changes in temperature, and the changing of the seasons have been identified as causes of nosebleeds. “The second most common cause is dry air. This causes the tissues to dry out, crack, and then bleed,” said Dr. Leavey. “This is why we recommend nose drops and spray.”
Health Conditions Tied to Nosebleeds
Many health disorders have nosebleeds as a symptom. These are largely classified as posterior nosebleeds and could require medical attention:
- Hypertension. Nosebleeds are not necessarily a symptom for hypertension, but one study found that 17 percent of people treated for high blood pressure eventually got nosebleeds, according to the American Heart Association.
- Allergies and colds. If your nose is constantly running, whether from allergies or a cold, trying to stop it can contribute to nosebleeds too. “Being ill, having a cold, or having allergies will irritate the nose and make it more susceptible to bleeding,” said Leavey. “A common cold, where you blow and blow and blow your nose, can wear down the vessels.”
Ultimately, nosebleeds might not be that large of a concern, but Dr. Leavey says to go see a doctor if they become a problem.
“If you’re making a habit of nosebleeds, please get checked. It could just be a small vessel that keeps bleeding and your doctor can help you with that,” he concluded.