Epistaxis

Nosebleeds can be frightening. However, they are fairly common, particularly in children, and can often be treated at home.

The medical name for a nosebleed is epistaxis.

During a nosebleed, blood flows from one nostril, or sometimes both nostrils. It can be heavy or light and last from a few seconds to more than 10 minutes.

Read more about the symptoms of a nosebleed.

When to see your GP

Most nosebleeds are minor and usually stop with some self care. You only need to visit your GP if you have heavy or frequent nosebleeds.

Bleeding may be heavier or last longer if you have high blood pressure (hypertension), heart failure, a condition where your blood doesn't clot (thicken) properly, or if you're taking medication that thins your blood (anticoagulants), such as warfarin or aspirin.

If you have a nosebleed that lasts longer than 30 minutes, go to your nearest accident and emergency (A&E) department as soon as possible.

What causes nosebleeds?

The inside of your nose is full of tiny blood vessels which can bleed if they're disturbed by a minor injury, such as when picking or blowing your nose.

Nosebleeds can also occur if the moist lining (mucous membrane) inside your nose dries out and becomes crusty. This can be caused by an infection, cold weather or the drying effect of central heating. If the mucous membrane becomes inflamed or cracked, it's more likely to bleed if it is disturbed.

Read more about the causes of nosebleeds.

Who gets nosebleeds?

Anyone can get a nosebleed, but they most commonly occur in the following:

young children
the elderly
pregnant women
people who regularly take aspirin and blood thinning medication, such as warfarin
people with blood disorders

Treating nosebleeds

You can usually stop a nosebleed yourself by pinching your nose just above your nostrils for 10 minutes. Leaning forward and breathing through your mouth will drain blood down your nose instead of down the back of your throat.

If you seek medical help because your nosebleed hasn't stopped bleeding after 20 minutes, a procedure called cauterising may be used to stop the bleeding. This involves sealing the bleeding area by using a low level of heat or a tiny dab of silver nitrate (which can be painful).

If cauterising doesn't work, your nose may be packed with ribbon gauze or a nasal sponge until the bleeding has stopped. This will need to be removed by your GP or a healthcare professional who will then examine your nose.

Are nosebleeds serious?

Nosebleeds aren't usually serious. However, frequent or heavy nosebleeds may indicate more serious health problems, such as high blood pressure, and should be checked.

A nosebleed can be more serious for older people whose blood takes longer to clot because they are at risk of losing more blood.

If your GP suspects a more serious problem, they may refer you to an ear, nose and throat (ENT) specialist for further tests.

Excessive bleeding over a prolonged period of time can lead to anaemia. Frequent nosebleeds (more than once a week) or heavy nosebleeds can make anaemia worse if you're losing a lot of blood.

Preventing nosebleeds

Things you can do to prevent nosebleeds include:

avoid picking your nose and blowing your nose hard if it's blocked due to a cold or hay fever
wear a head guard while playing sports in which your nose could get injured, such as boxing or rugby
always follow the instructions that come with nasal decongestants
talk to your GP if you're prescribed blood-thinning medicines (anticoagulants) and you have a history of nosebleeds

After having a nosebleed, a "crust" will form inside your nose. This may be unpleasant, but try not to remove it as it is part of the healing process and will help prevent nosebleeds from re-occurring.

While your nose is healing, it's more vulnerable to infection, so avoid people with coughs and colds. Also avoid alcohol, smoking and hot drinks because they expand the blood vessels in the lining of your nose.