Nosebleeds, also known medically as epistaxis, are a surprisingly common ailment, with approximately one in seven Americans experiencing one at some point in their lives. The sight of blood can be alarming, especially when it suddenly starts flowing from your nose. But while a bloody nose can be startling, it’s important to understand that they are usually not serious and can often be managed at home. So, Why Do Bloody Noses Happen? Often, the culprits are simple environmental factors or minor irritations.
Nosebleed graphic
Common Causes of Nosebleeds
Several factors can contribute to nosebleeds. Understanding these common causes can help you prevent them and manage them effectively when they occur.
Dry Air
One of the most frequent reasons for a bloody nose is dry air. Whether it’s the low humidity of a dry climate or the arid indoor air during winter months due to heating systems, dryness can irritate and dehydrate the delicate lining of your nose. This dryness can cause the nasal tissues to become brittle and crack, making them more susceptible to bleeding.
Nasal Irritation and Injury
Physical irritation or minor injuries to the nose are also common triggers for nosebleeds. This can include:
- Nose picking: This is a very common cause, especially in children. The nasal lining is delicate, and picking can easily rupture small blood vessels.
- Blowing your nose too hard: Forceful nose blowing, particularly when you have a cold or allergies, can irritate the nasal passages and lead to bleeding.
- Direct trauma to the nose: A bump or blow to the nose, even a minor one, can injure the blood vessels and cause a nosebleed.
- Steroid nasal sprays and decongestants: While helpful for congestion, overuse of these sprays can dry out and irritate the nasal lining, increasing the risk of nosebleeds.
Medications
Certain medications can also make you more prone to nosebleeds.
- Anticoagulants: Blood-thinning medications like warfarin, aspirin, and heparin are designed to prevent blood clots. However, this also means they can make it harder for your blood to clot when you have a nosebleed, potentially leading to heavier or more prolonged bleeding. If you are taking anticoagulants and experience frequent or severe nosebleeds, it’s important to consult your healthcare provider.
Less Common Causes
While less frequent, other factors can contribute to nosebleeds:
- High blood pressure: Hypertension can sometimes be associated with nosebleeds, though it’s not usually a primary cause of routine nosebleeds. If you experience a nosebleed along with symptoms of very high blood pressure, it’s important to seek medical attention.
- Underlying medical conditions: Rarely, nosebleeds can be a symptom of more serious conditions, such as bleeding disorders, hereditary hemorrhagic telangiectasia, or tumors in the nasal passages. Frequent, heavy, or unexplained nosebleeds should be evaluated by a doctor to rule out any underlying issues.
What To Do When You Get a Nosebleed: A Step-by-Step Guide
Knowing how to properly manage a nosebleed can help you stop the bleeding quickly and prevent it from recurring. Here’s a step-by-step guide on what to do when you get a bloody nose, adapted for adults and adolescents:
Step 1: Stay Calm and Lean Forward
The first and most crucial step is to remain calm. Anxiety can actually worsen the bleeding. Sit upright and lean slightly forward. Leaning forward is important because it prevents you from swallowing blood. If there is blood in your mouth, spit it out rather than swallowing it. Swallowing blood can irritate your stomach and potentially cause nausea or vomiting.
Step 2: Use a Decongestant Nasal Spray (Optional but Helpful)
If you have a decongestant nasal spray like Afrin or Neo-Synephrine available, using it can be helpful. Spray 2-3 times into the nostril that is bleeding. These sprays contain medications that constrict blood vessels, which can help to slow and stop the bleeding more quickly.
Step 3: Pinch Your Nose Properly
Using your thumb and index finger, firmly pinch the soft, fleshy part of your nose shut. Make sure you are pinching the soft part of the nose, below the bony bridge. Many people pinch too high up on the nasal bridge, which is not effective in stopping most nosebleeds.
Step 4: Time it Right: Pinch for 10 Minutes
This is a critical step that many people get wrong. You need to pinch your nose continuously for a full 10 minutes. Use a clock or timer to keep track of the time. Resist the urge to release pressure and peek to see if the bleeding has stopped before the 10 minutes are up. Peeking too early can disrupt the clotting process and restart the bleeding.
Step 5: What if it Still Bleeds? Repeat and Use Cotton with Nasal Spray
After 10 minutes, release the pressure and check if the bleeding has stopped. If your nose is still bleeding, soak a cotton ball with the decongestant nasal spray. Place the cotton ball into the bleeding nostril, pushing it just inside, and pinch your nose again for another 10 minutes.
Step 6: Post-Bleed Care: Don’t Blow Your Nose
Once the bleeding has stopped, it’s important to avoid activities that could restart it. Do not blow your nose for at least 2 days. Blowing your nose can dislodge any clots that have formed and trigger another nosebleed. Try to sneeze through your mouth if you need to sneeze.
Step 7: Check Your Blood Pressure (If Possible)
If you have a blood pressure monitor at home, it can be helpful to check your blood pressure after a nosebleed. While high blood pressure is not always the cause of a nosebleed, it can sometimes contribute. If your blood pressure is very high, and you are experiencing other symptoms like headache or dizziness, seek medical advice.
What NOT to Do During a Nosebleed
There are several common mistakes people make when dealing with nosebleeds that can actually worsen the situation or prolong the bleeding. Here are some things you should avoid doing during a nosebleed:
Don’t Tilt Your Head Back
A common misconception is that you should tilt your head back when you have a nosebleed. Do not tilt your head back. This will cause the blood to drain down the back of your throat. As mentioned earlier, swallowing blood can irritate your stomach and cause nausea and vomiting. It also makes it harder to tell if the bleeding has stopped and can potentially lead to choking if the bleeding is heavy.
Don’t Pack Your Nose with Tissues (or other household items)
Avoid the urge to stuff your nose with tissues, tampons, or other household items. While it might seem like a good way to absorb the blood, tissues are not very effective at applying pressure to the bleeding vessels. Furthermore, stuffing tissues far up into your nose can actually irritate the delicate nasal lining further and potentially worsen the bleeding when you remove them. Small pieces of cotton ball soaked with nasal spray are acceptable if needed as described above.
Avoid Strenuous Activity
After a nosebleed, especially a significant one, avoid strenuous activities, heavy lifting, and vigorous household chores like vacuuming for at least 24 hours, and ideally up to two full weeks for complete healing. Increased physical exertion can raise your blood pressure and potentially restart the bleeding. Avoid bending over for long periods as well.
When to Seek Emergency Medical Attention for a Nosebleed
Most nosebleeds are not emergencies and will stop with home treatment. However, there are certain situations when a nosebleed requires immediate medical attention in the emergency room:
- Bleeding that doesn’t stop after 30 minutes of continuous pressure. If you have followed the steps above and the bleeding continues for longer than 30 minutes despite consistent pressure, you need to seek medical help.
- Very heavy bleeding. If the bleeding is profuse, pouring down the back of your throat and out of your nose, this is a sign of a more serious nosebleed that requires medical intervention.
- Nosebleed with other concerning symptoms. If you experience a nosebleed along with other symptoms like chest pain, lightheadedness, rapid heart rate, or very high blood pressure, these could indicate a more serious underlying issue that needs immediate medical evaluation.
- Nosebleed following a significant injury to your head or nose. If your nosebleed is the result of a major trauma, you should go to the emergency room to rule out other injuries, such as a broken nose or head injury.
- Frequent and unexplained nosebleeds. If you are experiencing nosebleeds frequently (more than 3-4 times a week, or 6 or more times a month) despite following preventative measures, you should consult your doctor to determine the underlying cause and receive appropriate treatment.
Understanding why do bloody noses happen and knowing how to manage them at home can alleviate much of the worry associated with this common condition. Remember, most nosebleeds are easily treatable at home, but don’t hesitate to seek medical help when necessary.
