When to See a Doctor for Nosebleeds
Nosebleeds (medical term: epistaxis) are common, with about 60 million Americans experiencing at least one annually. Some people have them frequently; for others, it’s an unusual occurrence. Most of the time, these scary-looking and messy affairs clear up within 15 or 20 minutes and don’t require a doctor’s care. Other times, however, nosebleeds need medical attention, either in an emergency room or doctor’s office. It’s important to know when nosebleeds are serious enough for a physician to examine.
Common Causes of Nosebleeds
Nosebleeds happen when a blood vessel in your nose breaks open. Many blood vessels lie near the surface of the inside of your nose, where they can become irritated due to cold or dry air (which tends to occur more often in winter). These nosebleeds in the passages toward the front part of your nose are the most common area where bleeding starts. Other nosebleeds—potentially more serious—occur deeper and higher in your nose, such as in the cartilage separating your nostrils or at the base of your skull.
Some common causes of nosebleeds include:
- Irritation of the nasal passage, which can be caused by dry air, colds, allergies, or sinus infection
- Minor injury to the nasal lining, such as from picking your nose or placing foreign objects in your nose (a favorite habit of some younger children)
- Nasal fracture due to trauma
- Cocaine use
- Overuse of decongestant nasal sprays
- Use of medications that can prevent blood from clotting (such as aspirin, nonsteroidal anti-inflammatories like Advil, or blood thinners, such as heparin or warfarin). These drugs don’t cause the initial nosebleed, but they make it more difficult to stop.
- Having a blood-clotting disorder such as hemophilia, which can produce spontaneous hemorrhages
How Do You Stop a Nosebleed?
Here are some tips you can try nosebleed treatment at home, which should help combat everyday nosebleeds:
- Sit down, leaning slightly forward so blood doesn’t drain down your throat (which could irritate your stomach). Don’t tilt your head back.
- Pinch your nose gently between the tip and the bridge (the bony part where your nose connects to your face). Use your thumb and index finger, pressing for about 10 to 15 minutes, while breathing through your mouth.
- If you release the pressure and you still are bleeding, try this step again.
- If bleeding persists, you can try decongestant nasal spray, such as Neosynephrine, which can sometimes close off small blood vessels.
- Avoid lying down.
- For a few hours after your nosebleed stops, avoid heavy sneezing, picking your nose, bending, or other activities that could restart the bleed.
If you are prone to nosebleeds, you can try a few preventive steps to lessen their likelihood:
- Use a vaporizer or humidifier to keep interior air moisturized.
- Use saline nasal spray so the inside of your nose doesn’t dry out (which can cause bleeding).
- Dab some petroleum jelly (such as Vaseline) or water-soluble jelly (like Ayr) inside your nose with a cotton swab, up to three times daily.
- Trim fingernails, especially for your child, to prevent inadvertent cuts.
When to See a Doctor for Nosebleeds
Sometimes symptoms of nosebleeds warrant immediate care, such as at the emergency room or urgent care center. If you’re alone and are bleeding copiously, don’t try to drive yourself, but instead call 911 or get someone to drive you for care.
These signs of potential serious conditions include:
- Bleeding that lasts longer than 20 minutes
- Bleeding after a head injury, such as a fall that results in hitting your face
- Possible broken nose (if your nose was injured in some way, especially if it looks crooked)
- Difficulty breathing due to excessive bleeding
- Feeling dizzy or lightheaded
- Being on blood thinners
- Having a nosebleed in a child under age 2
- Having a history of serious nosebleeds requiring specialist care
Other times, you can get by without immediate care, but still need to have nosebleeds evaluated by a doctor. Make an appointment for an office visit if you have the following symptoms:
- You or your child experience frequent nosebleeds, such as one a week or more.
- You have nosebleeds that don’t seem related to either colds or other minor irritations.
- Nosebleeds happen after recent surgery such as sinus surgery.
Who to See for Nosebleeds
Nosebleeds may sometimes need to be cauterized (a procedure to close up the leaking blood vessel) or be packed with special material that puts pressure on the bleeding to encourage it to stop. Your primary care doctor or an emergency or urgent care physician can perform these nosebleed treatments.
Sometimes you may need to see a specialist to evaluate and treat frequent or otherwise worrisome nosebleeds. One type of doctor whose expertise covers nosebleeds is an otolaryngologist, a physician trained in ear, nose and throat procedures (sometimes referred to as an ENT doctor). Your insurance carrier may require a referral to this type of specialist.
Because nosebleeds are so common, they may seem like an everyday problem that isn’t worth visiting a doctor about. However, it’s always wise to have a physician check out concerning symptoms, such as frequent or excessive nosebleeds. This way you can catch and treat possible underlying problems early, potentially avoiding serious complications.