Whether you’re catching a new blockbuster at the cinema, enjoying a first date at a restaurant, or giving a presentation at work, the last thing you need is a nosebleed. Nosebleeds — also known as epistaxis — are common and thankfully rare. However, their normality does not prevent them from interrupting your daily life.
Read on to learn what causes nosebleeds, how to stop it, and steps you can take to prevent it.
1 Why do we get nosebleeds?
First, let’s talk about the anatomy of our nose and why nosebleeds occur. The nose can do more than just smell. It acts like a filter, removing toxins and bacteria from the air we breathe so we don’t get sick, while also warming and humidifying the air to prevent lung irritation.
To condition the air, our nasal passages are lined with blood vessels. These delicate blood vessels lie close to the surface of the nasal passage and transfer heat from our blood to the air when we breathe in.
Blood vessels in the nose usually rupture when they are disturbed in any way – either by environmental conditions or by something solid being inserted into your nose – leading to nosebleeds.
The two most common causes of nosebleeds are dry air and nose picking. Dry air causes the normally moist membranes in our nasal passages to dry out. When these membranes rupture and crust, they expose the underlying blood vessels and rupture. The reason nosebleeds are so common in winter is because heated indoor air contains almost no moisture.
Nose picking causes trauma to the delicate membranes in your nose, especially if your or your child’s fingernails are long – which is why nosebleeds are so common in children between the ages of 2 and 10. The force of an inserted finger is enough to damage blood vessels.
Sit up straight and lean your body forward, making sure your head stays over your heart. While it used to be common to tilt your head up and back to treat nosebleeds, this is no longer recommended because it can cause blood to flow to your throat and stomach, causing you to choke or vomit. If your head is tilted forward and slightly downward, blood can drain from your nose.
Find the spot on your nose where the bony ridge — the bridge of your nose — transitions into soft cartilage. Place your thumb and forefinger on either side of this area, just above your nostrils, and pinch with firm pressure. However, you should still be able to squeeze your nose under your fingers. 
Hold your nose for at least 10 minutes before checking to see if your nosebleed has stopped. If you release pressure from your nose before the ruptured blood vessel has had a chance to form a clot, you risk the bleeding starting again. Check the flow after 10 minutes. If you’re still bleeding, keep pinching and holding the pressure for another five minutes.
If your nose is still bleeding after 15 minutes, place an ice pack on the bridge of your nose. This helps narrow the blood vessels and stop the bleeding. Be sure to keep pinching your nose with your fingers while using the ice pack.
There are two different types of nosebleeds based on the location of the broken blood vessel in your nasal passages.
Anterior nosebleeds occur at the front of the nose where the blood vessels are relatively small. Blood flows from one or both nostrils. Anterior nosebleeds are more common and less severe than the posterior type. They can almost always be solved at home.
Posterior nosebleeds occur at the bridge of the nose, where the blood vessels are larger. The blood flow is stronger and you can feel blood trickling down your throat instead of just coming out of your nose. A back nosebleed can indicate a larger health problem and usually requires medical attention.
Avoid aspirin and ibuprofen, both of which act similarly to blood thinners. If pain relief is needed in the days after a nosebleed, use acetaminophen (Tylenol) instead.
You are currently taking blood thinners (anticoagulants).
You can have a nasal endoscopy, a procedure where a thin wire with a camera and a light on the end is inserted into your nose. This allows the ENT doctor to see the inside of your nasal passages and sinuses.
nasal cauterization: During this procedure, your doctor uses a chemical or electrical device to cauterize, or seal, abnormal blood vessels in your nose.
nose pack: Your doctor will insert gauze coated with an antibiotic ointment into one or both nasal passages to apply direct pressure to the blood vessels. The depth of insertion depends on whether you have an anterior or posterior nosebleed. The gauze will remain in your nose for a few days. Depending on the type of packaging, your doctor will send you back for removal or the gauze will dissolve on its own.
Surgery: If a deviated septum is the cause of your nosebleed, your doctor may suggest a procedure called a septoplasty. A septoplasty straightens your septum and allows for better airflow in your nose.
If nosebleeds have become a regular and disruptive part of your life or the life of your child, our ENT doctors are here to help.
