When to Worry About Bloody Noses
A bloody nose, or epistaxis (the medical term for a nosebleed), is a common occurrence, especially during colder months when the air is harsh and dry. While alarming, most nosebleeds are harmless and easily treated. Dr. Thomas Luft, UnityPoint Health, explains common bloody nose causes and how to manage them.
Why Do I Keep Getting a Bloody Nose?
- Blood Thinners: Certain medications, like blood thinners, can cause bloody noses in adults. They prevent blood from clotting, which can lead to spontaneous bleeding or unexpected bleeding from minor injuries.
- Dry Air: Bloody noses happen most commonly because of dry air. It causes the tissue inside your nasal passages to dry out, making them more likely to crack and bleed.
- Genetics: Some people are born with blood vessels close to the surface of the nostril, making them more likely to get nosebleeds.
- High Blood Pressure: Another reason you keep getting bloody noses may be due to high blood pressure. Hypertension weakens the blood vessels in your nose, making them more fragile and prone to rupture, leading to nosebleeds.
- Infections: A bloody nose from the common cold, sinus infection or COVID is normal. All create congestion and the dilation of blood vessels, which can cause a bloody nose or bloody mucus.
- Pregnancy: Bloody noses pop up during pregnancy, too. “Women experience fluid shifts when they become pregnant and blood vessels dilate — even in the nose. It makes pregnant women more prone to nosebleeds,” Dr. Luft says.
- Stress: Stress can cause bloody noses. Dr. Luft says this is primarily through an increase in blood pressure. “When stress raises your blood pressure, your blood vessels are more fragile and prone to bleeding, including nosebleeds,” Dr. Luft says.
- Underlying Health Conditions: Dr. Luft says, “Low platelets (tiny blood cells that help your blood clot), a bleeding disorder or liver problems that prohibit blood clotting all put people more at risk for nosebleeds.”
If your nosebleeds happen frequently, then allergies, the underlying conditions mentioned above or other health problems are likely to blame.
Nosebleeds happen at any time, day or night, so if you wake up with a nosebleed or have a nosebleed when you’re sleeping, it’s likely because of the reasons mentioned above. Talk to your doctor if it happens often.
What Causes a Nosebleed in Only One Nostril?
Nosebleeds in just one nostril are common and less worrisome than nosebleeds in both nostrils.
Dr. Luft says, “Your nose is separated by a septum, a wall of cartilage that splits the nasal cavity into two nostrils, which extend back to join other bones in the skull. If a nosebleed goes through both nostrils, it means the bleeding is coming from deeper in the head.”
How to Stop a Nosebleed
What to do for a bloody nose is the same for children and adults. Pinch and put pressure on the soft spot just below the bridge of the nose.
“We typically say to hold it for five minutes. If you have a bloody nose that won’t stop, that's a reason to go to urgent care or call your doctor,” Dr. Luft says.
The position you hold your head — up or down — matters less than keeping pressure on your nose.
“If you hold your head back, you’ll experience more post-nasal bleeding. If you hold your head forward, it’ll end at the nostril,” he says.
How Do You Prevent Bloody Noses
Depending on the cause, there are a few bloody nose treatments to try.
- Humidifier: If your dry, bloody nose is from dry air, an easy remedy is adding some humidity to your home.
- Saline: Many products help add moisture to your nose, like nasal or regular saline. Putting Vaseline on the outer surface of the nose is also helpful.
Treating the root cause is the best way to stop a bloody nose.
“If you have allergies, treating them will help. If you have high blood pressure, make sure your bloody pressure is controlled,” Dr. Luft says.
When to Worry About a Nosebleed
While most nosebleeds aren’t caused by anything serious, it’s concerning if there's head pain with your nosebleed, or if you have a history of high blood pressure.
“The other thing is if your nosebleed is associated with bleeding or bruising that’s not well-explained otherwise. For instance, take note if you get a papercut and it won’t stop bleeding, or a bruise anywhere on the body for no reason. Those things both indicate something more serious than dry air or allergies,” Dr. Luft says.
However, blood clots from a nosebleed are perfectly normal and no cause for concern.
Dr. Luft says, “Your body naturally starts a clotting process to stop a nosebleed. Once the clot forms, it seals damaged blood vessels to prevent more bleeding.”
If you have a frequent or severe bloody nose more than three times a month, talk your doctor and make sure nothing else is happening.