Nosebleeds are common—nearly 60 percent of us have had to deal with one at some point in our lives—and the pesky problem usually comes out of nowhere. You may be enjoying a walk on a brisk day or wake up in the morning and suddenly your nose starts dripping red. As the seasons change and the weather becomes colder and dryer, nosebleeds are more likely to occur.
“As we head into winter, the change in temperature and humidity has a significant effect on our overall well-being,” says Isaac Namdar, MD, Assistant Professor of Otolaryngology-Head and Neck Surgery at the Icahn School of Medicine at Mount Sinai. “One of the more common side effects that we see from the cold, dry winter months is nosebleeds.”
Nosebleeds are normally not serious and stop on their own within about ten minutes. Still, stopping the bleeding is an important first-aid skill everyone should know in case it happens to you—or someone in your family. And you may be surprised to learn that experts say don’t tilt your head back.
What causes nosebleeds?
The nose is one of the most common areas of the body for spontaneous bleeding to occur. “There is a very rich blood supply to the nose, which allows the nose to change the humidity and the temperature of the air you breathe, and the vessels are more close to the surface than other places in the body,” explains Dr. Namdar. This makes the vessels in the nose more delicate and susceptible to damage.
Nosebleeds are particularly problematic in the winter when the weather is cold and dry; when there is less heat, there is usually less humidity and moisture. This dryness can damage or crack the delicate nasal membrane lining the nose, resulting in a bleed.
The environment inside our homes also makes this dryness worse. Central heating is the source of heat for most people in the United States. This type of heat further dries out the air as it is warmed.
Trauma is another major cause. When the nose is scraped or banged up, the small blood vessels inside it can burst. That is why young children who pick their nose or stick objects into their nostrils are more susceptible to nosebleeds.
Allergy sufferers are also at risk since anything that causes inflammation to develop in the nose can cause it to bleed. People with allergies also commonly use nasal sprays, which can make matters worse.
“Inserting the nasal spray tip into the nostrils can scrape the inside of the nose. Or if the medication is not evenly dispersed when it is sprayed, it can accumulate in the front of the nose and cause irritation,” says Dr. Namdar.
Some individuals with certain medical conditions are prone to nosebleeds. Patients with uncontrolled high blood pressure or genetic conditions such as Von Willebrand disease or hemorrhagic telangiectasia are more likely to bleed. People who take blood thinners, such as aspirin or warfarin, are also more likely to have nosebleeds.
How do I stop a nosebleed?
Even if you know the reason behind the nosebleed, getting one can be disconcerting. Follow these simple steps to stop the bleed:
- Stay calm. Breathe through your mouth. Remind yourself—or the person you are helping—that the bleeding will stop soon.
- Pinch the nostrils. Use two fingers to apply firm pressure to the fleshy part of the nostrils below the bridge of the nose. This pressure will allow the blood vessels to form a clot over the leak. Continue to hold this position for about ten minutes.
- Sit up tall and lean forward. Do not lie down or tilt your head back. Avoid blowing your nose. If you need to remove a blood clot, wipe gently with a tissue.
- Use an ice pack. Take a bag of frozen peas or something similar in the freezer and place it on top of the nose. The cold will shrink the blood vessels and reduce the bleeding.
- Make a plan. If the bleeding continues after 15 minutes or begins to spurt, go to the emergency room.
When should I be concerned about a nosebleed?
Nosebleeds are generally not cause for alarm. However, there are some red flags that could indicate something more serious is happening. If you experience any of the following symptoms, seek medical attention immediately:
- A nosebleed that lasts more than 15 minutes
- Blood that is squirting rather than dripping from the nose
- The amount of blood from the nose could fill an eight ounce cup
When you have a nosebleed, a blood clot may come out of your nose or mouth. These clumps of blood may look concerning, but they are actually the body’s way of trying to stop the bleed. Since the airway is connected, the clot may end up in the throat.
“If the nosebleed starts to form a blood clot, gently spit it out,” advises Dr. Namdar. “When clots are swallowed, they can end up in the stomach and cause discomfort.”
If you suffer from recurrent nosebleeds—more than two in a season—it is probably time to make an appointment with an ear, nose, and throat physician.
When nosebleeds are recurrent, they may require medical attention. Specialists like Dr. Namdar can seal the leaky blood vessels by either packing or cauterizing the area to prevent bleeding.
How do I prevent nosebleeds?
Since dryness is the main culprit for nosebleeds, finding ways to moisturize the nasal passageways are key to prevention.
“These are basically saline solutions, or a mix of salt and water, and some of them have moisturizers built in. I generally recommend using a nasogel spray. Some patients also use bacitracin ointment or petroleum jelly,” says Dr. Namdar.
Hydrating your body and drinking plenty of water is a good start. Dr. Namdar suggests using a humidifier—which puts moisture back into the air—in the bedroom. And if you spend several hours a day in your living room or office, you may want to consider having a humidifier in those spaces as well.