Topic Overview
Most nosebleeds are not usually serious and
can be stopped with home treatment. Most nosebleeds occur in the front of the
nose (anterior epistaxis) and involve only one nostril. Some blood may drain
down the back of the nose into the throat. Many things may make a nosebleed
more likely.
- Changes in the environment. For example:
- Cold, dry climates; low
humidity
- High altitude
- Chemical
fumes
- Smoke
- Injury to the nose. For example:
- Hitting or bumping the
nose
- Blowing or picking the nose
- Piercing the
nose
- An object in the nose. This is more common in children, who
may put things up their noses, but may be found in adults, especially after an
automobile accident, when a piece of glass may have entered the nose.
- Medical problems. For example:
- An abnormal structure inside the nose, such
as
nasal polyps or a
deviated nasal septum
- Colds, allergies, or sinus
infections
- High blood pressure
- Kidney
disease
- Liver disease
- Blood clotting disorders, such
as
hemophilia,
leukemia,
thrombocytopenia, or
von Willebrand's disease
- Abnormal blood
vessels in the nose, such as with Osler-Weber-Rendu syndrome. This syndrome is
passed in families (inherited). The abnormal blood vessels make it hard to
control a nosebleed.
- Medicines. For example:
- Those that affect blood clotting, such as
aspirin, warfarin (such as Coumadin), enoxaparin (Lovenox), clopidogrel (Plavix), or nonsteroidal anti-inflammatory drugs (NSAIDs)
- Cold and allergy
medicines
- Oxygen
- Nasal inhalers, such as
Afrin
- Steroid nasal sprays
- Nasal abuse of
illegal drugs, such as cocaine and amphetamines
A less common but more serious type of nosebleed starts in the
back of the nose (posterior epistaxis) and often involves both nostrils. Large
amounts of blood may run down the back of the throat. Posterior epistaxis
occurs more often in older adults because of other health conditions they
may have. Medical treatment will be needed to control the bleeding from
posterior epistaxis.
Check your symptoms to decide
if and when you should see a doctor.
Check Your Symptoms
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Home Treatment
How to stop a nosebleed
Follow these steps to stop a
nosebleed:
- Sit up straight, and tip your head slightly
forward. See a picture of
how to stop a nosebleed.
- Note: Do not tilt
your head back. This may cause blood to run down the back of your throat, and
you may swallow it. Swallowed blood can irritate your stomach and cause
vomiting. And vomiting may make the bleeding worse or cause it to start again.
Spit out any blood that gathers in your mouth and throat rather than swallowing
it.
- Use your thumb and
forefinger to firmly pinch the soft part of your nose shut. The nose consists
of a hard, bony part and a softer part made of cartilage. Nosebleeds usually
occur in the soft part of the nose. Spraying the nose with a medicated nasal
spray (such as Afrin) before applying pressure may help stop a nosebleed. You
will have to breathe through your mouth.
- Apply an ice pack to your
nose and cheeks. Cold will constrict the blood vessels and help stop the
bleeding.
- Keep pinching for a full 10 minutes. Use a clock to time
the 10 minutes. It can seem like a long time. Resist the urge to peek after a
few minutes to see if your nose has stopped bleeding.
- Check to see
if your nose is still bleeding after 10 minutes. If it is, hold it for 10 more
minutes. Most nosebleeds will stop after 10 to 20 minutes of direct
pressure.
- Put a light coating of a moisturizing ointment (such as
Vaseline) or an antiseptic nasal cream inside your nose. Do not blow your nose
or put anything else inside your nose for at least 12 hours after the bleeding
has stopped.
- Rest quietly for a few hours.
Nosebleeds in children
- Crying increases the blood flow to the face and
makes bleeding from the nose worse. If your child has a nosebleed and is
crying, speak in a quiet, relaxed manner to help control your child's
fear.
- Make sure to check for an object in the nostrils. If an
object is found, go to the topic
Objects in the Nose.
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home
treatment:
- A nosebleed cannot be stopped after 10 to 20
minutes of direct pressure.
- Nosebleeds recur 4 or more times in 1
week after you have tried prevention measures.
- Nosebleeds become more
severe or more frequent.
Prevention
The following tips may reduce your risk
for developing nosebleeds.
- Use saltwater (saline) nose drops or a
spray.
- Avoid forceful nose-blowing.
- Do not pick your
nose or put your finger in your nose to remove crusts.
- Avoid
lifting or straining after a nosebleed.
- Elevate your head on one or
two pillows while sleeping.
- Apply a light coating of a moisturizing
ointment, such as Vaseline, to the inside of your nose.
- Limit your
use of aspirin, warfarin (such as Coumadin), enoxaparin (Lovenox), clopidogrel (Plavix), and nonsteroidal anti-inflammatory drugs (NSAIDs). Acetaminophen, such as Tylenol, may be used
to relieve pain.
- Do not use nonprescription antihistamines,
decongestants, or medicated nasal sprays. These medicines can help control cold
and allergy symptoms, but overuse may dry the inside of the nose (mucous
membranes) and cause nosebleeds.
- Keep your blood pressure under
control if you have a history of
high blood pressure. This will help decrease the risk
of nosebleeds.
- Do not smoke. Smoking slows healing. For more
information, see the topic
Quitting Smoking.
- Do not use illegal
drugs, such as cocaine or amphetamines.
Make changes in your home
- Humidify your home, especially the bedrooms.
Low humidity is a common cause of nosebleeds.
- Keep the heat low
[60°F (16°C) to
64°F (18°C)] in sleeping areas.
Cooler air does not dry out the nasal passages.
- Breathe moist air,
such as from a shower, for a while if your nose becomes very dry. Then put a
little moisturizing ointment, such as Vaseline, inside your nostrils to help
prevent bleeding. But do not put anything inside your nose if your nose is
bleeding. Occasional use of
saline nasal sprays may also help keep nasal tissue
moist.
Prevent nosebleeds in children
- Keep your child's fingernails trimmed, and
discourage nose-picking.
- Caution children not to put any object in
their noses.
Preparing For Your Appointment
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your
doctor diagnose and treat your condition by being prepared to answer the
following questions:
- How often do you have nosebleeds?
- When was your last
nosebleed?
- How long do your nosebleeds usually last? Do you swallow
blood?
- What do you think may be causing your
nosebleeds?
- Have you had a nose injury?
- What home
treatment measures have you tried to stop the nosebleeds? Did they
help?
- What nonprescription medicines have you tried? Did they help?
- What prescription and nonprescription medicines do you take? Are
you taking aspirin, warfarin (such as Coumadin), enoxaparin (Lovenox), clopidogrel (Plavix), or nonsteroidal anti-inflammatory drugs (NSAIDs)? Do you take herbal supplements or vitamins?
Bring a list of your medicines with you to your appointment.
- Do you
have a family history of bleeding problems?
- Do you have any
health risks?
Credits
|
By
|
Healthwise Staff |
|
Primary Medical Reviewer
|
Kathleen Romito, MD - Family Medicine |
|
Specialist Medical Reviewer
|
H. Michael O'Connor, MD - Emergency Medicine |
|
Last Revised
|
March 22, 2011 |