When to seek care for nosebleed

Overview

A nosebleed, also called epistaxis, is bleeding from the inside of your nose. It happens when tiny blood vessels in the lining of the nose break open.

Yes, nosebleeds are very common. Most people will have at least one in their lifetime.

Nosebleeds can happen to anyone, but they occur most often in children aged 2–10 years and in adults over 50.

Symptoms

Common symptoms

• Blood dripping from one nostril (sometimes both)
• A feeling of liquid running down the back of your throat (this is blood draining into the throat)
• Lightheadedness or dizziness if the bleeding is heavy

Symptoms in children

• Blood from the nose, often stop suddenly
• Child may be frightened but usually not in pain
• If bleeding does not stop after 20 minutes of pressure, seek medical help

Symptoms in older adults

• Bleeding may be heavier and harder to stop because blood vessels are more fragile
• May also have bleeding from the back of the nose (posterior bleed), which can be more serious
• Older adults on blood‑thinning medication may need extra care

Causes

Main causes

• Dry air (low humidity) that dries out the nasal lining
• Picking or scratching inside the nose
• Blowing your nose too hard or too often
• Minor injury to the nose
• Allergies or colds that cause congestion and sneezing
• Inhaling irritants like tobacco smoke or strong chemicals

Risk factors

• Living in a dry climate or during winter when indoor heating is used
• Taking blood‑thinning medications (such as aspirin or warfarin) — talk to your doctor
• Having a bleeding disorder (like haemophilia or von Willebrand disease)
• High blood pressure (persistent high blood pressure can make nosebleeds harder to stop)
• Having a tumour or growth in the nose (rare)

When to see a doctor

See a doctor urgently if:

• You need emergency care as described in the emergency section above
• Bleeding continues for more than 20 minutes even with correct pressure
• You lose a lot of blood and feel lightheaded or weak
• The nosebleed is caused by a serious injury or accident

Book a routine appointment if:

• You get nosebleeds often (more than once a week) without a clear reason
• The nosebleeds happen while you sleep
• You have other symptoms like unexplained bruises or bleeding elsewhere
• You want to check if there is an underlying cause

Diagnosis

A doctor will ask about your symptoms, how often the nosebleeds happen, and your medical history. They will look inside your nose with a small light and a tool called a speculum to see where the bleeding is coming from.

Tests that may be done

• Blood tests to check for clotting problems or anaemia
• A nasal endoscopy (a thin, flexible tube with a camera) to look inside the nose further back
• Imaging tests like a CT scan are rarely needed, only if a more serious cause is suspected

What to expect at your appointment

The doctor will first check your breathing and pulse. They will ask you to sit up and lean forward. They may use a cotton ball with a numbing spray or a small pack to stop the bleeding. Most check‑ups are quick and not painful.

Treatment

Treatment for nosebleeds depends on how heavy the bleeding is and where it comes from. Most nosebleeds stop on their own or with simple first aid. For persistent or severe nosebleeds, a doctor may need to treat the bleeding blood vessel.

Self-care at home

• Sit up straight and lean your head forward — do not tilt your head back
• Pinch the soft part of your nose firmly with your thumb and index finger for 10–15 minutes without stopping
• Breathe through your mouth while pinching
• Place an ice pack or cold cloth across the bridge of your nose to help slow bleeding
• Do not blow your nose or put anything inside for at least 12 hours after the bleeding stops

Medical treatments

If self‑care does not stop the bleeding, a doctor may use a special spray or gel to numb the nose and seal the bleeding vessel. Sometimes they place a dissolvable pack or a small balloon inside the nose to apply pressure. In rare cases, a procedure called cautery (using heat or a chemical to seal the vessel) is done. Your doctor will explain the safest option for you.

When is surgery considered?

Surgery is rarely needed. It is only considered if nosebleeds do not respond to other treatments and are caused by a specific problem like a blood vessel that needs to be tied off or a tumour.

Living with this condition

Most people with occasional nosebleeds do not need to change their daily life. If you get nosebleeds often, keep a small supply of cotton or tissues handy and know the first‑aid steps. You can keep a diary of when nosebleeds happen to share with your doctor.

Lifestyle tips

• Use a humidifier in your bedroom at night, especially in dry climates or winter
• Apply a thin layer of saline gel or petroleum jelly inside your nostrils to keep them moist
• Avoid picking your nose or blowing it too hard
• Keep your fingernails short if you find you pick your nose without thinking
• Trim children's fingernails to reduce damage from nose picking

Diet and exercise

A balanced diet rich in vitamin C and vitamin K (found in green leafy vegetables) may help support healthy blood vessels. Drink enough water to stay hydrated. Avoid very strenuous exercise right after a nosebleed, but normal activity is fine once bleeding has stopped.

Mental health and emotional wellbeing

Frequent nosebleeds can be worrying or embarrassing. It is normal to feel anxious. Remember that most nosebleeds are not dangerous. If anxiety affects your daily life, talk to your doctor — they can help you manage both the nosebleeds and your feelings.

Prevention

Many nosebleeds can be prevented by keeping the inside of your nose moist and avoiding irritation. You cannot prevent all nosebleeds, especially if they are caused by medication or an underlying condition, but you can reduce how often they happen.

Complications

If left untreated

• Anaemia (low red blood cells) from frequent or heavy blood loss
• Swallowing a lot of blood can cause vomiting or nausea
• In rare cases, severe bleeding may lead to fainting or shock
• If a nosebleed is due to a clotting problem, untreated bleeds can be harder to control

Long-term outlook

The outlook for nosebleeds is very good. Most stop on their own or with simple first aid. Even for people who have frequent nosebleeds, treatments are effective and safe. With proper care and prevention, you can usually manage nosebleeds well.

Find support

International organisations

• World Health Organization (WHO) — patient safety information ↗

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