About nosebleeds
Nosebleeds can be frightening, but they aren't usually a sign of anything serious and can often be treated at home.
The medical name for a nosebleed is epistaxis.
During a nosebleed, blood flows from one or both nostrils. It can be heavy or light and last from a few seconds to 15 minutes or more.
What to do
To stop a nosebleed:
- sit down and firmly pinch the soft part of your nose, just above your nostrils, for at least 10-15 minutes
- lean forward and breathe through your mouth – this will drain blood into your nose instead of down the back of your throat
- place an ice pack or bag of frozen vegetables covered by a towel on the bridge of your nose
- stay upright, rather than lying down, as this reduces the blood pressure in the blood vessels of your nose and will discourage further bleeding
If the bleeding eventually stops, you won't usually need to seek medical advice. However, in some cases you may need further treatment from your GP or in hospital (see below).
When to seek medical advice
Contact your GP or call NHS 24's 111 service if:
- you're taking a blood-thinning medicine (anticoagulant) such as warfarin or have a clotting disorder such as haemophilia and the bleeding doesn't stop
- you have symptoms of anaemia such as heart palpitations, shortness of breath and a pale complexion
- a child under two years of age has a nosebleed
- you have nosebleeds that come and go regularly
Ask someone to drive you to your nearest accident and emergency (A&E) department or call 999 for an ambulance if:
- the bleeding continues for longer than 20 minutes
- the bleeding is heavy and you've lost a lot of blood
- you're having difficulty breathing
- you swallow a large amount of blood that makes you vomit
- the nosebleed developed after a serious injury, such as a car crash
What causes nosebleeds?
The inside of your nose is full of tiny, delicate blood vessels that can become damaged and bleed relatively easily.
Common causes of nosebleeds include:
- picking your nose
- blowing your nose very hard
- a minor injury to your nose
- changes in humidity or temperature causing the inside of the nose to become dry and cracked
Occasionally, bleeding can come from the blood vessels deeper within the nose. This can be caused by a blow to the head, recent nasal surgery and hardened arteries (atherosclerosis).
Who gets nosebleeds?
Nosebleeds are fairly common and most people will experience them every now and again. Anyone can get a nosebleed, but they most often affect:
- children between two and 10 years of age
- elderly people
- pregnant women
- people who regularly take aspirin or anticoagulants, such as warfarin
- people with blood clotting disorders, such as haemophilia
Bleeding may also be heavier or last longer if you take anticoagulants, have a blood clotting disorder, or have high blood pressure (hypertension).
Are nosebleeds serious?
Nosebleeds aren't usually serious. However, frequent or heavy nosebleeds may indicate more serious health problems, such as high blood pressure or a blood clotting disorder, and should be checked.
Excessive bleeding over a prolonged period of time can also lead to further problems such as anaemia.
If your GP suspects a more serious problem is causing your nosebleeds, they may refer you to an ear, nose and throat (ENT) specialist for further tests.
Preventing nosebleeds
Things you can do to prevent nosebleeds include:
- avoid picking your nose and keep your fingernails short
- blow your nose as little as possible and only very gently
- keep your home humidified
- wear a head guard during activities in which your nose or head could get injured
- always follow the instructions that come with nasal decongestants – overusing these can cause nosebleeds
Causes of nosebleeds
Nosebleeds can be caused by a number of different things. It's not always possible to identify the exact reason why one occurs.
Nosebleeds can start just inside your nostrils (anterior) or at the back of your nose (posterior). These different types of nosebleeds tend to have different causes.
Anterior nosebleeds
The vast majority of nosebleeds are anterior nosebleeds, which means the bleeding comes from the wall between the two nose channels (the lower septum), just inside your nose. This part of the nose, known as Little's area, contains many delicate blood vessels that can be easily damaged.
The cause of anterior nosebleeds is sometimes unknown, but they can be caused by a number of things, including:
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