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October 24, 2024

What causes nosebleeds? And when should medical attention be sought?

The experience is unpleasant, but rarely serious. People who get nosebleeds several times per week, or can't get them to stop after 30 minutes, should consult a doctor.

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Nosebleeds may be frightening, but they usually are not dangerous. Having several nose bleeds a week, losing a significant amount of blood or being unable to stop a nosebleed in 30 minutes warrants medical attention, health experts say.

Nosebleeds can feel alarming, with the surge of blood dripping onto clothes or sheets and the handfuls of tissues used to stop it turning crimson.

But a bloody nose, also known as epistaxis, usually isn't serious.


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"Think about if you put just a drop of blood in a toilet bowl — the whole bowl goes red," Dr. Brandon Hopkins, an ear, nose and throat specialist at the Cleveland Clinic, said last year. "It doesn't take a lot of blood to look like something extreme. We usually vastly overestimate the volume of blood that's present."

About 60% of people will experience a nosebleed during their lives. Common causes of nosebleeds include dry air due to climate or indoor heating, colds and allergies. Some nasal sprays irritate tissue inside the nose, which can cause epistaxis. People who pick their noses – and those who snort recreational drugs – also may experience bleeds.

People who take anticoagulant medication are more susceptible to nosebleeds, too. Epistaxis also can result from a sports accident, car crash or other injury.

Most nosebleeds, especially in children, are anterior nosebleeds that occur in the front part of the nose, where the tissue contains a lot of delicate blood vessels that can damage easily, according to the Children's Hospital of Philadelphia. Posterior nosebleeds are more rare and usually occur in older people or people who have had nose injuries or surgeries.

How to stop a nosebleed

If you have a nosebleed, the Cleveland Clinic recommends taking the following steps to stop it:

• Breath through the mouth.
• Sit down and lean slightly forward over a bowl or cloth.
• Pinch your nostrils together with your thumb and index finger for at least 10 minutes, using a timer.
• Resist releasing pressure from your nose to check if the bleeding has stopped.
• Repeat for another 10 minutes if the nosebleed hasn't stopped.

Nosebleeds are recurrent for about 15% of people, but only about 10% of cases are serious, according to health experts. The Mayo Clinic characterizes frequent nosebleeds as those that occur more than once a week.

"When nosebleeds are frequent, they can really get in the way of daily activities and be a significant hindrance to having a normal and healthy quality of life," Dr. David Gudis, an otolaryngology-head and neck surgery specialist at the Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, said in 2021. 

Sometimes, frequent nosebleeds may be a sign of a medical condition, such as a nasal tumor or hereditary hemorrhagic telangiectasia, a genetic condition that causes abnormal blood vessel formation.

Here's when experts say people should seek medical attention:

• If they are interfering with your day-to-day life
• If they occur three or four times a week, or more than six times in a month
• If one lasts longer than 30 minutes, even with compression
• If one involves a greater than expected amount of blood
• If one interferes with breathing• If one occurs along with high blood pressure

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