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What causes nosebleeds?

A nosebleed happens when one or more of the many small blood vessels in your nose break. A nosebleed can be caused by many things including irritation from dry air, strong nose blowing, an injury to or near the nose, some drugs (like aspirin and warfarin), high blood pressure, and clotting disorders.


There are two types of nosebleeds. Anterior nosebleeds are the most common. They start in the front of the nose and cause blood to flow out through the nostrils. Posterior nosebleeds, which are much less common, start in the back of the nose. They cause blood to flow into the throat and may cause choking.


How can I stop a nosebleed?

If your nosebleed was caused by a fall, injury to your head or face, or recent nose surgery; if you find it hard to breathe; or if you have chest discomfort, immediately call 911.


Take these steps to stop most nosebleeds:


* Sit upright and lean slightly forward at the waist. Don't lie down or tilt your head back. Sitting upright lessens the blood pressure in your nose, which lessens bleeding. Leaning slightly forward stops blood from going down your throat.


* Pinch all the soft parts of your nose shut using your thumb and index finger.


* Breathe through your mouth and apply pressure to your nose for 5 minutes.


* If it's still bleeding, apply pressure for an additional 10 minutes. Use a clock to time yourself, and don't release the pressure to check on the bleeding before the time is up.


* If the nosebleed hasn't stopped after 15 minutes (in adults), apply an icepack (or a bag of frozen peas or beans) to the bridge of your nose. This can help shrink blood vessels and reduce bleeding.


* If your nose continues to bleed, repeat these steps. If the bleeding still doesn't stop, call your healthcare provider or seek immediate medical care at an emergency department or urgent care clinic. Call 911 if the bleeding is heavy.


* If the bleeding stops, don't blow or pick your nose or bend down for several hours. Keep your head higher than your heart.



How can I prevent nosebleeds?

Use a humidifier to combat dry air, especially when sleeping. Use a saline nasal spray or gel to keep your nose moist. Don't smoke or pick your nose.


Medicines like warfarin (Coumadin), clopidogrel (Plavix), nose sprays for allergy symptoms, and daily aspirin can cause nosebleeds. If you take any of these medicines and you get frequent nosebleeds, talk with your healthcare provider.


Should I be worried if I get nosebleeds a lot?

Most nosebleeds are harmless, but sometimes frequent nosebleeds may mean something more serious. If you're taking the precautions listed above to keep your nose moist and you're still getting nosebleeds, talk with your healthcare provider to find out why.




Alter H, Messner AH. Patient information: nosebleeds (epistaxis). UpToDate.


American Academy of Otolaryngology-Head and Neck Surgery. Nosebleeds.


Mayo Clinic. Nosebleeds: first aid.


University of Washington Medical Center. Preventing and treating nosebleeds: for patients taking warfarin.