Understanding and Managing Nosebleeds: 11 Common Nosebleed Triggers

What causes a nosebleed? A nosebleed, or epistaxis, can be triggered by anything that damages blood vessels. The most common triggers are: 

• dried-out nasal passages
• digital trauma (yes, picking your nose!) 

Tiny blood vessels in the nose, called capillaries, break and cause bleeding. Most nosebleeds are not serious and can be managed easily at home.

“Nosebleeds may look scary, but they’re usually very simple to care for,” says family medicine physician, Daniel Khan, M.D. “In most cases, the bleeding should stop within 10 to 15 minutes.”

Nosebleeds tend to affect certain groups more than others. Children, typically between the ages of 2 and 10, and older adults are more prone to nosebleeds. They are also more common among pregnant women and individuals who take blood thinners.

You should seek medical help for nosebleeds if the bleeding does not stop – talk to your doctor if you have any concerns. 

11 Common Causes of a Nosebleed

Anything that damages blood vessels inside the nose may trigger nosebleeds.

Dried-out nasal passages may crack when they’re rubbed or scratched, triggering bleeding. 

Dryness may result from:

1. Breathing dry, heated indoor air during winter
2. Exposure to dry, arid environments
3. Harsh winter weather conditions

Physical trauma to the nose, known as digital trauma, can cause tiny blood vessels (capillaries) to break. Other forms of trauma include:

1. Nose picking
2. Excessively blowing your nose
3. Having allergies, which may irritate nasal passages and lead to frequent nose-blowing
4. A foreign object placed in the nostril
5. External injuries to the nose
6. Using prescription blood thinners
7. Overusing steroid nasal spray
8. Cocaine usage
   
   

How to Stop a Nosebleed

Most nosebleeds can be stopped within 10 to 15 minutes, while some may take up to 20 minutes. Try to remain calm; nosebleeds are common and are rarely medical emergencies.

You may stop a nosebleed with these actions:

• Firmly pinch the soft part of your nose shut for 10 minutes, without pausing
• Sit upright and lean forward while pinching the nose shut
• Breathe through your mouth
• Spit out any blood that may have run into your mouth
• Optional: Place an ice pack on the bridge of your nose 

These are things that you should not do when you have a nosebleed:

• Swallow blood that enters your mouth
• Blow your nose
• Lie down

"Sitting upright – not lying down – makes it harder for blood to reach your nose," advises Dr. Khan. "And swallowing blood may make you vomit and irritate your stomach, so spit it out."

Once your nosebleed stops, avoid these activities for a few days, to promote healing:

• Blowing your nose
• Lifting heavy objects
• Bending over head-first

How to Prevent a Nosebleed

It’s possible to reduce the risk of nosebleeds. Try these ideas, if you’re prone to the occasional nosebleed:

• Use a humidifier to add moisture to dry indoor air
• Gently apply a thin layer of petroleum jelly to the nasal passages
• Use saline nasal spray (following package directions) to keep the nasal passages moist
• Keep fingers out of the nose; if you have young children, keep their fingernails short
• Blow the nose more gently
• Wear a face shield during contact sports, to reduce the risk of nose injuries
• Follow steroid nasal spray instructions carefully, to avoid overuse
• Do not snort drugs, like cocaine
• Don’t smoke, and avoid secondhand smoke

When to See a Doctor About Nosebleeds

There are some circumstances when you should see a doctor about nosebleeds:

• If you have nosebleeds frequently
• If the bleeding doesn’t stop after 20 minutes
• If you’ve lost a considerable amount of blood
• If you have trouble breathing
• If your nosebleed was caused by major trauma, like a car accident
• If a child under age 2 has a nosebleed

A serious nosebleed may indicate a bleeding disorder, high blood pressure or other medical conditions.

"It is advisable to consult your physician when things seem problematic," emphasizes Dr. Khan. "Obtaining a diagnosis will help determine the appropriate treatment."

Remember, while nosebleeds can be unsettling, they are typically manageable and rarely constitute a medical emergency. With the right knowledge and a calm approach, you can effectively address and prevent nosebleeds.

Next Steps & Resources:

• Meet our source: Daniel Khan, M.D.
• To make an appointment with Dr. Khan, or a doctor near you, call 800-822-8905 or visit our website. 

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.