Nosebleed (Epistaxis)

Overview

A nosebleed (called epistaxis) is when blood flows from the lining inside your nose. It can be startling but is usually not serious.

Yes, nosebleeds are very common, especially in children and older adults.

Anyone can get a nosebleed, but they happen most often in children aged 2–10 and adults over 50.

Symptoms

Common symptoms

• Blood dripping from one or both nostrils
• Feeling of liquid running down the back of the throat (postnasal drip)

Symptoms in children

• Bleeding from the front of the nose which usually stops quickly
• Often caused by dry air or nose picking

Symptoms in older adults

• May bleed from the back of the nose (posterior bleed), which can be heavier and harder to stop
• More likely to have high blood pressure or be on blood-thinning medications

Causes

Main causes

• Dry air (from heating or dry climate) that dries out the nasal lining
• Picking or scratching the inside of the nose
• Forceful nose blowing or sneezing
• Injury to the nose
• Allergies, colds, or sinus infections that irritate the nose

Risk factors

• Living in a dry or low-humidity environment
• Using nasal sprays (like steroids or antihistamines) frequently
• Having a deviated septum or other nasal structure issue
• Taking blood-thinning medications (e.g., for heart conditions or to prevent clots)
• High blood pressure (hypertension)
• Alcohol use (can thin blood and dilate vessels)

When to see a doctor

See a doctor urgently if:

• Bleeding that doesn't stop after 20 minutes of pressure
• You lose a large amount of blood (more than a cup)
• You feel dizzy, faint, or have chest pain with the nosebleed

Book a routine appointment if:

• You have frequent nosebleeds (more than once a week)
• You have a family history of bleeding disorders
• You are concerned about the cause

Diagnosis

Your doctor will ask about your medical history and examine your nose. They may use a small light to look inside (nasal endoscopy).

Tests that may be done

• Blood tests to check for anemia or bleeding disorders
• Nasal endoscopy to see the source of bleeding
• Imaging (CT scan) if a more serious cause is suspected

What to expect at your appointment

Your doctor will likely perform a simple inspection of your nose. They may apply a gentle spray to numb the area. You will be asked about your health and medications.

Treatment

Treatment aims to stop the current bleed and prevent future ones. Many nosebleeds can be managed with simple first aid.

Self-care at home

• Sit upright and lean forward slightly to avoid swallowing blood
• Pinch the soft part of your nose just below the bony bridge for 10–15 minutes without releasing
• Breathe through your mouth
• Apply a cold pack or ice wrapped in cloth to the bridge of your nose
• Do not tilt your head back (this can cause blood to flow down your throat)

Medical treatments

For persistent or heavy bleeding, a doctor may use a silver nitrate stick to cauterize (burn) the bleeding vessel, or pack the nose with special gauze or inflatable balloons to apply pressure. Sometimes a prescription nasal spray or ointment is given to keep the nose moist. If a specific blood vessel is identified, it can be deliberately blocked (embolization) or tied off (ligation). Always consult a healthcare provider for the best option for you.

When is surgery considered?

In rare cases, surgery to tie off the blood supply to the nose (arterial ligation) is needed for severe, recurring nosebleeds that don't respond to other treatments.

Living with this condition

Most people can manage nosebleeds at home. Keep your nose moist with a saline spray or a thin layer of petroleum jelly inside your nostrils (outside the nose) if recommended by your doctor.

Lifestyle tips

• Use a humidifier in your bedroom, especially in winter
• Avoid picking your nose or blowing it too hard
• Quit smoking, as it dries out the nose
• Wear protective headgear during sports that could injure your nose

Diet and exercise

A balanced diet rich in vitamin C and K may help with blood vessel health. Stay hydrated to prevent dryness. Avoid heavy lifting or straining if you are prone to nosebleeds.

Mental health and emotional wellbeing

Recurrent nosebleeds can be stressful or embarrassing. It's normal to feel anxious. Talk to your doctor if they affect your quality of life.

Prevention

Not all nosebleeds can be prevented, but you can reduce your risk by keeping the inside of your nose moist, avoiding nose picking, and treating underlying conditions like allergies or high blood pressure.

Vaccines

No direct vaccine for nosebleeds, but getting vaccinated against flu and pneumonia can reduce respiratory infections that might irritate the nose.

Screening programmes

No routine screening, but if you have a family history of bleeding disorders, your doctor may recommend blood tests.

Complications

If left untreated

• Significant blood loss leading to anemia (low red blood cells)
• Swallowing blood can cause nausea or vomiting
• Aspiration (breathing in blood) into the lungs, which can cause pneumonia or breathing problems
• In rare cases, prolonged bleeding from the back of the nose can be life-threatening

Long-term outlook

The vast majority of nosebleeds stop on their own or with simple treatment. Even recurrent nosebleeds can often be managed with preventive measures and medical care. With proper guidance, you can feel confident handling a nosebleed.

Find support

International organisations

• NHS (National Health Service) ↗
• Mayo Clinic ↗

Local organisations

• Your local GP or primary care doctor · International

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