Nosebleeds

Epistaxis, or nosebleed, happens when blood comes from the tissue inside the nose and can affect people of any age. Most people will experience a nosebleed at least once in their life. Common causes include dry air, nose picking, or minor injuries, and most nosebleeds are not serious. Nosebleeds can occur in one or both nostrils and may last only a few seconds or several minutes.

They often look alarming but are usually easy to treat at home. People who take blood thinners or have certain health conditions may be more likely to get nosebleeds or experience heavier bleeding. This article explains why nosebleeds happen, how to prevent them, and simple steps for stopping a nosebleed.

Types of Epistaxis

Nosebleeds are grouped by where the bleeding starts in the nose. The two main types are anterior and posterior nosebleeds, each with its own causes and risks.

Anterior Epistaxis Overview

Anterior epistaxis is the most common type of nosebleed. Children and young adults get this type most often. Bleeding starts from the front part of the nasal septum, mainly from an area called the Kiesselbach plexus. This area has many small blood vessels close to the surface that can break easily.

Common causes include nose picking, dry air, allergies, or minor injuries. Most anterior nosebleeds affect just one nostril and stop on their own or with simple first aid, such as pinching the nostrils and leaning forward. Usually, they are not serious and do not need medical treatment. However, frequent nosebleeds from this area may signal nasal irritation or environmental factors that need attention.

Key Points

• Location: Front part of the nasal septum.
• Main Blood Supply: Kiesselbach plexus.
• Common Causes: Trauma, dryness, or irritation.

Posterior Epistaxis Overview

Posterior epistaxis starts deeper in the nose, most often from the Woodruff plexus along the side wall. This type is less common but more serious, especially in older adults. Bleeding here often flows down the back of the throat and may be harder to control.

People with high blood pressure or certain health problems have a higher chance of posterior nosebleeds. Unlike anterior bleeds, posterior epistaxis may involve both nostrils and can cause more blood loss.

Recurrent and Severe Nosebleeds

Some people have frequent or severe nosebleeds, which can be caused by health factors or environmental issues. Bleeding disorders, frequent trauma, nasal infections, or uncontrolled blood pressure can lead to repeated nosebleeds. Severe nosebleeds, whether anterior or posterior, might lead to significant blood loss or anemia if not treated quickly.

In rare cases, repeated bleeding may be linked to tumors or structural problems inside the nose. Doctors look for the main causes using exams, blood tests, or imaging. If needed, treatments include cauterization, nasal packing, or changes to medication.

Common Triggers

• Frequent picking or blowing nose
• Use of blood thinners
• Bleeding disorders
• Uncontrolled hypertension

If nosebleeds happen often or are hard to stop, seek medical advice.

At-risk population

Certain groups are more likely to experience nosebleeds.

• Children and elderly people have a higher risk because their nasal blood vessels are fragile. Kids often get nosebleeds from picking their noses or minor injuries. Older adults have delicate nasal tissues and may have health problems that increase bleeding.
• People with specific health conditions are also at risk. This includes those with high blood pressure, bleeding problems, or frequent respiratory infections. Dry indoor air or oxygen use can make things worse.
• Medication use increases risk, too. People taking blood thinners, aspirin, or nasal sprays may bleed more easily.
• Other risk factors include:
  • Frequent exposure to dry or cold air
  • Use of nasal irritants
  • Smoking

At-risk Group	Common Factors
Children	Nose picking, minor trauma
Elderly	Thinner tissues, health conditions
Medical conditions	Hypertension, clotting problems
Medication users	Blood thinners, nasal medications
Environmental factors	Dry air, irritants, oxygen therapy

Not everyone in these groups will get frequent nosebleeds, but their risk is higher.

Should You Worry?

Most nosebleeds are not dangerous and often stop with simple home care. Dry air, a small injury, or even picking the nose can cause them.

When to Seek Medical Help

• The nosebleed lasts longer than 20 minutes.
• Blood flow is heavy and not slowing down.
• The person feels weak, dizzy, or faint.
• Nosebleeds happen often, even if each one stops easily.
• There is trouble breathing, coughing up blood, or blood after a head injury.

If you notice any of these signs, go to a healthcare professional or emergency care.

Common Causes

• Dry air or heating in winter
• Allergies or irritation from sprays
• Minor injuries
• Blowing the nose too hard

People who take blood-thinning medicine or have bleeding problems should be more careful. Frequent nosebleeds may mean you need more testing to check for health issues.

Quick Tip: Use a cool mist humidifier and avoid picking or blowing the nose too roughly to lower the risk.