What causes nosebleeds?
The nose is a part of the body rich in blood vessels (vascular) and is located 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, Jantoven], clopidogrel [Plavix], 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 risk factors predispose people to nosebleeds:
- Trauma, including self-induced by nose picking (this is a common cause of nosebleeds in children)
- Allergic and non-allergic rhinitis
- Hypertension (high blood pressure)
- Use of blood thinning medications
- Alcohol abuse
- Less common causes of nosebleeds include tumors and inherited bleeding problems
- Hormonal changes during pregnancy may increase the risk of nosebleeds.