Nosebleed in children

Overview

A nosebleed, also called epistaxis (ep-ih-STAK-sis), is bleeding from the inside of the nose. It happens when tiny blood vessels in the lining of the nose break open.

Yes, nosebleeds are very common in children, especially between ages 2 and 10.

Children of any age can get nosebleeds, but they are most common in school‑aged children. Boys and girls are affected equally.

Symptoms

Common symptoms

• Blood dripping from one or both nostrils
• Blood trickling down the back of the throat (may cause spitting or swallowing blood)

Symptoms in children

• Blood from the nostril(s) – often only one side
• Child may cough or spit up blood if it goes down the throat
• Pale or sweaty skin if a lot of blood is lost (rare)

Symptoms in older adults

• Nosebleeds in older adults are less common but may be from the back of the nose, which can be harder to stop
• May be linked to high blood pressure or blood‑thinning medicines

Causes

Main causes

• Dry air (especially in heated homes or dry climates) – dries out the lining of the nose
• Picking or scratching the inside of the nose
• Blowing the nose too hard or too often
• Colds, allergies, or sinus infections that irritate the nose
• Minor injury to the nose (like a bump)

Risk factors

• Living in a dry climate or spending time in air‑conditioned or heated rooms
• Having a cold or allergies
• Taking blood‑thinning medicines (but rare in children)
• Having a structural problem in the nose (like a deviated septum – when the wall inside the nose is off‑centre)

When to see a doctor

See a doctor urgently if:

• Bleeding does not stop after 20 minutes of firm pressure
• Nosebleed is very heavy or accompanied by dizziness or fainting
• Child has a head injury just before the nosebleed

Book a routine appointment if:

• Recurrent nosebleeds that happen several times a week
• Nosebleeds that cause the child to feel weak or look pale
• You are worried about a bleeding disorder

Diagnosis

A doctor will ask about the child's medical history and what happens during the nosebleed. They will examine the inside of the nose using a light (otoscope – a small tool with a light).

Tests that may be done

• Blood tests may be done if nosebleeds are frequent or heavy – to check for anaemia (low blood count) or a bleeding disorder
• A simple swab test of the nose may be done if infection is suspected

What to expect at your appointment

The doctor will look for visible blood vessels, crusts, or a source of bleeding. They might apply a small medicine to stop bleeding. In most cases, no further tests are needed.

Treatment

Most nosebleeds can be managed at home with simple first aid. For persistent or heavy bleeding, a doctor may need to use special treatments.

Self-care at home

• Sit the child upright and lean their head forward (not back) – this keeps blood from going down the throat
• Pinch the soft part of the nose (just below the bridge) for 10–15 minutes without stopping
• Place a cold cloth or ice pack over the bridge of the nose to help shrink blood vessels
• Ask the child to breathe through the mouth and spit out any blood that goes into the mouth

Medical treatments

If a nosebleed does not stop with pressure, a doctor may use a chemical called silver nitrate to seal the bleeding spot (cauterisation – a burning process) or place a special nasal pack or balloon to apply pressure inside the nose. These are done in a clinic or emergency room.

When is surgery considered?

Rarely, if nosebleeds are very severe and do not respond to other treatments, an ear‑nose‑throat specialist may recommend a procedure to tie off or block the bleeding blood vessel (ligation or embolisation). This is only for extreme cases.

Living with this condition

Nosebleeds can be unsettling for both children and parents, but most children grow out of them. Keep a calm, reassuring manner during a bleed. Afterward, encourage rest and gentle activity – avoid rough play for a few hours.

Lifestyle tips

• Use a cool‑mist humidifier in the child's bedroom at night to keep the air moist
• Apply a thin layer of petroleum jelly (like Vaseline) just inside the nostrils before bedtime to prevent dryness
• Discourage nose picking – keep nails short and offer tissues for blowing gently

Diet and exercise

No special diet is needed, but staying well hydrated helps keep the nose lining moist. Avoid very hot foods or drinks right after a nosebleed.

Mental health and emotional wellbeing

Nosebleeds can sometimes frighten children. Reassure them that it is not dangerous. If a child feels anxious about school or sports because of nosebleeds, talk to their doctor for extra advice.

Prevention

Many nosebleeds can be prevented by keeping the inside of the nose moist. Not all nosebleeds can be prevented, especially those caused by injuries.

Complications

If left untreated

• Heavy bleeding that lasts a long time can lead to anaemia (low iron in the blood), but this is very rare in children
• Swallowing a large amount of blood may cause vomiting
• Very rarely, severe bleeding from the back of the nose can block breathing – this needs urgent medical help

Long-term outlook

The outlook for children with nosebleeds is excellent. Most children have occasional nosebleeds that stop easily. They often stop happening as the child gets older. Even if a child needs medical treatment, it is usually quick and effective.

Find support

International organisations

• International Epistaxis Trust (example – not a real organization)

Local organisations

• Your local GP practice or health visitor

Helplines

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