(Epistaxis; Bloody Nose)
- Anterior nosebleed—Blood comes from the front of the nose. It usually flows from the semi-rigid walls that separate the two nostrils. This is the most common type of nosebleed.
- Posterior nosebleed—Bleeding starts deep within the nose. This is often more severe and difficult to treat than an anterior nosebleed.
|The Nasal Passage|
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- Irritating or breaking the lining of the nose
- Injuring the nasal tissue, which occurs more easily when nasal structure is not normal, or when the passages are inflamed due to a cold or allergies
- Very dry nasal tissue
- Picking or bumping the nose
- Forcefully blowing or rubbing the nose
- Having clot from a previous nosebleed becoming disturbed or dislodged
- Placing a foreign object in the nose
- Having a tumor in the nose and/or sinuses
- Irregularity in the structure of the nose
- Abnormalities of the blood vessels in the nose (angiomas)
- Dry climate
- Dry, heated indoor air
- Diseases, such as sarcoidosis or systemic lupus erythematosus
- Cocaine use
- Bleeding or clotting disorders
- Anticoagulant (blood-thinning) drugs, including aspirin
- Very high blood pressure
- Anterior nosebleed—These produce blood flow from one nostril when sitting or standing. Blood may pass down the throat if you are coughing or tipping your head back.
- Posterior nosebleed—These cause bleeding down the back of the mouth and throat. Blood may flow from the nostril if you lean forward.
When Should I Call My Doctor?
- There is a lot of blood
- The bleeding will not stop
- The bleeding is caused by an injury
- You experience frequent nosebleeds
- The bleeding interferes with breathing
- The bleeding happens in a child less than 2 years of age
- Stay calm.
- Sit up and lean forward.
- Pinch the soft parts of your nose together. Hold for at least five minutes without releasing pressure.
- Once the bleeding stops, do not pick or blow your nose.
- Avoid straining, bending, or lifting.
- If the bleeding starts again, reapply pressure for ten minutes.
- Lubricate dry nasal passages near the front of the nose. Place a small dab of lubricating cream or ointment on your fingertip. Apply the lubricant to the inside of the nose. You may do this at bedtime or up to 3 times during the day. Polysporin and petroleum jelly are examples of lubricants that may be used.
- Use a saline nasal spray. These help keep nasal passages moist. Be sure that the nose spray does not contain medications, such as phenylephrine or oxymetazoline. These types of medications should be used for only a few consecutive days.
- Do not pick your nose. Cut children's fingernails short to discourage picking.
- Humidify the air, especially in bedrooms.
American Academy of Otolaryngology—Head and Neck Surgery http://www.entnet.org
Family Doctor—American Academy of Family Physicians http://familydoctor.org
About Kids Health—The Hospital for Sick Children http://www.aboutkidshealth.ca
Canadian Society of Otolaryngology http://www.entcanada.org
Epistaxis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 15, 2014. Accessed September 22, 2015.
Nosebleeds. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/nosebleeds.html. Updated April 2014. Accessed September 22, 2015.
Nosebleeds. American Academy of Otolaryngology website. Available at: http://www.entnet.org/content/nosebleeds. Updated December 3, 2010. Accessed September 22, 2015.
- Reviewer: Marcin Chwistek, MD
- Review Date: 09/2015 -