Most of the time, a bloody nose (epistaxis) is not serious and will stop quickly. However, frequent nosebleeds for no apparent reason should be treated.
Bloody nose symptoms
Even though a bloody nose can be unnerving, this condition is not severe most of the time. The cause of a bloody nose will usually be evident because bleeding will follow an injury, nasal surgery, or a lengthy cold. The nose has an extensive supply of thin, delicate blood vessels needed for your sense of smell. The nose is already somewhat vulnerable to injury, illness, and medication use (or misuse). A nosebleed is also called epistaxis.
Common characteristics of a bloody nose
If you're experiencing a bloody nose, it can likely present as:
- Lighter bleeding: A trickle of red blood may appear from one or both nostrils following a mild injury, or after blowing your nose due to a cold.
- Heavier bleeding: A heavier gush of red blood may appear from one or both nostrils following a more severe injury, after nasal surgery, or with blood clotting problems (bleeding disorders).
Is a bloody nose serious?
The severity of a bloody nose depends on the cause.
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Bloody nose causes
- Dry air: This dries the passages and makes them thinner and more prone to bleeding.
- Picking and blowing the nose: This causes irritation that can be severe.
- Irritating fumes from chemicals
- Overuse of nasal sprays: These can be very drying.
- Cocaine use: This is extremely damaging to the lining of the nasal passages.
- Allergies: Most often to dust, pollen, and other inhaled irritants.
- The common cold
- Sinusitis: Either viral or bacterial
- Chronic rhinitis: This is ongoing congestion and other cold-like symptoms not due to allergies.
Direct trauma or injury
Trauma to the nose in itself can result in bleeding.
- Injury from an accident, fall, or sport
- Foreign body: Young children may push small objects up their noses, which become lodged and cause chronic pain and bleeding.
- Deviated septum: This means that the "wall" of cartilage dividing the left nostril from the right is crooked and possibly misshapen. The abnormal airflow is very drying and leads to bleeding of the nasal tissue.
- Nasal surgery: This may have created spots of incomplete healing that continue to bleed.
Bleeding disorders can manifest as a bloody nose.
- Taking blood thinners: "Thin" blood that does not clot right away due to prescribed blood thinners, such as Coumadin, or, sometimes, aspirin.
- Low levels of platelets in the blood: This may follow a viral infection.
- Hereditary malformations of the blood vessels
Abnormal growths within the nose
Such growths may include nasal polyps, tumors, or even cancer of the blood-forming tissues anywhere in the body, which may have nosebleeds as a symptom.
The body increases in vascularity, the number of blood vessels it carries, during pregnancy. These vessels are sometimes more vulnerable to minor bleeding.
Regular consumption of alcohol can have a blood-thinning effect, especially if you are already taking a prescribed blood thinner or taking aspirin.
6 bloody nose conditions
The list below shows results from the use of our quiz by Buoy users who experienced bloody nose. This list does not constitute medical advice and may not accurately represent what you have.
Normal nosebleed (epistaxis)
A bloody nose can be caused by a host of things, but is often idiopathic (without cause).
Top Symptoms: bloody nose, vomiting with streaks of blood
Symptoms that always occur with normal nosebleed (epistaxis):bloody nose
Symptoms that never occur with normal nosebleed (epistaxis):severe nosebleed, nausea or vomiting
Nosebleed requiring treatment
Nosebleeds are a common disorder that many (60%) will experience. It can be caused by a number of things that rupture the blood vessels in the nose such as: dry air, picking your nose, getting hit in the nose, or even just getting older
Top Symptoms: severe nosebleed
Symptoms that always occur with nosebleed requiring treatment:severe nosebleed
Urgency: In-person visit
Iatrogenic nose condition
Surgery of the nose or nose piercing can result in side effects ranging from infection, pain and swelling to numbness and decreased sense of smell.
Top Symptoms: nose pain, bloody nose, bump in or on the nose, nose redness, swollen nose
Urgency: Phone call or in-person visit
Platelets are tiny cells in the blood that help form blood clots and seal minor cuts and wounds. Immune thrombocytopenia, also known as immune thrombocytopenic purpura (ITP), is a condition where there are not enough platelets in the blood, causing easy bruising and tiny reddish purple dots on the skin from bleeding under the surface.
Top Symptoms: being severely ill, rectal bleeding, red stool, unexplained/excessive bleeding from cuts or wounds, unexplained bruising
Symptoms that always occur with immune thrombocytopenia: being severely ill
Urgency: Primary care doctor
Allergies are an overreaction by the immune system to something that does not bother most other people. Many people who have allergies are sensitive to pollen, but other things such as dust mites, animal dander, cockroaches, and mold can also cause a reaction.
Top Symptoms: fatigue, irritability, trouble sleeping, runny nose, congestion
Symptoms that never occur with chronic allergies: fever, yellow-green runny nose, chills, muscle aches
Nasal fractures are common occurrences. The force needed to break the nasal bones is less than any of the other bones of the face because of their thinness and position. For kids, treatment and diagnosis is different because of the bones may not be fully formed.
Top Symptoms: mouth breathing, constant nose pain, swollen nose, nose pain caused by trauma, nose bruise
Symptoms that always occur with broken nose: nose pain caused by trauma, swollen nose, constant nose pain
Urgency: Hospital emergency room
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Bloody nose treatments and relief
When it is an emergency
Seek immediate treatment in the emergency room or call 911 if your bleeding is heavy and will not stop, whether or not there is also an injury.
When to see a doctor
You should schedule an appointment for:
- Frequent nosebleeds that occur for no apparent reason
- Small, bright red spots that appear within the skin of the face, lips, or hands
For mild congestion, try using a salt water spray instead of a nasal decongestant spray.
Questions your doctor may ask about bloody nose
- Did your nose start bleeding after being hit in the nose?
- Have you experienced any nausea?
- Do you have any issues with bruising?
- Do you have an object stuck in your nose?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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- Nosebleed. Seattle Childrens Hospital. Updated November 3, 2018. Seattle Childrens Hospital Link
- Chronic nosebleeds: What to do. American Academy of Pediatrics: HealthyChildren.org. Updated June 1, 2009. HealthyChildren.org Link
- Nosebleed. Health Navigator. Health Navigator Link
- Nosebleed (epistaxis) in children. Johns Hopkins Medicine. Johns Hopkins Medicine Link
- Blaivas AJ, Brown K, Kirsi JS, eds. Allergic rhinitis in children. University of Rochester Medical Center. URMC Link
- Quillen DM, Feller DB. Diagnosing rhinitis: Allergic vs. nonallergic. American Family Physician. 2006;73(9):1583-1590. AAFP Link
- Idiopathic thrombocytopenic purpura (ITP). FamillyDoctor.org. Updated January 18, 2018. FamillyDoctor.org Link
- Nosebleeds during pregnancy. NCT. NCT Link