When are nosebleeds a cause for concern
While it may not be possible to prevent all causes of a nosebleed, taking the following precautions can help:
When Should You Worry About a Nosebleed?
Nosebleeds typically resolve on their own. But if they are severe or long lasting, they may be a sign of another health condition, such as internal bleeding, and require immediate medical care.
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A nosebleed can be scary, especially when it happens to your child. But while nosebleeds can appear out of nowhere, most aren’t a serious cause for concern and usually resolve with home care.
The surface lining of your nose contains several blood vessels, and it only takes the slightest injury or irritation to trigger bleeding.
Nosebleeds are common in children and adults, but some nosebleeds are more severe, in which case you’ll need to contact a doctor.
Patients, too, are unhappy with the care they receive during those brief interactions with their doctors. Healthcare communications company West Corporation reported that 25% of patients don’t feel that their provider cares about them as an individual and nearly 20% aren’t convinced their doctor is focused on improving their health – even though 93% of doctors strongly agree that patient satisfaction is important.
Here’s a look at common causes of nosebleeds, different ways to manage nosebleeds at home, as well as advice on when to talk with a doctor.
Most adults and children will have at least one nosebleed in their lives. In most cases, the bleeding will stop after a few minutes of self-care. Other times, though, nosebleeds have symptoms that may warrant a call or trip to a doctor.
When to contact a doctor for children
Understandably, a nosebleed in your child can invoke panic. Keep in mind, though, that nosebleeds are common in children. Of course, this doesn’t mean you should ignore every nosebleed.
Some nosebleeds are minor and you’ll notice blood dripping or running from your child’s nose. They might bleed from one nostril or both nostrils. Immediate home care helps stop the bleeding.
You should, however, talk with a doctor under the following circumstances:
- The nosebleed doesn’t stop after 20 minutes of direct pressure, especially if your child has an injury to their head or face. Serious injuries can affect the nose or skull.
- There’s an object stuck in your child’s nose.
- Your child has other symptoms such as dizziness, headache, tiredness, vomiting, or trouble breathing. This can indicate too much blood loss, or blood dripping down their throat.
When to contact a doctor for adults
Even if you’re used to having nosebleeds as an adult, you shouldn’t ignore certain symptoms.
- Similar to a child, call your doctor if a nosebleed doesn’t stop after 20 minutes of direct pressure, or if you lose a lot of blood (more than a cup).
- You should also talk with your doctor if you experience trouble breathing, gagging, or vomiting due to blood dripping down your throat.
- A serious injury to your head or that face causes a nosebleed also needs medical attention.
- If you’re bleeding from other parts of your body — ears or rectum, for example, this could indicate internal bleeding, blood clotting problems, or blood vessel disorders.
Both adults and children should also be examined by a doctor for repeated, frequent nosebleeds, even minor ones. This can indicate an ongoing problem within the nose, perhaps nasal growths or nasal polyps.
Warning
If you’ve lost a lot of blood, don’t drive yourself to the emergency room. Instead, have a friend or relative drive you or call 911.
When are nosebleeds a cause for concern?
Nosebleeds are relatively common and occur when there is damage to a blood vessel in the nose. They are not typically a cause for concern, unless the bleeding is persistent or severe.
As the nose is full of blood vessels, any minor injury to the area can cause a nosebleed. These are often mild and easy to treat.
Seek immediate medical attention if the bleeding:
- is severe
- lasts longer than 15–30 minutes
- follows a blow to the head
- results in swallowing a lot of blood
- causes weakness or trouble breathing
While roughly 60% of people experience a nosebleed at some point, only 10% of cases are severe enough to require medical attention.
In this article, we explore when a nosebleed may become worrying, as well as causes, treatments, and strategies for prevention.
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A nosebleed, also known as epistaxis, refers to bleeding from the nose typically following damage to the blood vessels in the nasal passage.
Depending on the area where tissue damage occurs, a doctor can categorize nosebleeds as either anterior (front), which are more common, and posterior (back), which are more likely to require medical treatment
Nosebleeds are more common in children and older adults, but are not usually a sign of a problem. They are also common in people with a history of bleeding disorders, genetic bleeding conditions, those who take blood-thinning medications, and those who take medications through the nose.
Many people will experience a nosebleed and in most cases, the bleeding will stop after a few minutes of self-care. Whether the bleeding is minor or severe, it is usually advisable to apply appropriate first aid to reduce or stop the bleeding. This typically involves getting the person with a nosebleed to tilt their head forward, breathe through their mouth, and pinch the soft part of their nose.
Many guidelines advise people to receive professional care for a nosebleed that:
- is heavy
- is long lasting
- comes back
- makes the person feel weak or dizzy
- interrupts day to day activities
People should also seek medical care if:
- The bleeding lasts longer than 15–30 minutes.
- They have a history of hospitalization for nosebleeds.
- They have had a blood transfusion for nosebleeds.
- They have had more than three recent episodes of nasal bleeding associated with headaches.
Additionally, consider contacting a doctor if a nosebleed occurs in:
- a baby younger than 2 years
- anyone taking blood-thinning drugs
- anyone with symptoms of anemia
- anyone with a condition that prevents the blood from clotting properly
Nosebleeds usually stem from a rupture of a blood vessel in the nose, and there may be no obvious cause. They happen most often due to trauma, certain medications, or as a result of an underlying health condition.
Some common causes of nosebleeds include:
- picking the nose
- blowing the nose too hard
- dryness, which may result from climate or altitude changes
- swelling and irritation
- a foreign body in the nose
- nasal allergies
Some causes of nosebleeds that are more likely to require professional treatment include:
- severe trauma, particularly including a blow to the head
- bleeding disorders, such as hemophilia
- blood-thinning medications, such as heparin
- genetic conditions, such as Von Willebrand’s disease
- extremely high blood pressure, known as a hypertensive crisis
- head and neck cancer
If a person has a severe or recurring nosebleed, a doctor aims to stop the bleeding and may use a rhinoscope to investigate the cause. What they find can help guide their treatment plan.
Treatment options may include:
- Nasal packing: This involves inserting a gauze-like material into the nose to help stop the bleeding. The material applies constant pressure, absorbs excess blood, and encourages clot formation.
- Drops, sprays, ointments, or gels: Lubricating agents can help keep the nasal passage moist, while nasal sprays can constrict the blood vessels in the nose.
- Changing medication: A doctor may recommend this, but a person should not make any changes before they consult their doctor.
- Cautery: This involves using a chemical swab or an electrical device to seal off the area of bleeding.
- Surgery: If other approaches are ineffective, procedures such as tying off or blocking a blood vessel can help prevent bleeding.
While it may not be possible to prevent all causes of a nosebleed, taking the following precautions can help:
- not picking the nose
- blowing gently
- keeping the nasal area clean and moist using saltwater sprays or gels
- using a humidifier to help keep the environment moist, if possible
- avoiding irritants such as smoke
- avoiding allergens and managing allergies
- taking steps to manage conditions that require blood-thinning medications
Nosebleeds can be concerning, but they are generally not a cause for alarm. They may stem from medication use, nose picking, trauma, or a range of other factors.
Seek medical attention if the bleeding is severe or persistent. Also, if a nosebleed follows a blow to the head or leads to weakness, trouble breathing, or swallowing a significant amount of blood, the person requires professional care. We have more specific information about when to see a doctor above.
Nosebleeds may be more severe in people with bleeding disorders, people who take blood-thinning medications, and people who take medications through the nose.
Last medically reviewed on July 12, 2021
- Blood / Hematology
- Ear, Nose, and Throat
- Pediatrics / Children’s Health
- Sports Medicine / Fitness
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