What are nosebleeds?

Bleeding from your nose, also known as a nosebleed, is very common, especially in children and in people over 65. The medical term for a nosebleed is ‘epistaxis.’ There are several causes of nosebleeds but they are only rarely concerning.

Nosebleeds can be distressing for children, but usually they can be easily stopped with first aid and don’t cause any longer lasting problems.

What symptoms are related to nosebleeds?

If a nosebleed is caused by a foreign object up the nose, there may also be pain or itching, a smelly discharge from one nostril and bad breath in addition to the bleeding.

If your nosebleed is caused by hay fever, you may also have a runny, itchy or congested nose, sneezing and itchy or watery eyes.

If, apart from a nosebleed, you also have symptoms like tiredness, anaemia (making you pale, weak and breathless), repeated infections and lots of bruising, you may have a blood disorder.

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What causes nosebleeds?

Nosebleeds are caused when the tiny blood vessels on the inside of your nose start to bleed.

Nosebleeds can occur if you:

• pick your nose
• blow your nose too hard
• strain too hard on the toilet
• have an infection in the nose, throat or sinuses
• have a cold
• receive a bump, knock or blow to the head or face
• have a stuffy nose from a cold or allergy
• are taking some types of medicines, such as anti-inflammatories, blood thinners or nose sprays
• are in hot or cold weather with low humidity

Nosebleeds are more common if you have some medical conditions like allergies, leukaemia, nasal polyps or sinusitis.

You are more likely to get nosebleeds when you are pregnant.

Children often like to experiment by pushing items up their noses. This can make their nose bleed.

In people over the age of 50, nosebleeds sometimes arise from deeper blood vessels in the nose/face and the bleeding can be quite heavy and difficult to stop. You should go to the emergency department for any heavy or difficult-to-control nosebleeds.

How to stop a nosebleed?

A child with a nosebleed may be very frightened or distressed about it. Try to comfort and reassure your child that nosebleeds are very common and lots of other kids get them. It doesn’t mean they are ill, and they will get better very soon.

To treat a nosebleed:

If a nosebleed is very heavy and does not stop after 15 minutes of non-stop pressure, you need to go to your nearest emergency department. It may be necessary for a doctor or nurse to apply a topical medication or stop the blood vessel from bleeding by burning or freezing it. Sometimes it’s necessary to pack your nose with dressings to stop the bleeding.

If you have a facial injury and cannot put pressure on your nose to stop the bleeding, visit your nearest emergency department for further treatment.

If your child has an object up their nose, don’t try to remove the object yourself. Take your child to your doctor or an emergency department straightaway.

If the object falls back into the throat and you or your child start to choke, call an ambulance on triple zero (000). If the object contains chemicals (like a button battery) or is a bean (which can swell) you should go to the Emergency Department immediately.

When should I see my doctor?

Most nosebleeds are usually mild and do not last long. You don’t need to see a doctor.

Seek emergency medical help if:

• you are injured
• there is very heavy bleeding
• you are having trouble breathing
• the nosebleed lasts longer than 15 minutes
• a child younger than 2 has a nosebleed
• you are taking blood thinning medication
• you are vomiting blood

Nosebleeds can be a nuisance but are usually nothing to worry about. However, frequent, persistent or unusually heavy nosebleeds should be discussed with your doctor as they may want to investigate that there is no underlying medical condition which is causing the bleeds.

If you suspect that your child’s nosebleeds are caused by any type of violence rather than by accident, you should seek help from a healthcare professional as soon as possible. Consider talking to your doctor, community nurse, emergency department or school nurse.

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How are nosebleeds diagnosed?

Nosebleeds are usually diagnosed from looking at your symptoms. The doctor will ask some questions and do a short examination to try to identify the cause of the nosebleed.

If you have frequent nosebleeds or certain risk factors, your doctor may want to investigate further. They may order blood tests and refer you to a specialist, for example, an ear, nose and throat specialist.

Can nosebleeds be prevented?

In some cases, nosebleeds may be preventable. It depends on the cause. For example, if nosebleeds are caused by nose picking, then they can be stopped by not picking the nose.

If your nosebleeds persist and become a problem, you may need treatment, such as surgery to cauterise (burn) the blood vessels in the nose. Talk to your doctor about your options.

After you have had a nosebleed, try not to pick your nose. Instead, blow it gently. Prevent the inside of your nose from drying out by using a humidifier or putting a small amount of lubricant cream like Vaseline or paw paw ointment inside your nose. Ensure you have washed your hands before applying the lubricant cream.

Drinking plenty of fluids and eating fibre will prevent constipation, so you won’t strain on the toilet which may start another nosebleed.