If you often deal with nosebleeds, it can be easy to start seeing them as just a hassle.
However, while most are mild and harmless, they really shouldn’t occur “if everything inside the nose is healthy,” notes Dr. Patricia Loftus, an ear, nose, and throat specialist at the University of California, San Francisco.
Here’s what the experts have to say about nosebleeds.
What is a nosebleed?
Nosebleeds, or epistaxis in medical terms, come in two types: anterior and posterior.
Approximately 90% of nosebleeds are anterior, beginning in the area between your nostrils called Kiesselbach’s plexus, according to Loftus. This area is rich in tiny blood vessels that help warm the air you breathe. When these vessels break, blood typically flows from the nostril, though it can also run down the throat if your head is tilted back.
Posterior nosebleeds are less common and usually more severe. They occur when larger blood vessels deep within the nasal passage rupture. If there’s a significant amount of blood traveling down the back of your throat—potentially causing choking—that’s considered a posterior nosebleed, explains Dr. Amin Javer, an ENT surgeon at the University of British Columbia.
Posterior nosebleeds are more critical than anterior ones and require immediate medical care. Older adults, particularly those on blood thinners, are more likely to experience these.
What should you do when your nose is bleeding?
Many people instinctively lean their head back when a nosebleed occurs.
“That’s the worst thing you could do,” cautions Javer. “You’ll end up swallowing the blood.” And that can lead to nausea, so it’s best to avoid it.
Instead, tilt your head forward and gently pinch your nose, he advises. Applying a cold compress on your neck or nose may help constrict the blood vessels and slow the bleeding—or even using a nasal decongestant like oxymetazoline.
Seeing thick clots come out of your nose can be unsettling, but it’s often not a bad sign. “It just means your blood is clotting properly,” says Dr. Peter Manes, an ENT surgeon and residency director at Yale School of Medicine.
If you find yourself having nosebleeds multiple times a week, if they disrupt your daily life, or if they last longer than 30 minutes, it’s a good idea to see a doctor for an evaluation.
What causes nosebleeds?
“A common cause of anterior nosebleeds is dryness,” says Loftus.
Dry air is particularly troublesome in winter. “It doesn’t matter how much rain is outside; when the heaters come on, the humidity drops,” explains Javer. He suggests cracking a window during the night or using a humidifier to maintain humidity levels between 40% and 50%. Keeping your nasal lining moisturized with saline spray or a thin layer of Vaseline can also help.
Another frequent cause is “digital manipulation,” or more simply, picking your nose or scratching it, notes Loftus. The nose is quite delicate, and even a minor bump can rupture a capillary and lead to bleeding.
Inflammation from allergies or viral infections can also weaken the nasal lining, making it more prone to cracking. Plus, certain physical activities can contribute. Exercises where your head dips below your heart, like downward dog, can create pressure that incites a bleed.
Medications and supplements pose additional risks. Blood thinners and aspirin increase the chances of bleeding, and some herbal supplements can do the same. “Ginseng, garlic, ginkgo—some of those herbal medications can thin your blood,” says Manes.
Why am I having frequent nosebleeds?
If you’re experiencing daily nosebleeds without any clear cause, it’s important to get evaluated, says Loftus. “Even if they’re not a huge bother, that’s enough of a reason to see a doctor.”
Manes agrees that people often normalize nosebleeds, brushing them off as minor, but they sometimes signal more serious health concerns.
Frequent nosebleeds could suggest that your blood isn’t clotting properly, Loftus mentions. A doctor might ask about your alcohol intake and look for potential liver problems.
Hormonal changes during pregnancy can also be a factor. Loftus states that increased levels of hormones like estrogen and progesterone may lead to lobular capillary hemangioma, a benign growth in the nose that can cause nosebleeds. While these growths aren’t dangerous, they should still be assessed by a physician.
For those in their 20s experiencing sudden, heavy nosebleeds, it could be a sign of “hereditary hemorrhagic telangiectasia” (HHT), a genetic vascular issue emerging in young adulthood. If untreated, HHT can pose serious health risks, including death from nosebleeds, cautions Javer.
Frequent nosebleeds from only one nostril are particularly concerning. Such a pattern may indicate a tumor or polyp, especially if other symptoms are present on the same side, like breathing difficulties, facial pain, or vision changes. “That needs to be checked,” Loftus advises.
How do doctors treat a nosebleed?
Many nosebleeds can be managed at home. However, if you experience persistent, frequent, or severe nosebleeds that disrupt daily life, or suspect you have a posterior bleed, seek medical help.
When you arrive at a doctor’s office or the emergency room with an active bleed, you can expect a thorough examination of your nasal cavity to find the source of the bleeding, explains Manes. Most cases can be controlled with nasal packing—essentially a nasal tampon.
A doctor might also cauterize the bleeding area, which can sting, though a numbing cream should help ease the discomfort.
They may check your vitals and take blood tests to look for conditions like anemia or clotting issues. If there’s concern about a mass in the sinuses, a CT or MRI might be ordered. In cases of substantial blood loss, a transfusion could be necessary.
