Why Does It Seem Like Your Nosebleed Won't Stop?
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Medically reviewed by Karis Cho, MD
Around 60% of the population experiences a nosebleed at some point in life. Nosebleeds, medically known as epistaxis, are common health ailments that usually occur because of dry or cold weather, allergies, or other respiratory issues.
While nosebleeds can look serious, they usually aren't cause for concern and can resolve on their own. In rare cases, you might have a difficult time stopping the bleeding and need medical attention.
Why Do Nosebleeds Happen?
Your nose is home to many small blood vessels. When something like a foreign object or drug irritates the blood vessels on the delicate nasal membranes, it can ultimately cause bleeding.
The most common nosebleeds, called anterior nosebleeds, occur in the area around the front of the nasal septum (the part of your nose that separates your nostrils).
More severe nosebleeds, called posterior nosebleeds, occur when bleeding comes from deeper inside the nose, in areas like the sinuses. These nosebleeds are much less common.
People are more likely to experience nosebleeds during the winter months because cold air can dry out the nasal cavity. Other factors, like illnesses, facial trauma, and different drugs can also contribute to nosebleeds.
Environmental Irritants
Changes in temperature and humidity can often impact the amount of mucus the nose produces; when the nasal passage becomes too dry, it can cause bleeding. Seasonal ailments like respiratory infections and hay fever may also play a part.
Other environmental irritants can include:
Cold weather
Dry air
Allergies
Illness
Certain conditions may be associated with an increased likelihood of nosebleeds, including:
Chronic sinusitis or respiratory illnesses that cause sneezing
Bleeding disorders
Hypertension
Liver disease
Vitamin deficiencies
Trauma or Anatomy
Physical impacts or changes to the nose or nasal area may also cause bleeding. This may include:
Nose injury
Picking the nose
Surgery
Tumors
Drugs
Using certain medications, especially for long periods, can start to damage the thin skin or blood vessels inside your nose. These can include:
Use of nasal sprays such as nasal steroids like Flonase (fluticasone) and nasal antihistamines like Astepro (azelastine)
Blood thinners such as warfarin (Coumadin), clopidogrel (Plavix), or aspirinsd
Illicit drugs that are snorted
How to Stop a Nosebleed
If you're experiencing a nosebleed at home, first, take a few deep breaths. While nosebleeds can appear serious and sometimes scary, they are usually fairly easy to treat and are rarely life-threatening.
To stop the nosebleed, squeeze the lower third of your nose with your thumb and finger for around ten to fifteen minutes. While you're compressing the area, you can place a cold compress on your nose.
You can also administer a nasal spray that contains oxymetazoline (Afrin) to help stop the bleeding.
While you are treating the nosebleed, make sure to sit up straight, lean forward, and avoid laying down so you don't risk swallowing any blood.
Once you have compressed the nose for about ten minutes, check to see if the bleeding has stopped. Avoid sneezing or blowing your nose for the next few days to avoid re-aggravating the area.
If your nose is still bleeding past twenty minutes, you should seek emergency care.
Why Won't Your Nosebleed Stop?
There could be a few reasons why your nose won't stop bleeding.
The amount of bleeding you experience might depend on the type of nosebleed. While anterior nosebleeds, which occur at the front of the nasal septum, are more common and easy to treat, posterior nosebleeds which occur deeper within the nose, can be harder to control. Posterior nosebleeds can often occur among older patients.
Additionally, existing conditions or medications, like blood thinners, can make your nosebleed worse and require medical attention. Some bleeding disorders, like hemophilia or von Willebrand disease, can also cause heavy nosebleeds that often need medical attention to treat.
If you haven't been diagnosed with a blood disorder, signs of bleeding disorders include longer-than-normal bleeding after an injury, easy bruising, and nosebleeds that occur for no clear reason.
When to Contact a Healthcare Provider
You should get medical care if the bleeding doesn't stop after 20 minutes of firm compression on the nose. If you have a nosebleed and are taking blood thinning medication or recently had surgery, you should also get emergency care.
If you broke your nose or have bleeding with any nasal or head injury or trauma, you should seek immediate emergency medical care.
Additionally, if you're experiencing other symptoms like nausea or dizziness, or are losing a significant amount of blood, you should get immediate medical attention.
What to Expect When You See a Healthcare Provider
When you see a healthcare provider, they will perform a series of tests to look for potential underlying causes of the bleeding. Based on what they find, there are a few different treatment methods they could turn to.
They might order bloodwork, including a complete blood count (CBC), and a test that measures your prothrombin time (PT) to evaluate any factors for blood clotting. If you have experienced significant head trauma, they might perform a computerized tomography (CT) scan of the nose.
These tests can help the provider assess symptoms, determine the primary cause, and inform their treatment. Here are a few techniques healthcare providers often use to stop nosebleeds:
Employ nasal packing by inserting petroleum jelly-soaked cotton strips or nasal tampons into the nose.
Apply silver nitrate sticks to chemically cauterize and stop the source of the bleeding.
Use an electric current to cauterize and stop the source of the bleeding.
Correct a broken nose to stop the bleeding.
Remove a foreign body that's causing bleeding in the nose.
Reduce the amount of blood thinner you're on or diagnose any underlying blood clotting issues.
How to Prevent Nosebleeds
You can prevent nosebleeds during cold or dry months by investing in a humidifier to keep in your bedrooms and other living spaces. You can also try gently swabbing an antibacterial ointment onto the inside of the nose a few times a day to keep your nose moist.
If you're experiencing chronic nosebleeds, you can talk to a healthcare provider to determine if there are any underlying causes.
A Quick Review
While nosebleeds are a common nuisance, they are very rarely life-threatening.
Different environmental and chemical irritants, illnesses, medications, injuries, and other factors can cause nosebleeds. Plus, some medications and underlying health conditions can make the average nosebleed worse.
You can usually easily treat a nosebleed at home by applying compression to your nose and leaning forward. But if you experience heavy bleeding or the bleeding fails to go away on its own, you should see a healthcare provider for nosebleed treatment.
Your healthcare provider can run a series of tests to diagnose any underlying causes and provide treatment so you'll be feeling better in no time.
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