Most nosebleeds are not 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.
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
warfarin (Coumadin), heparin, Lovenox, Plavix, aspirin, and 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 frequently in older adults because of other health conditions they
may have. Medical treatment will be needed to control the bleeding from
posterior epistaxis.
Review the Emergencies and Check Your
Symptoms sections to determine if and when you need to see a health
professional.
If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.
Review
health risks that may increase the seriousness of your
symptoms.
If your nosebleed occurred after any of
the following situations, evaluate those symptoms first.
If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.
Review
health risks that may increase the seriousness of your
symptoms.
If your nosebleed occurred after any of
the following situations, evaluate those symptoms first.
If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.
If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.
Home Treatment
How to stop a nosebleed
Follow these steps to stop
a nosebleed:
Sit up straight and tip your head slightly
forward. See an illustration 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.
Blow all the clots out of your nose. This may
require fairly forceful blowing, and the bleeding may increase when clots come
out of the nose.
After blowing out the clots, 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, 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
Use the Check Your Symptoms section to
evaluate your symptoms 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 trying 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 and other nonsteroidal anti-inflammatory drugs (NSAIDs), such as
ibuprofen and naproxen sodium, if you have frequent nosebleeds.
Acetaminophen, such as Tylenol or Panadol, 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 Tobacco Use.
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. However, 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.
You can help your
health professional 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?
Have you recently been in an automobile
accident?
What home treatment measures have you tried to stop the
nosebleeds? Did they help? Be sure to include any nonprescription medicines you
have taken.
What prescription and nonprescription medicines do you
take? Are you taking blood thinners, aspirin, 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?
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