Dr. MJ Bazos MD, Patient Handout
Nosebleeds: What to Do When Your Nose Bleeds
What should I do when I get a nosebleed?
A nosebleed can be scary to get--or see--but try to stay calm. Most nosebleeds look much worse than they really are. Almost all nosebleeds can be treated at home.
Epistaxis200.jpg
Epistaxis201.jpg
Pinch your nose to stop a nosebleed
If you get a nosebleed, sit down and lean slightly forward. Keeping your head above your heart will make your nose bleed less. Lean forward so the blood will drain out of your nose instead of down the back of your throat. If you lean back, you may swallow the blood. This can cause nausea, vomiting and diarrhea.
Use your thumb and index finger to squeeze together the soft portion of your nose. This area is located between the end of your nose and the hard, bony ridge that forms the bridge of your nose. Keep holding your nose until the bleeding stops. Don't let go for at least 5 minutes. If it's still bleeding, hold it again for 10 minutes straight.
You can also place a cold compress or an ice pack across the bridge of your nose.
Once the bleeding stops, don't do anything that may make it start again, such as bending over or blowing your nose.
What causes nosebleeds?
The most common causes are dryness (often caused by indoor heat in the winter) and nose picking. These two things work together--nose picking occurs more often when mucus in the nose is dry and crusty.
Other, less common, causes include injuries, colds, allergies or cocaine use. Children may stick small objects up the nose. Older people may have atherosclerosis ("hardening of the arteries"), infections, high blood pressure and blood clotting disorders, or they may be taking drugs like aspirin that interfere with blood clotting. The cause of nosebleeds often can't be determined.
Why is the nose prone to bleeding?
Blame it on anatomy. The nose has many blood vessels in it to help warm and humidify the air you breathe. These vessels lie close to the surface, making them easy to injure.
Are nosebleeds serious?
Most aren't. Most nosebleeds occur in the front part of the nose and stop in a few minutes.
See your doctor if:
  • The bleeding goes on for more than 15 minutes.
  • The bleeding was caused by an injury.
  • You get nosebleeds often.
A few nosebleeds stem from large vessels in the back of the nose. These nosebleeds can be dangerous. They may occur after an injury. This type of nosebleed is more common in the elderly and is often due to high blood pressure, atherosclerosis, daily aspirin use or bleeding disorders. Usually, the older the patient, the more serious the nosebleed.
You'll need to get medical attention if a nosebleed goes on for more than 15 minutes or if it occurs after an injury, such as a punch in the face, especially if you think you may have a broken nose. A nosebleed after a fall or car wreck could be a sign of internal bleeding.
Frequent nosebleeds may mean you have a more serious problem. For example, nosebleeds and bruising can be early signs of leukemia. Nosebleeds can also be a sign of blood clotting disorders and nasal tumors (cancerous and non-cancerous).
What will my doctor do for a nosebleed?
Your doctor will try to find out where the bleeding is coming from in your nose. He or she will probably ask you some questions and examine your nose. If the bleeding doesn't stop on its own or with pressure applied, your doctor may cauterize the bleeding vessel or pack your nose to stop the bleeding.
Cauterization involves using special solutions or an electrical or heating device to burn the vessel so that it stops bleeding. Your doctor will numb your nose before the procedure.
Packing the nose involves putting special gauze or an inflatable latex balloon into the nose so that enough pressure is placed on the vessel to make it stop bleeding.
Tips on preventing nosebleeds
  • Keep the lining of your nose moist: Gently apply a light coating of petroleum jelly (brand name: Vaseline) inside your nose with a cotton swab twice a day.
  • Keep children's fingernails short to discourage nose picking.
  • Counteract the drying effects of indoor heated air by using a humidifier at night in your bedroom.
  • Quit smoking. Smoking dries out your nose and also irritates it.
  • Open your mouth when you sneeze.