Nosebleeds are also known by their medical name epistaxis and are extremely common. In most cases, nosebleeds are not concerning and tend to stop on their own within a couple of minutes or with the help of self-administered first aid. The majority of nosebleeds are caused by damage to the lining of the inside of the nose due to picking it or minor damage when you blow your nose. Other causes of a nosebleed include suffering trauma to the nose or head, high blood pressure, poor blood clotting (this can be due to medication or medical conditions), or pregnancy where changes of hormones lead to increased blood flow in your nose and an increased chance of getting a nosebleed. Nosebleeds are also more common in young children and the elderly due to the lining of the nose being more fragile.
Most nosebleeds do not need medical attention and can be treated successfully at home with self-administered treatment. The best thing to do during a nosebleed is sit down, lean slightly forwards and keep your chin tucked towards your head so that your head is tilted forwards. Pinch the soft lower part of your nose continuously for 10 minutes. Sitting forwards with your head tilted the same way helps the blood run out of your nose and not back towards your throat. Don’t pinch the hard upper part of the nose but you can put a wrapped ice pack or cold flannel on it to help stem the nosebleed.
You should book a routine visit with your doctor if you are having regular nosebleeds. You should seek more urgent medical advice if the nosebleed occurs after a severe head injury, if the bleeding is profuse and lasting more than 20 minutes, if you are on blood-thinning medication and if you have a known clotting disorder. This could be through calling your doctor, NHS 111 or 999 depending on the severity. The risks with severe nosebleeds are the loss of blood but also the blood running back into the throat and blocking the airway. This is why forward positioning is important whilst you wait for medical help.
The doctor will ask you about your medical history and your current symptoms. They will examine your nose and take basic health measurements such as your heart rate and blood pressure. They may also refer you to a hospital ear nose and throat specialist. Emergency department doctors and ENT (ear nose and throat) doctors are able to place different types of packs into the nose that help stop nosebleeds. These aim to help put pressure on the bleeding areas to stop the bleeding from continuing. Other treatment options include cauterisation which uses an electrical current or silver nitrate on the bleeding blood vessel in your nose to prevent it from continuing to bleed.
After a nosebleed, there are lots of things to avoid. Hot drinks, alcohol, hot baths, and smoking all have the potential effect of expanding blood vessels in the nose. This will increase the chance of getting a further bleed. You should try to keep your head upright when bending down and try to avoid straining your abdominal muscles such as when you are on the toilet. Exercise can also increase the chance of a further bleed, so you could give things a few days off. And finally, the simplest way of avoiding a re-bleed is not to pick your nose!