Nosebleeds (medically known as epistaxis) can be caused by a number of factors including sneezing, trauma, dry air, nose picking, high blood pressure, and anticoagulants. Blood vessels found in the nasal passages are close to the mucosal surface while helping warm and humidify the air you breathe, also make them susceptible to bleeding.

There are 2 types of nose bleeds, the most common are those caused by blood vessels in the front of your nose (anterior) and less common are caused by blood vessels in the back of your nose (posterior). Posterior nose bleeds require special nasal packing that only a physician can do (please see “when to see a physician” below)

How to treat a nosebleeds

• Breathe through your mouth.
• Lean forward to prevent blood going down the back of your throat, causing you to choke and cough.
• Pinch the front, soft part of your nose for 5 minutes. This will compress the anterior nasal blood vessels, which are the most common cause of nose bleeding.
• If this does not stop the bleeding, spray your nose with neosynephrine, if available, before pinching your nose again. This will help constrict the nasal passage blood vessels.
• Pinch your nose for an additional 10 minutes.
• If these 2 attempts pinching your nose fail to stop the bleeding, it’s time to go to the Emergency Room. A physician may need to pack your nose, or use cauterization, to stop the bleeding.

Preventing nosebleeds

• Use a room humidifier, which will keep your nasal passages moist and less susceptible to bleeding.
• Apply Vaseline to your nasal passages to keep them moist and less prone to bleeding.
• Sneeze with your mouth open, which will minimize nasal airway trauma
• Avoid nose picking

When to see a physician

• Any nose bleed that lasts for more than 15 minutes, despite pinching and compression measures.
• A nose bleed caused by trauma, which may be a sign of a more serious head injury.
• If you pinch your nose while leaning forward and get blood going down the back of you throat, it’s time to visit the Emergency Room. This may be a sign of a posterior bleed requiring special packing that only a physician can do.
• You get nose bleeds frequently (especially accompanied by easy bruising, gum bleeding) as these may be signs of a bleeding disorder.
• If you are on anti-coagulants such as Coumadin, also know as warfarin, since these are likely going to need packing. Nasal bleeding for those on Coumadin may also be a sign that the blood is dangerously too thin requiring reversal, so it’s a good idea to have a physician also check your protime, (INR) blood levels.
• Nose bleeds caused by high blood pressure.