What are nosebleeds?

Bleeding from your nose is also known as a nosebleed. The medical word for a nosebleed is 'epistaxis.'

Nosebleeds are very common, especially in children and older people.

Most nosebleeds are mild and do not last long.

Nosebleeds can be distressing for children, but the bleeding can usually be easily stopped with first aid. Most nosebleeds do not need special treatment.

What symptoms are related to nosebleeds?

You may have sudden bleeding from one or both nostrils.

Some people with nosebleeds may have a have a blood disorder. Other symptoms of a blood disorder can be:

• tiredness
• bruising
• repeated infections

You should see your doctor if you have these symptoms.

What causes nosebleeds?

Nosebleeds are caused when the tiny blood vessels on the inside of your nose break. This causes bleeding. The blood comes out of your nose, and can come from one or both nostrils.

Nosebleeds can happen if you:

• pick your nose
• blow your nose too hard
• receive a bump, knock or blow to the head or face
• strain too hard on the toilet
• are in hot or cold weather with low humidity
• have an object in your nose (usually seen in children)

Nosebleeds can also be related to:

• an infection in your nose, such as a cold
• hay fever (allergic rhinitis)
• some types of medicines, including anti-inflammatory medicines, blood thinners or some nose sprays
• use of cocaine

Nosebleeds can also happen with some medical conditions, such as:

• nasal polyps
• sinusitis
• leukaemia
• blood disorders that cause problems with blood clotting

You are also more likely to get nosebleeds when you are pregnant.

How is the cause of nosebleeds diagnosed?

Your doctor will ask about your symptoms and recent health. They will also ask what medical conditions you have and about any medicines you take.

Your doctor will examine your nose and may do a general examination.

In some cases, blood tests may be needed to see if there is a medical issue that is causing your nosebleeds.

Your doctor may refer you to an ear, nose and throat specialist doctor.

When should I see my doctor?

Nosebleeds can be a nuisance but are usually nothing to worry about. However, frequent, persistent or unusually heavy nosebleeds should be discussed with your doctor.

When to seek urgent care

Seek emergency medical help if:

• you are injured
• there is very heavy bleeding
• you are having trouble breathing or have chest pain
• you feel dizzy or lightheaded
• the nosebleed lasts longer than 20 minutes
• a child younger than 2 years has a nosebleed
• you are vomiting blood

It's important to seek urgent medical attention if you have a nosebleed while taking blood thinning medicines.

How are nosebleeds treated?

Try to stay calm if you have a nosebleed. Most nosebleeds can be treated at home with self-care measures.

A child with a nosebleed may be very frightened or distressed. Try to comfort and reassure your child. Tell them that nosebleeds are very common and lots of kids get them.

Self-care at home

To stop a nosebleed:

1. Sit up and lean forward.
2. Apply firm pressure to the outside of both nostrils (the lower, soft part of your nose).
3. Keep pinching the nostrils for 10 minutes.
4. Breathe through your mouth, and spit out any blood that goes into your mouth.
5. You can put a cold compress around your nose or on the front of your face.

After 10 minutes, see if your nose is still bleeding. If the bleeding starts again, repeat the advice above for another 10 minutes.

While you are holding your nostrils, try having a cold drink or sucking on some ice cubes.

When the bleeding has stopped:

• Try not to pick or blow your nose, even if it feels uncomfortable — this may cause another nosebleed.
• Avoid any strenuous activity, such as playing sports, for 24 hours after the bleeding has stopped.
• Avoid hot food, hot drinks and hot showers and baths for at least 24 hours.
• Don't pack your nostrils with tissues or cotton wool.

Other treatment options

If a nosebleed is very heavy and does not stop after 20 minutes of pressure, you need to go to your nearest emergency department. You may need treatment with:

• a nose spray, cream or ointment to constrict (close) the blood vessels in your nose
• packing with special dressings
• a procedure to seal off a bleeding blood vessel

If your nosebleeds persist and become a problem, you may need further treatment. The treatment might be surgery to close off the blood vessels in the nose. Talk to your doctor about your options.

Can nosebleeds be prevented?

In some cases, nosebleeds can be prevented. It depends on the cause.

You can help prevent some nosebleeds by:

• not picking your nose
• blowing your nose gently
• using a humidifier and putting a small amount of lubricant, such as petroleum jelly (Vaseline), inside your nostrils to prevent them drying out

Treating underlying conditions such as hay fever may also help prevent a nosebleed.

Complications of nosebleeds

If you swallow blood from a nosebleed, you may feel sick and vomit.

Rarely, nosebleeds can cause serious blood loss.

Frequent, heavy nosebleeds may cause anaemia.

Resources and support

You can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.