Nosebleed
(Epistaxis, Nose Bleed, Bloody Nose)

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Nosebleed facts

  • Nosebleeds are common due to the location of the nose on the face, and the large amount of blood vessels in the nose.
  • The most common causes of nosebleeds are drying of the nasal membranes and nose picking (digital trauma), which can be prevented with proper lubrication of the nasal passages and not picking the nose.
  • Most nosebleeds can be stopped at home.
  • Consult a doctor for a nosebleed if bleeding cannot be stopped, there is a large amount of blood lost, or you feel weak or faint.
  • A doctor may use nasal packs to stop nosebleeds when conservative measures fail.
  • Do not take aspirin or other blood thinning products when you get a nosebleed (if they are doctor-prescribed, consult your doctor before stopping any medication).

What causes nosebleeds?

The nose is a part of the body rich in blood vessels (vascular) and is situated in a vulnerable position  protruding on the face. As a result, trauma to the face can cause nasal injury and bleeding. The bleeding may be profuse, or simply a minor complication. Nosebleeds can occur spontaneously when the nasal membranes dry out and crack. This is common in dry climates, or during the winter months when the air is dry and warm from household heaters. People are more susceptible to a bloody nose if they take medications that prevent normal blood clotting (warfarin [Coumadin], aspirin, or any anti-inflammatory medication). In this situation, even a minor trauma could result in significant bleeding.

The incidence of nosebleeds is higher during the colder winter months when upper respiratory infections are more frequent, and the temperature and humidity fluctuate more dramatically. In addition, changes from a bitter cold outside environment to a warm, dry, heated home result in drying and changes in the nose which make it more susceptible to bleeding. Nosebleeds also occur in hot dry climates with low humidity, or when there is a change in the seasons. The following factors predispose people to nosebleeds:

  • Infection
  • Trauma, including self-induced by nose picking, especially in children
  • Allergic and non-allergic rhinitis
  • Hypertension (high blood pressure)
  • Use of blood thinning medications
  • Alcohol abuse
  • Less common causes include tumors and inherited bleeding problems
  • Hormonal changes during pregnancy may increase the risk of nosebleeds.
Medically Reviewed by a Doctor on 3/12/2014

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First Aid for Nosebleeds

If you get a nosebleed, sit down and bend forward. Sitting is preferable to lying down, since keeping the head above the level of the heart will help reduce the bleeding. Bending forward is also important. It lets the blood drain out through the nose rather than down the throat.

Hold the soft portion of your nose pinched together with your fingers until the bleeding stops. This might take five to ten minutes. Placing an ice pack across the bridge of your nose can also be helpful.

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