What are nosebleeds?
A nosebleed occurs when the tissue lining of the nose breaks and blood is released. This tissue contains small blood vessels, called arterioles, which can rupture easily. A nosebleed is medically known as epistaxis. Nosebleeds are very common, and children between the ages of two and 10 and adults between 50 and 80 years seem to be most susceptible.
The most common nosebleeds happen in the front (anterior) of the nose. Anterior nosebleeds flow down and out of the nose. These nosebleeds generally occur in the septum, which divides the nostrils. Anterior nosebleeds are most frequently caused by some type of trauma. The blood vessels in the septum can be broken by scratching with a fingernail or during a high-impact injury to the nose. Dry air can cause the septum lining to dry out and crack, which may also cause a nosebleed in the anterior of the nose.
Anterior nosebleeds can be stopped by sitting upright to ensure that your head is higher than your heart. Breathe through your mouth instead of your nose and lean forward slightly to avoid swallowing blood. Using your thumb and index finger, gently pinch the soft fleshy part of your nose closed for 15 minutes.
Nosebleeds in the back (posterior) of the nose are less common and potentially more dangerous. Posterior nosebleeds occur higher and deeper in the nose, causing blood to flow down the throat. A posterior nosebleed can also result from a blow to the face or nose. Stopping a posterior nosebleed may require the assistance of a health care provider.
Frequent nosebleeds may be a symptom of a blood clotting disorder that is present from birth and should be discussed with your health care provider.
Seek immediate medical care (call 911) for a nosebleed that occurs after a head injury, if the nosebleed lasts longer than 30 minutes, if you are vomiting blood or having difficulty breathing, or if you experience confusion or loss of consciousness even for a brief moment.
Seek prompt medical care if you have recurring nosebleeds.
What are the symptoms of nosebleeds?
Nosebleed symptoms are easily recognizable: blood coming out of your nose, or from your nose down the back of your throat.
Symptoms that might indicate a serious condition
In some cases, gingivitis can be a serious condition that should be evaluated immediately in an emergency setting. Seek immediate medical care if you, or someone you are with, have any of these serious symptoms including:
Abnormal pupil size or reactivity to light
Coughing up blood (hemoptysis)Deformity or fracture of bones
Nosebleed after a head injury
Nosebleed along with a misshapen nose after a blow or injury to the nose
Nosebleed that lasts longer than 30 minutes
Slowed or stopped breathing
Unconsciousness (even if brief)
What causes nosebleeds?
Nosebleeds can be caused by a variety of factors. The most common cause of a nosebleed is dry air or dryness in the nasal passages. An injurious blow to the nose may also cause a nosebleed. Chronic nosebleed can be caused by blood clotting disorders that run in families.
Everyday causes of nosebleeds
Your nosebleed may be due to common causes including:
Change in altitude
Cold or dry air
Medications such as anti-inflammatory drugs, blood thinners, or aspirin
Vigorous nose blowing
Serious causes of nosebleeds
Serious causes of nosebleed that may require medical attention include:
Foreign object in the nose
Surgery of the nose or face
Trauma to the nose
Genetic causes of nosebleeds
Nosebleeds can also be caused by disorders that run in families including:
Hemophilia (rare hereditary disorder in which blood does not clot normally)
Hemorrhagic telangiectasia (hereditary disorder that makes blood vessels very fragile)
Thrombocytopenia (low blood platelet count; platelets help form clots to stop blood loss)
Von Willebrand’s disease (hereditary bleeding disorder)
What are the risk factors for nosebleeds?
A number of factors increase the risk of developing nosebleeds. Not all people with risk factors will get nosebleeds. Risk factors for nosebleeds include:
How are nosebleeds treated?
Stopping an anterior nosebleed is simple. You should sit upright to ensure that your head is higher than your heart and use your mouth to breathe. Lean forward slightly to avoid swallowing blood. Using your thumb and index finger, gently pinch the soft fleshy part of your nose closed for 15 minutes.
Stopping posterior nosebleeds is more difficult and may require the assistance of a health care provider. Posterior nosebleeds are less common than anterior nosebleeds and occur higher and deeper in the nose, with blood flowing down the throat.
Recurring nosebleeds should be discussed with your health care provider. Your health care provider may elect to treat a recurring nosebleed by cauterization or sealing the affected blood vessel. Another treatment option is a packing. A piece of treated gauze is packed into the vessel to stop the flow of blood.
What you can do to prevent nosebleeds
You can also prevent or limit nosebleeds by:
Avoid long-term use of nasal decongestant sprays
Keeping fingernails short to mitigate damage to the interior of the nose
Using a cool-mist humidifier to counteract the effects of dry air
Using a moisturizing nasal spray
What are the potential complications of nosebleeds?
In some cases, chronic nosebleeds may be the result of a hereditary blood clotting disorder. You should consult your health care provider if you are experiencing frequent nosebleeds. You may be referred to an otolarynogologist (eye, ear, nose and throat specialist) for further evaluation and treatment.
Because chronic nosebleeds can be caused by serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:
Adverse effects of nosebleed treatment
Uncontrollable blood loss