A nosebleed (Epistaxis) is usually caused by a broken blood vessel in the nose or sinuses. Nasal bleeding, particularly when blowing it, is very common and usually not a cause for worry.

As many as 60% of people experience nosebleeds but only around 6% need medical attention. It can be difficult to know what causes broken blood vessels in the nose. There are several things that can contribute to this.

Common Causes:

  • Dry nasal cavities
  • Nasal injury
  • Nose picking
  • Blowing too hard or too often
  • Infection or allergies
  • Dry cavities or sinuses
  • Exposure to dry or cold air
  • Antibiotic medications
  • Blood thinning medications
  • Changes in humidity
  • High altitude
  • Septum issues

Less common causes:

  • Nasal, sinus, face, or eye surgery
  • Nasal tumors
  • Inflammatory conditions
  • High blood pressure
  • Holes in the septum
  • Blood disorders
  • Leukemia
  • Liver or kidney issues
  • Severe vitamin C deficiency
  • Cocaine use
  • Chemotherapy
  • Exposure to toxic chemicals

Treatment

Often, a nosebleed will stop after a few minutes without treatment. If not, you can try the following:

  • Gently pinching the nose over the soft lower part that can be squeezed between thumb and finger (not the bony part at the top)
  • Relax and breathe orally
  • Tilting your head slightly back
  • Avoid touching or picking the nose
  • Nasal packing
  • Local haemostatic agents
  • Antiseptic creams and antibiotics
  • Blood vessel surgery
  • Clotting medicines

Prevention

  • Be gentle when blowing your nose
  • Avoid picking
  • Avoid exposure to cold air
  • Treat allergies with sprays or pills
  • Use nasal lubricants or saline for dryness
  • Avoid exposure to toxic chemicals
  • Do not use cocaine

When to seek advice

If nosebleeds are chronic or repetitive then you should seek medical advice. If your nosebleeds are accompanied by any of the following you should also see your doctor:

  • The nosebleed does not stop after 20 minutes
  • The nosebleed does not slow down or stop when you apply pressure and tilt your head
  • Eye pain
  • Persistent stuffy nose
  • Excess mucus in the throat
  • Vision changes
  • Swollen neck glands
  • The appearance of the nose changes
  • Pus
  • Facial numbness
  • Headache
  • Persistent watery eyes
  • Loss or reduction in sense of smell
  • Ear pain or pressure
  • Loss of hearing
  • Tooth pain or looseness
  • Trouble opening the mouth