Patient education: Nosebleeds (The Basics)

Why do people get nosebleeds? — It can be scary when blood starts coming out of your nose or your child's nose. But nosebleeds are not usually serious. They are very common. The most common causes are dry air and nose picking.

If you or your child gets a nosebleed, the important thing is to know how to deal with it. With the right care, most nosebleeds stop on their own.

How do I know if a nosebleed is serious? — You should see a doctor or nurse right away if your nosebleed:

●Makes it hard to breathe

●Causes you to turn very pale, or makes you tired or confused

●Will not stop even after you do the steps listed below

●Happens right after surgery on your nose, or if you know you have a tumor or other growth in your nose

●Happens with other serious symptoms, such as chest pain

●Happens after a serious injury, like a car accident or a hard hit to the face

●Will not stop, and you take medicines that prevent blood clots, such as warfarin (brand name: Jantoven), dabigatran (brand name: Pradaxa), apixaban (brand name: Eliqius), rivaroxaban (brand name: Xarelto), clopidogrel (brand name: Plavix), or daily aspirin

If you have chest pain, trouble breathing, or feel woozy, call for an ambulance (in the US and Canada, call 9-1-1). Do not drive yourself to the hospital, and do not ask someone else to drive you.

How can I stop a nosebleed on my own? — With the right self-care, most nosebleeds stop on their own. Here's what you should do:

1. Sit down while bending forward a little at the waist. DO NOT lie down or tilt your head back.

2. Pinch the soft area toward the bottom of your nose, below the bone (picture 1). DO NOT grip the bridge of your nose between your eyes. That will not work. DO NOT press on just 1 side, even if the bleeding is only on 1 side. That will not work either.

3. Squeeze your nose shut for at least 15 minutes. (In children, squeeze for only 10 minutes.) Use a clock to time yourself. For young children, a caregiver should calm the child and squeeze their nose. Do not release the pressure before the time is up to check if the bleeding has stopped. If you keep checking, you will ruin your chances of getting the bleeding to stop.

If you follow these steps, and your nose keeps bleeding, repeat all of the steps once more. Apply pressure for a total of at least 30 minutes (or 20 minutes for children). If you are still bleeding, go to the emergency department or an urgent care clinic.

You can also try using 2 sprays of oxymetazoline (sample brand name: Afrin Nasal Spray, Mucinex Nasal Spray), an over-the-counter nose spray, in the bleeding nostril. Do not do this more than 3 days in a row.

What if I get repeated nosebleeds? — Frequent nosebleeds can be caused by:

●Breathing dry air all of the time

●Using cold or allergy nasal sprays too much

●Frequent colds

●Nose picking

●Snorting drugs into your nose, such as cocaine

In some cases, repeat nosebleeds can be a sign that your blood does not clot normally. If that is the case, there are often other clues. For instance, people with clotting problems bruise easily and might bleed more than expected after a small cut or scrape.

If you have nosebleeds often, call your doctor or nurse for advice.

How are nosebleeds treated? — If you do see a doctor or nurse for your nosebleed, they will make sure that you can breathe OK. Then, they will try to get the bleeding to stop. To do that, they might have to put a device or some packing material into your nose.

What can I do to keep from getting nosebleeds? — In general, you can:

●Use a humidifier (a machine that makes the air less dry) in your bedroom when you sleep.

●Keep the inside of your nose moist with a nasal saline spray or gel, or petroleum jelly (sample brand name: Vaseline).

●Do not pick your nose, or at least clip your nails before you do to avoid injury.

Also, if you have had a nosebleed in the last 24 hours, you should avoid:

●Heavy lifting

●Bending over

●Blowing your nose very hard

These things can cause your nose to start bleeding again.

More on this topic

Patient education: Nose fracture (The Basics)

Patient education: Nosebleeds (epistaxis) (Beyond the Basics)