Why Does Nose Bleed?


A nosebleed is the loss of the blood from tissues that lines the inside of your nose. And the medical term for this condition is epistaxis. About 60% of the individuals will have at least one incident of a nosebleed in their lifespan.

A large number of blood vessels close to the surface in your nose’s lining and the location of your nose (in the middle of the face) make it an easy target for nosebleed and injuries.

Symptoms of Nosebleed

Blood coming from your nose is the main symptom of a nosebleed, and it can range from light to heavy. The blood comes out of either of the nostril, and in most cases, only one nostril is damaged. It is common to feel the liquid in the back of your throat if the nosebleed occurs while lying; the symptom comes before the blood comes from the nose.

It is best not to swallow the blood as it can lead to vomiting and nausea. In case of severe nose bleeding, seeking immediate medical attention is vital. Symptoms to watch for include:

  • Turning pale
  • Heavy bleeding
  • Swallowing a large amount of blood, causing vomiting
  • Palpitations (an irregular heartbeat)
  • Shortness of breath

Who Gets Nosebleeds?

It is not uncommon to have a nosebleed; anyone can get it. And most people will have it at least once in their lifespan. However, there is some individual who is more likely to have a nosebleed, and they include:

  • People who take blood-thinning drugs, like warfarin or aspirin.
  • During pregnancy, the blood vessels present in the nose expand, putting more pressure on the delicate blood vessels in the lining of their nose.
  • Children with an age range between two and ten can have this condition. Allergies, cold, dry air, and sticking objects and fingers into their nose make the children of this age group more prone to nosebleeds.
  • People with blood clotting disorders, like Von Willebrand disease or hemophilia.
  • For adults between ages 45 and 65, the blood takes longer to clot in older adults and mid-life. They are more likely to have high blood pressure, bleeding disorder, or atherosclerosis (hardening of the walls of arteries). Moreover, they may be taking blood-thinning drugs daily (like aspirin).

Causes of Nosebleed

A nosebleed can be classed as a posterior or anterior.

In anterior nosebleed, the bleeding takes place from the wall between the two nostrils, while in posterior nosebleed, it originates further back and higher up the nose in an area where the blood gets supplied to the nose by artery branches – this is the reason why the bleeding of posterior is heavier.

As compared to the anterior nosebleed, the posterior nosebleed is more significant and requires medical attention.

Causes of Anterior Nosebleed

Sometimes, the causes of anterior nosebleed remain unknown, but some of the common causes include:

  • Deviated septum: when the wall that separates the two nostrils has deviated or off-center.
  • A blow or knock to the nose can damage the mucous membrane’s delicate blood vessels.
  • High altitude: the availability of oxygen decreases with an increase in the altitude, making the air drier and thinner, causing the nose to bleed.
  • The act of picking the inside of the nose, mainly if done more frequently. Or if the inside of the nose is already tender or irritated, and if the fingernails are long.
  • Sinusitis is an inflammation of the sinuses, which is the air-filled cavities of the skull and bone surrounding the nose.
  • Excessive use of some particular medications, like non-steroidal anti-inflammatory drugs (NSAIDs) or blood thinners.
  • The dry climates can result in the cracking and drying inside the nose, causing a nosebleed. It is when the climate changes from bitter cold to warm.
  • Excessive use of illegal drugs, like cocaine.
  • A nasal allergy, flu, or a cold can cause a nose to bleed due to several reasons: Individuals with such conditions can blow off their nose more often. During a viral infection, the inside of the nose may be tender and irritated, making it more vulnerable to bleeding.
  • Liver disease can result in severe and frequent nosebleeds since it interferes with blood clotting.

Causes of Posterior Nosebleed

  • Calcium deficiency
  • Tumors
  • Nasal surgery
  • Blood diseases, like leukemia or hemophilia
  • High blood pressure
  • Exposure to chemicals

Other Causes of Nosebleed

The other causes of nosebleed include:

  • Osler-Weber – Rendu disease
  • Broken nose
  • Glomerulonephritis (nephritis)
  • Low platelet count (thrombocytopenia)
  • Aortic coarctation
  • Foreign body in the nose
  • Von Willebrand disease
  • Factor X deficiency (Stuart-Prower factor deficiency)
  • Rheumatic fever
  • Ebola
  • Leishmaniasis
  • Deficiency of factor II, V, OR VII
  • Liver cirrhosis
  • Idiopathic thrombocytopenic purpura
  • Celiac disease

Treatment of Nosebleed

Treatment of Nosebleed

If a physician suspects an underlying cause, such as anemia, high blood pressure (hypertension), or nasal fracture, he may run more tests. They include pulse rate and checking blood pressure; before recommending a suitable treatment option, the doctor may also order an X-ray.

There are several treatments options doctors have to offer; these include:

1. Septal Surgery

It is a surgical process to straighten a crooked septum (the wall between the nostrils), whether it became like that after injury or birth. The surgery minimizes the occurrence of nosebleed.

2. Nasal Packing

Stuffing special nasal sponges or ribbon gauze as far back as possible into your nose and putting pressure on the source of the nosebleed.

3. Ligation

It is a “last resort” surgical procedure that includes tying the bleeding ends, causing identified blood vessels. Sometimes even the artery is tied off since the blood vessels stem from it. More major surgery may require if the bleed source is further back.

4. Cautery

It is a minor procedure that burns (cauterizes) the area (where the bleeding is coming from) to seal it off, and only done if the specific blood vessels get identified. However, the region around the cautery starts to bleed occasionally.


Nose bleeding is a common condition and can happen to anyone. Just look for the symptoms and severity and consult your physician. There several treatments available according to your symptoms of the condition.