A moist tissue, or mucosa, lines the inside of the nose. This tissue is delicate and has many blood vessels close to the surface. Damage to the lining of the nose, including small scratches, can cause the blood vessels to break and bleed.
Nosebleeds can happen due to dry air or trauma to the nose. Daily or frequent nosebleeds may be due to certain medications or underlying conditions.
Here we look at possible causes, treatment options, and when to see a doctor.
There are a number of possible causes for daily nosebleeds, including the following:
Picking or blowing the nose
Picking the nose can cause scratches or nicks in the delicate lining of the nose. This can cause blood vessels to break, making the nose bleed.
Blowing the nose too vigorously can also cause a nosebleed. If people have recently had a nosebleed, even gently blowing the nose may cause another one.
Colds and allergies
Allergies, colds, and upper respiratory tract infections can cause frequent nosebleeds. Inflammation and congestion in the nose can increase the risk of nosebleeds.
Congestion causes blood vessels in the nose to expand, making them more at risk of breaking and bleeding.
Hot or dry climates
Very hot or dry air can increase the frequency of nosebleeds. Hot or dry air causes cracks in the lining of the nose, making it bleed.
Seasonal changes can cause frequent nosebleeds, as the nose has not had time to adjust to changes in temperature and humidity.
People experiencing frequent nosebleeds may have a clotting disorder. Genetics or hereditary factors can cause these clotting disorders.
Hemophilia is a condition where the blood does not clot correctly. This can cause frequent bleeding inside and outside the body, especially after any injuries or surgery. People with hemophilia may have frequent nosebleeds that are difficult to stop.
Von Willebrand’s disease is another type of bleeding disorder that causes blood to clot slower than usual. People with von Willebrand’s disease may have frequent nosebleeds that are hard to stop.
Nosebleeds can sometimes be a side effect of medication. Certain medications stop blood clotting, which may cause frequent nosebleeds.
These drugs can include blood thinners, such as coumadin or warfarin, and anti-inflammatory drugs, such as ibuprofen or aspirin.
Certain dietary supplements can work similarly to blood-thinning medication. Some supplements contain chemicals that can lengthen bleeding. These supplements include:
- vitamin E
- ginko biloba
- dong quai
Certain underlying health conditions can cause frequent or recurring nosebleeds. These can include:
- high blood pressure
- seasonal allergies
- drug abuse
- kidney failure
Thrombocytopenia is a condition that leads to low levels of platelets in the blood. Platelets are necessary for blood clotting.
Certain abnormalities in the nose can also cause frequent nosebleeds.
A deviated septum is an abnormality that can occur from birth or through injury to the nose.
The septum is the thin wall of cartilage that separates each nostril. If the septum is not central, it can cause uneven airflow in the nose. This can cause one side of the nose to become very dry, increasing the risk of nosebleeds.
Tumors in the nose or sinuses can cause frequent nosebleeds. Tumors may be cancerous or noncancerous. Tumors in the nose or sinuses may be more likely in older adults or smokers.
A persistent stuffy nose or foul smelling discharge from the nose may be additional symptoms of a tumor in the nose or sinuses.
Heavy alcohol consumption
Heavy use of alcohol can affect the platelets in the blood and slow down blood clotting. Alcohol can also enlarge blood vessels that are close to the surface, making it easier for them to break and bleed.
Certain chemicals can irritate the lining of the nose. If people are regularly around chemical irritants, these could cause frequent nosebleeds. Chemical irritants may include:
- cigarette smoke, including secondhand smoke
- sulphuric acid
The immediate treatment of nosebleeds is to stop blood flow from the nose.
If people have a nosebleed towards the front of the nose, they may be able to stop it with the following steps:
- Sit up straight and lean forward a little.
- Breath through the mouth rather than the nose.
- Using the thumb and index finger, pinch the fleshy tip of the nose, just below the bone.
- Pinch for 5 minutes to give the blood time to clot.
- If bleeding continues, pinch in the same place for another 10 minutes.
- After 10 minutes, stop pinching to see if the bleeding has stopped.
- Avoid blowing your nose or snorting up the blood for up to an hour after bleeding stops to avoid dislodging the clot before healed.
- If the nose is still bleeding, use an over-the-counter decongestant nasal spray, such as Afrin, which constricts the blood vessels.
- If necessary, insert the nasal spray just inside the bleeding nostril and spray, hopefully when the bleeding is slowing down.
- Continue to pinch the fleshy part of the nose to allow the medication to be absorbed and repeat up to three times.
- If the nose is still bleeding, seek medical help.
If people cannot stop a nosebleed themselves, they will need to go to their doctor or emergency room straightaway.
A doctor may stop a nosebleed by:
- packing the nose with a gauze dressing
- using an electric current or chemical, such as silver nitrate, to freeze or burn the blood vessels
- applying a medicine inside the nose to stop blood flow
People may need laser therapy or surgery to seal off blood vessels and prevent further bleeding.
Long-term treatment for daily or frequent nosebleeds will depend on the underlying cause. People may need to reduce or change certain medications or supplements they are using.
If chemical irritants or allergens are causing nosebleeds, it may be necessary to avoid or reduce exposure to them, take antihistamines, or wear protective masks.
If someone has an injury, deformity, or tumor in their nose, they may require surgery.
When people have an underlying condition that is causing nosebleeds, they may need treatment for the condition.
If people have frequent nosebleeds with no clear cause, they can see their doctor.
A doctor will carry out a physical examination and go through a person’s medical history. They will also assess any medications people are taking to see if it is causing the bleeding.
If your healthcare provider does not find any obvious cause straightaway, people may require blood tests to check for any underlying conditions, such as clotting disorders.
People should also seek immediate medical attention if they have a nosebleed that will not stop.
If a large amount of blood is going down the back of the throat, even when leaning forward, a person should go to the closest emergency department immediately.
Nosebleeds are a common occurrence and usually harmless, although serious cases can occur. If people are experiencing daily or frequent nosebleeds, it may be a side effect of medication or sign of an underlying condition.
Seeing a doctor can establish the underlying cause of recurring nosebleeds, and treatment may help to prevent future nosebleeds.
If people are unable to stop a nosebleed themselves, they will need to seek medical help straightaway.