Ask a Doctor: How to Stop a Nosebleed

Introducing: Ask a Doctor

At UTHSC ENT, we understand that patients need clear, helpful answers to their questions. We also know that a flood of new information can be overwhelming.

That’s why our department’s introducing Ask a Doctor: an ongoing series of posts that tackle Frequently Asked Questions about common issues. We hope these articles give you a better understanding of your situation and an easy path to treatment.

Today, we answer a common question: what’s the best way to stop a nosebleed?

Prepared by: Ezer Benaim
Reviewed by: Dr. Sanjeet Rangarajan

First, what is a nosebleed (epistaxis)?

Expistaxis is the medical term for a common issue: nosebleeds.

Nosebleeds are simply bleeding from the inner lining of the nose. Expistaxis is quite common and are rarely life-threatening. Roughly 60% of people have had a nosebleed at some point, but only 10% nosebleeds require treatment.

What are its causes?

Frequently the cause of a nosebleed is unknown. However, common causes are irritation to the lining by dry air in low humidity/cold weather and injury from nose-picking or nose-blowing.

Other causes include infection, allergies, injury to the face, bleeding disorders, blood vessel abnormalities, and, in rare instances, cancer.

Certain medications can also cause nosebleeds, such as blood thinners (e.g. warfarin, clopidogrel), over the counter pain medication (e.g. aspirin, ibuprofen), and chronic steroid nasal spray.

While hypertension is not a direct cause of nosebleeds, it can lengthen how long the nosebleed lasts.

What are its symptoms?

Nosebleeds range from light to profuse bleeding that should not last for more than a few minutes. Blood that dries up can form clots that block the nose and interferes with nasal breathing. Sometimes, blood can be swallowed which irritates the stomach to cause vomiting and you may notice black tarry stools.

If the bleeding is severe, you may experience light-headedness, dizziness, and weakness. These are all signs that urgent medical attention is necessary.

What are some simple solutions can I try at home?

Home treatment works for most nosebleeds:

1. Gently clear your nose to get rid of any clots that may have formed. Have a washcloth or tissues ready to catch any blood. If available, you may apply over the counter nasal sprays like oxymetazoline or phenylephrine in both nostrils.

2. Staying upright, lean your body and head slightly forward. Avoid laying down or tilting your head back to avoid swallowing blood.

3. Pinch using your thumb and index finger the soft part of the lower 1/3 of your nose. Make sure to grip both nostrils.

4. Squeeze your nostrils for at least 10 minutes (timed with a watch) without letting go. If you release pressure too soon, the bleeding may return and would need to restart the process.

5. If the bleeding did not resolve, try the above steps again but apply pressure for at least 30 minutes.

If bleeding stopped, avoid picking or blowing your nose for several hours.

When should I call my doctor?

You should call your doctor or go to the emergency room if the bleeding has still not stopped after the above steps, experiencing difficulty breathing, bleeding profusely (more than 1 cup), feeling faint or lightheaded, or if the bleeding was caused by a fall or injury to the face.

Do not drive yourself to the emergency department. Call 911 for an ambulance if you have severe symptoms like lightheadedness or profuse bleeding. Otherwise, have someone else drive you.

If you have a history of recurrent nosebleeds, you should schedule an appointment with your doctor to help treat and prevent further nosebleeds.

What are my treatment options?

If bleeding hasn’t stopped, your provider may be able to identify the source of the bleeding. If identified, the vessel that is bleeding can be cauterized using chemical substance applied in the nose to stop the bleeding.

Different types of packing may also be used such as gauze, sponges, and balloons to create pressure at the site. Some types of packing are long enough to stop bleeding that is further back in the nose.

If none of the above methods work, the bleeding vessel may need to be directly closed with surgery or the bleeding can be blocked with a special x-ray technique called embolization.

How do I prevent nosebleeds?

• Use a humidifier while sleeping
• Use saline nasal sprays, gels, or ointments to keep your nose moist.
  Avoid blowing your nose forcefully or nose-picking. Make sure to keep your nails trimmed.
• Consult your doctor If you have concerns about medications that could be causing nosebleeds. Do not stop taking medications without talking with your doctor.

How can our Dream Team help?

UTHSC ENT’s Dream Team provides world class treatment in your hometown. If you’re experiencing recurring nose bleeds, we can help!

We’d love to hear from you: (901) 866-8384