Anterior nosebleeds usually come from tiny blood vessels at the very front part of the nose (septum) and are easy to stop. Posterior nosebleeds usually come from an artery in the back part of the nose and are much less common than anterior nosebleeds. They tend to occur more often in elderly people. Those nosebleeds are harder and more complicated to stop, and usually require management by a specialist.
Common causes of nosebleeds include direct injury (e.g. a punch) to the nose, nose-picking, repeated episodes of cold or allergic rhinitis, sticking of foreign objects into the nose and forceful blowing of nose. Excessive exposure to cold or dry air can also cause bleeding, as well as exposure to irritating chemicals like cigarette smoke. In these cases, nosebleeds can be prevented by avoiding actions that cause direct trauma to the nose. Applying a tiny jab of petroleum jelly to the inside of your nostrils or using a humidifier or nonprescription saline nasal spray can help moisturise the inside of the nose in excessively dry conditions.
Less common bleeding disorders, which result in inability of the blood to clot, may contribute to bleeding. Inability of the blood to clot, however, is most often due to blood-thinning medications such as warfarin or aspirin. Abnormal blood vessels, high blood pressure, chronic kidney failure or cancers in the nose are also rare causes of nosebleeds, which require diagnosis and treatment by a doctor.
Dealing with regular nosebleeds
Sit upright and lean forward. By remaining upright, you reduce blood pressure in the veins of your nose, discouraging further bleeding. Sitting forward will help you avoid swallowing blood. Applying a cool compress on the bridge of the nose may help.
1. Pinch your nose for five minute using your thumb and index finger. Breathe through your mouth. This manoeuvre stems pressure to the bleeding point and stems the flow of blood.
2. Release your nose after you have pinched it for five minutes, to see if the nosebleed continues.
3. Pinch your nose for 10 minutes if it is still bleeding.
4. After 10 minutes, release your nose and check if it is bleeding. If it is still bleeding, seek help from the doctor.
5. To prevent re-bleeding after bleeding has stopped, don't pick or blow your nose and don't bend down for several hours after the bleeding episode.
Once the bleeding has stopped, try to prevent any irritation to the nose, such as sneezing or nose-blowing for 24 hours.
Medical treatments from doctors are reserved for more complicated cases of nosebleeds and usually focus on the cause. These may include
- Closing the blood vessel using heat or silver nitrate sticks
- Reducing the amount of blood thinners or stopping aspirin
- Controlling blood pressure
- Healing a broken nose or removing a foreign object
- Nasal packing placed inside the nostril to exert pressure and halt bleeding
Contact your doctor if you experience repeated episodes of nosebleeds, nosebleeds that do no stop within 15 minutes of nose pinching, or bleeding that occurs after injury to head or nose. Fever, vomiting of blood, dizziness, light-headedness, rapid heartbeat or difficulty in breathing along with a nosebleed requires urgent treatment. Other symptoms like easy bruising and blood in bowels and urine are signs of more serious underlying problems that require consultation with your doctor.
This article is written with the help of
Family Doctor health magazine
Pamphlet: Nose Bleeds
Personal experiences and friends' experiences
