Nosebleed

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KEY POINTS

• A nosebleed is bleeding that comes out of your nostrils.
• Most nosebleeds are minor and respond to first aid. Usually a nosebleed stops after you have put pressure on it by pinching it. If a nosebleed lasts more than 20 minutes in spite of first aid, or if you have several nosebleeds in one week, see your healthcare provider.
• Follow the full course of treatment prescribed by your healthcare provider. Ask your provider if there are activities you should avoid and when you can return to your normal activities.

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What is a nosebleed?

A nosebleed is bleeding that comes out of your nostrils. If there is a lot of bleeding, you may also spit or cough up blood.

What is the cause?

The small blood vessels inside the nose are very close to the surface, which makes them easy to injure. The most common cause of nosebleed is irritation of the lining of the nose caused by dry air, or by picking or rubbing your nose. Blowing your nose too hard can also cause a nosebleed, especially if the nasal lining is irritated because of allergies or an infection such as with a cold or sinus infection.

Less common causes of nosebleed include:

• Injury to your face or nose
• High altitude
• Drug abuse involving the nose, such as cocaine snorting or glue sniffing
• High blood pressure
• Medicine that makes it harder for your blood to clot
• Medical problems that prevent your blood from clotting normally, such as liver disease
• Rarely, a tumor

Nosebleeds may occur during pregnancy. Pregnant women have more blood volume, which can swell the blood vessels in the nose and cause nosebleeds.

If you have a nosebleed after a head injury, you should be examined right away.

What are the symptoms?

The blood may trickle or flow from one or both nostrils. It may also flow down your throat.

How is it diagnosed?

If you see your healthcare provider when you have a nosebleed, your healthcare provider will ask about your symptoms and medical history and examine you. You may have blood tests.

How is it treated?

Most nosebleeds are minor and respond to first aid. If your nose is bleeding:

• Sit up and lean forward to keep blood from going down your throat. Try not to swallow any blood. Blood in your throat could make you cough or choke.
• Pinch the soft part of your nose just below the nasal bones gently but firmly between your thumb and index finger and hold it for 5 to 10 minutes. Breathe through your mouth.
• Try not to blow your nose or put anything in your nose for several hours after the bleeding stops.

Usually a nosebleed stops after you have put pressure on it by pinching it. If a nosebleed lasts more than 20 minutes in spite of first aid, see your healthcare provider. Also see your healthcare provider if you have several nosebleeds in one week.

If you go to your healthcare provider with a nosebleed, it can be treated in different ways.

• Your healthcare provider might use a chemical or a tiny amount of electricity to seal the bleeding area. This will also help keep it from bleeding again.
• Your provider may put a cotton ball soaked with medicine in your nose for 5 to 10 minutes.
• If you have heavy bleeding, your healthcare provider may pack your nose with gauze coated with petroleum jelly or put a special balloon in your nose to put pressure on the bleeding blood vessel. Don’t remove any packing yourself. Your provider must remove the packing to be sure the bleeding has stopped and does not start again when the packing is removed. If you remove the packing yourself, your nose may start bleeding heavily, which can be dangerous. You may need to stay at the hospital while the balloon and packing are in place.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Check with your provider about any medicines you are using. For example, nosebleeds may be more serious or you may have them more often if you are taking a medicine that affects blood clotting, such as aspirin.

Ask your provider:

• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent a nosebleed?

Some causes of nosebleeds can be prevented as follows:

• To prevent dryness, keep the lining of your nose moist. Gently put a light coating of petroleum jelly inside your nose or use a saline nose spray or saline nose drops twice a day.
• Avoid injuring the nasal lining. Don’t pick your nose, rub it too hard, or blow your nose too hard.
• Use a humidifier to put more moisture in the air. Avoid steam vaporizers because they can cause burns. Be sure to keep the humidifier clean, as recommended in the manufacturer's instructions. It's important to keep bacteria and mold from growing in the water container.
• Don’t use illegal drugs, especially anything snorted up the nose such as cocaine.
• If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking.