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Nosebleeds — No Big Deal Or Cause For Concern?

If you’ve had a nosebleed, you know they can be scary — and frightening to see. But nosebleeds are seldom a sign of something more serious and can often be treated at home. Family Nurse Practitioner Gina Orlando explains what you can do to avoid nosebleeds, what causes them, and when it’s time to call your doctor.

Two Types Of Nosebleeds

About 90 percent of nosebleeds are anterior, Orlando explains. They occur when the blood vessels in the front of your nose break open and bleed. Posterior nosebleeds come from the arteries in the back of your nose. “These bleeds are a lot more significant and often require a trip to the Emergency Department,” she adds. They mostly occur in adults older than 50 and typically are only seen in children who have suffered head trauma.

Common Nosebleed Causes

The skin inside your nose is delicate and filled with tiny blood vessels. That’s why even a minor injury to your nose can make it bleed. Common causes of anterior nosebleeds which are most common, include:

• Picking your nose
• Blowing your nose really hard
• Dry air, which can make the inside of your nose dry and cracked
• A blocked or stuffy nose caused by a cold
• A sinus infection 
• Overusing nasal decongestants 
• Daily aspirin or blood thinner use
• High altitude

How To Stop a Nosebleed

You can usually stop the bleeding yourself, says Orlando. She recommends this approach: “Sit and lean forward just a bit,” she says. Resist the temptation to tilt your head back or to lay down. “Pinch the soft part of your nose, just below the wide bony part. There are lots of blood vessels in this area. Gently squeeze both sides of your nose and hold the squeeze for 10 to 15 minutes, or a bit longer. This will help form a clot and stop the bleeding,” she says.

“You’ll probably be tempted to release the squeeze to see if the bleeding has stopped; but you really need to wait at least 10 to 15 minutes,” Orlando says. “If you release too soon, the bleeding may begin again and you’ll have to start over.”

How To Avoid Nosebleeds

You may be able to avoid nosebleeds with one or more of these approaches:

• Blow your nose gently, not forcefully
• Sleep with a cool mist humidifier
• Use a swab and carefully put a small amount of petroleum jelly inside your nostrils to keep them from drying out
• When using nose spray, point the tip away from the bone (septum) to decrease the risk of irritating the blood vessels

Are Nosebleeds Ever Serious?

Most nosebleeds are nothing to be concerned about. But occasionally they can indicate a health problem like:

• High blood pressure
• Atherosclerosis (hardening of the arteries)
• Bleeding disorder
• Trauma
• Bleeding following head or neck surgery
• Nasal cancer

If you have frequent or heavy nosebleeds, talk with your doctor. She can help you figure out what’s causing them and give you options for treatment.

When To Seek Medical Care

Seek medical help immediately if you: 

• Have bleeding that lasts for more than 15 to 30 minutes, or is severe
• Have a nosebleed caused by an injury like a car accident, fall, or blow to the face
• Feel weak or faint
• Have trouble breathing
• The nosebleed occurs in a child younger than 2

Source: Gina Orlando, FNP, Fairborn Medical Center; Family Doctor.org; UpToDate.com