Nosebleeds: How to Stop One, Common Causes and When to Be Seen

What it involves

MedlinePlus defines a nosebleed as loss of blood from the tissue lining the nose, usually from one nostril. It says nosebleeds are very common and rarely life threatening. The nose holds many small blood vessels that bleed easily, and most bleeds start on the front of the nasal septum, the wall of tissue that separates the two sides of the nose.

Who this is for

• Patients whose nosebleeds keep coming back, even if each one stops on its own
• Patients who take a blood thinner or daily aspirin and have a nosebleed
• Patients whose nosebleeds are not tied to a cold, dry air, or picking
• Patients who want to know what to do at home and when a bleed is an emergency

What to expect

• Questions about how often the bleeding happens, which side, and how long it lasts
• A review of your medicines, including blood thinners, aspirin, and nasal sprays
• A look at the nose and a check of your blood pressure
• A plan that may include blood tests or a referral to an ear, nose, and throat specialist

How to stop a nosebleed at home

MedlinePlus gives a short routine. Sit down and lean forward so the blood does not run down your throat, and breathe through your mouth. Gently squeeze the soft part of the nose between thumb and finger so both nostrils are closed, and hold it for a full 10 minutes without checking early. A cold compress across the bridge of the nose may help. It says not to pack the inside of the nose with gauze, not to lie down, and to avoid sniffing or blowing your nose for several hours afterward.

Why the nose bleeds

MedlinePlus says most nosebleeds come from minor irritation of the lining of the nose. Colds, allergies, sneezing, very cold or dry air, blowing the nose hard, picking, and overuse of decongestant nasal sprays are all on its list. Bleeds are more common in winter, when cold viruses spread and indoor air is drier. If sneezing and congestion are the pattern, the seasonal allergies guide covers that side of it.

Causes that deserve a closer look

MedlinePlus says repeated nosebleeds can be a symptom of another condition, so a pattern is worth raising with a provider:

• High blood pressure, which a quick check in the office can screen for
• A bleeding disorder or a problem with blood clotting
• Blood thinners such as warfarin, clopidogrel, or aspirin, which can cause or worsen bleeds
• A deviated septum, an injury or broken nose, or an object stuck in the nose
• Rarely, a tumor of the nose or sinuses

Get emergency care if

MedlinePlus says to get emergency care if the bleeding does not stop after 20 minutes, if it follows a head injury, which can point to a skull fracture, or if the nose may be broken and looks crooked. It adds that emergency care is also advised for anyone who takes medicine to prevent blood from clotting and for anyone who has needed a specialist to treat nosebleeds before. Do not wait for an appointment in those cases.

When to book a visit instead

MedlinePlus says to contact your provider if you or your child has frequent nosebleeds, if they are not tied to a cold or other minor irritation, or if they begin after sinus or other surgery. A nosebleed that comes with a lot of facial pressure and a stuffy nose may be a sinus problem, which the sinus infection or cold guide explains. A review of your blood pressure numbers is also useful, and the blood pressure readings guide shows what the ranges mean.

What testing and treatment can involve

MedlinePlus says a provider examines the nose and may order a complete blood count with a platelet count, clotting tests such as PT and PTT, or a CT scan of the nose and sinuses. Treatment depends on the cause and can include controlling blood pressure, adjusting a blood thinner, sealing the bleeding vessel with heat, electric current, or silver nitrate sticks, or nasal packing. Those last steps and any imaging are done by a specialist or a hospital, so this practice would arrange a referral. A blood count can be discussed in the complete blood count guide.

Preventing the next one

MedlinePlus suggests keeping the home cool and using a vaporizer to add moisture to the air. It also suggests nasal saline spray and a water-soluble jelly in the nose to stop the lining from drying out in winter, and skipping hard nose-blowing.

Sources

• MedlinePlus — Nosebleed
• MedlinePlus — Nose Injuries and Disorders