Nosebleed

Nosebleeds can be frightening, but they aren't usually a sign of anything serious. You can often treat them at home.

The medical name for a nosebleed is epistaxis.

During a nosebleed, blood flows from one or both nostrils. It can be heavy or light. It can last from a few seconds to 15 minutes or more.

What to do

To stop a nosebleed:

sit down at a table, lean forward and firmly pinch the soft part of your nose, just above your nostrils, for at least 10 to 15 minutes
lean forward and breathe through your mouth – spit out any blood that collects in your throat or mouth into a bowl; do not swallow any blood
place an ice pack or bag of frozen vegetables covered by a towel on your forehead or back of your neck
stay upright or seated, rather than lying down, as this reduces the blood pressure in the blood vessels of your nose and will help reduce further bleeding

If the bleeding eventually stops, you won't usually need to seek medical advice. But in some cases you may need further treatment from your GP or in hospital.

When to seek medical advice

Immediate action required: Go to your nearest accident and emergency (A&E) or phone 999 if:

the bleeding continues for longer than 20 minutes
the bleeding is heavy and you've lost a lot of blood
you're having difficulty breathing
you swallow a large amount of blood that makes you vomit
the nosebleed developed after a serious injury, such as a car crash

Non-urgent advice: Contact your GP practice if:

you're taking a blood-thinning medicine (anticoagulant) such as warfarin or have a clotting disorder such as haemophilia and the bleeding doesn't stop
you have symptoms of anaemia such as heart palpitations, shortness of breath and a pale complexion
a child under 2 years of age has a nosebleed
you have nosebleeds that come and go regularly

If your GP practice is closed, phone 111.

What causes nosebleeds?

The inside of your nose is full of tiny, delicate blood vessels that can become damaged and bleed relatively easily.

Common causes of nosebleeds include:

picking your nose
blowing your nose very hard
a minor injury to your nose
changes in humidity or temperature causing the inside of the nose to become dry and cracked

Occasionally, bleeding can come from the blood vessels deeper within the nose. This can be caused by a blow to the head, recent nasal surgery and hardened arteries (atherosclerosis).

Who gets nosebleeds?

Nosebleeds are fairly common. Most people will experience them every now and again. Anyone can get a nosebleed, but they most often affect:

children between 2 and 10 years of age
elderly people
pregnant women
people who take blood thinning medication such as aspirin or anticoagulants, such as warfarin
people with blood clotting disorders, such as haemophilia

Bleeding may also be heavier or last longer if you take anticoagulants, have a blood clotting disorder, or have high blood pressure (hypertension).

Preventing nosebleeds

There are things you can do to prevent nosebleeds.

Do

avoid picking your nose and keep your fingernails short
blow your nose as little as possible and only very gently
keep your home humidified
wear a head guard during activities in which your nose or head could get injured
always follow the instructions that come with nasal decongestants – overusing these can cause nosebleeds

Talk to your GP if you experience nosebleeds frequently and aren't able to prevent them.

Medical treatment

If you see your GP or go to hospital with a nosebleed, you'll be assessed to find out how serious your condition is and what's likely to have caused it. This may involve:

looking inside your nose
measuring your pulse and blood pressure
carrying out blood tests
asking about any other symptoms you have
additional treatments such as ointments for your nose, cautery to seal blood vessels in your nose, or nasal packing may be required – but will be discussed with you by the doctor