What causes nose bleeding?

What causes nosebleed? 29 possible conditions

Medically Reviewed by George Krucik, MD, MBA

Nosebleeds are common. They may be scary, but they rarely indicate a serious medical problem. The nose contains many blood vessels. These blood vessels are located close to the surface in the front and back of the nose. They are very fragile and bleed easily. Nosebleeds are common in adults and children between the ages of 3 and 10.

There are two kinds of nosebleeds. An anterior nosebleed occurs when the blood vessels in the front of the nose break and bleed. A posterior nosebleed occurs in the back or the deepest part of the nose. In this case, blood flows down the back of the throat. Posterior nosebleeds can be dangerous.

Causes of Nosebleeds

There are many causes of nosebleeds. A sudden or infrequent nosebleed is rarely serious. If you have frequent nosebleeds, you could have a more serious problem. 

Dry air is the most common cause of nosebleeds. Living in a dry climate and using a central heating system can dry out the nasal membranes, which are tissues inside the nose. This dryness causes crusting inside the nose. Crusting may itch or become irritated. If your nose is scratched or picked, it can bleed.

Taking antihistamines and decongestants for allergies, colds, or sinus problems can also dry out the nasal membranes and cause nosebleeds. Frequent nose blowing is another cause of nosebleeds.

Other common causes of nosebleeds include:

• foreign object stuck in the nose
• chemical irritants
• allergic reaction
• injury to the nose
• repeated sneezing
• picking the nose
• cold air
• upper respiratory infection
• large doses of aspirin

Other causes of nosebleeds include high blood pressure, a bleeding disorder, blood clotting disorder, and cancer.

Most nosebleeds do not require medical attention. However, you should seek medical attention if your nosebleed lasts longer than 20 minutes or occurs after an injury. This may be a sign of a posterior nosebleed, which is more serious.

Injuries that might cause a nosebleed include a fall, a car accident, or a punch in the face. Nosebleeds that occur after an injury may indicate a broken nose, skull fracture, or internal bleeding.

Diagnosing a Nosebleed

If you seek medical attention for a nosebleed, your doctor will conduct a physical examination to determine a cause. He or she will check your nose for signs of a foreign object. Your doctor will also ask questions about your medical history and current medications.

Tell your doctor about any other symptoms you have and any recent injuries. There is no single test to determine the cause of a nosebleed. However, your doctor might use diagnostic tests to find the cause. These tests include:

• complete blood count, which is a blood test to check for blood disorders
• nasal endoscopy, which is an examination of the nose using a special instrument
• partial thromboplastin time, which is a blood test that checks how long it takes your blood to clot
• CT scan of the nose, which is an imaging test that takes cross-sectional pictures of the nose
• X-ray of the face and nose, which is an imaging test that uses radiation to produce pictures of the nose

How to Treat a Nosebleed

You can treat a nosebleed at home. While sitting up, squeeze the soft part of your nose. Make sure that your nostrils are fully closed. Keep your nostrils closed for 10 minutes, lean forward slightly, and breathe through your mouth.

Do not lie down when trying to stop a nosebleed. Lying down can result in swallowing blood and can irritate your stomach. Release your nostrils after 10 minutes and check to see if the bleeding has stopped. Repeat these steps if bleeding continues.

You can also apply a cold compress over the bridge of your nose or use a nasal spray decongestant to close off the small blood vessels.

See your doctor if you’re unable to stop a nosebleed on your own. If a foreign object is the cause, your doctor can remove the object. A medical technique called cauterization can also stop persistent or frequent nosebleeds. This involves your doctor burning the blood vessels in your nose with silver nitrate (a compound used to remove tissue) or a heating device. Your doctor may also pack your nose with cotton or gauze to apply pressure to your blood vessels and stop the bleeding.

How to Prevent Nosebleeds

There are several ways to prevent nosebleeds.

• Use a humidifier in your house to keep the air moist.
• Avoid picking your nose.
• Limit your intake of aspirin, which can thin your blood and contribute to nosebleeds. Discuss this with your doctor first because the benefits of taking aspirin might outweigh the risks.
• Use antihistamines and decongestants in moderation. These can dry out the nose.