Nosebleed

(Epistaxis): What should you do?

What is a nosebleed?

Nosebleeds are very common, especially in children and older adults. They usually come from small blood vessels at the front of the nose and can be stopped in most cases with simple first aid at home.

What causes nosebleeds?

• Dry nasal lining, especially in dry climates and with air conditioning
• Picking the nose or inserting fingers into it
• Colds, allergic rhinitis, and frequent nose blowing
• Nasal injuries
• Blood-thinning medications
• Misuse of certain nasal sprays

Less commonly, nosebleeds may be related to blood disorders or other nasal problems that need evaluation.

High blood pressure can make bleeding heavier or harder to stop, so it's worth checking and monitoring your blood pressure if nosebleeds recur.

Correct first aid

1. Sit down and tilt your head slightly forward.
2. Pinch the soft, lower part of the nose below the bone, between your thumb and index finger.
3. Hold continuous pressure for 10–15 minutes without stopping — use a clock to time it.
4. Breathe through your mouth, and spit out any blood that runs into your mouth rather than swallowing it.
5. If bleeding continues, repeat the pressure for another 10–15 minutes.

Common mistakes

• Tilting the head back or lying down
• Pinching the bony bridge instead of the soft lower part
• Releasing pressure every minute to check if bleeding has stopped
• Packing the nose deeply with cotton or tissues

After the bleeding stops

For roughly the next day:

• Don't blow your nose hard or pick at it.
• Avoid lifting heavy objects and strenuous exercise.
• If you sneeze, do so with your mouth open.

If you take blood-thinning medication: don't stop it on your own because of a nosebleed. See your doctor to decide what's appropriate for you.

How does a doctor treat recurrent nosebleeds?

• Nasal endoscopy to locate the bleeding site
• Cauterizing the bleeding vessel
• Temporary nasal packing for severe bleeding
• Treating the underlying cause, such as dryness or allergy

How can I reduce how often it happens?

• Moisturize the nose with saline spray or nasal moisturizing gel, especially in dry climates.
• Use a room humidifier in the bedroom if needed.
• Avoid picking the nose, and keep children's nails trimmed.
• Blow your nose gently, one nostril at a time.
• Use nasal sprays correctly, aiming away from the septum.
• Monitor your blood pressure if it's elevated.

In children, nosebleeds are common and usually not serious, and they typically become less frequent with age.

When should I see a doctor?

• If nosebleeds recur.
• If bleeding always comes from the same side.
• If accompanied by one-sided nasal obstruction.
• If you take blood thinners and nosebleeds recur.
• If you notice easy bruising or bleeding elsewhere on the body.
• With recurrent heavy nosebleeds and nasal obstruction in adolescent boys.

Go to the emergency room immediately if:

• Bleeding continues more than 20 minutes despite correct pressure
• Bleeding is heavy or running heavily into the throat
• You feel dizzy, faint, or have difficulty breathing
• The nosebleed follows a strong blow to the head or face

Remember

• Sit, lean forward, and pinch the soft part of the nose for 10–15 minutes.
• Don't tilt your head back.
• Bleeding that doesn't stop after 20 minutes needs emergency care.
• Recurrent or one-sided bleeding needs an examination.

This information is for health awareness and education, and does not replace a doctor's consultation or direct medical assessment.

Prepared by: Saudi Society of Otolaryngology–Head & Neck Surgery · Version 1.0 · Last reviewed: May 2026 · saudiorl.com