When to worry about frequent nosebleeds and what doctors advise

ENT specialists including Dr Patricia Loftus at the University of California, San Francisco, and Dr Amin Javer at the University of British Columbia say most nosebleeds are mild but recurrent bleeding is not normal if the nasal lining is healthy and should prompt medical evaluation.

Nosebleeds occur in two forms. About 90% are anterior, starting in Kiesselbach’s plexus between the nostrils where many small capillaries lie. Posterior bleeds come from larger vessels deeper in the nasal passage, are rarer and more serious, and are most often seen in older adults, particularly those taking anticoagulants.

Common causes include dry air, especially from indoor heating, digital manipulation such as nose picking, inflammation from allergies or infections, physical exertion, and medications or supplements that increase bleeding risk, such as prescription blood thinners, aspirin, and some herbal products.

For first aid, experts advise leaning the head forward and gently pinching the nose, using a cold compress or a nasal decongestant like oxymetazoline, and avoiding tipping the head back. Thick clots can show effective clotting, but nosebleeds that occur multiple times a week, last longer than 30 minutes, or happen daily warrant a clinical assessment.

Key Topics

Health, Epistaxis, San Francisco, British Columbia, Anticoagulants, Oxymetazoline