Nosebleeds may be alarming, but they’re usually not serious. In most cases, they clear up quickly when treated correctly. Learn how to respond, when to seek help, and simple ways to prevent recurrences.

What is a nosebleed (epistaxis)?

Also known as epistaxis, a nosebleed is a discharge of blood through the nostrils caused by the rupture of small blood vessels. In most cases, blood flows from the front of the nose (anterior bleeding) and stops on its own or by simply pinching the nose. More rarely, bleeding comes from the back of the nose (posterior bleeding) and requires medical attention.

Anterior bleeding

The nasal mucosa is lined with an extensive network of blood vessels. Located at the front of the nose, Kiesselbach’s plexus is a particularly fragile area responsible for almost 90% of nosebleeds. When these vessels rupture, blood normally flows forward but may also flow down the throat, especially if the head is tilted backwards or a person is lying down—two positions to be avoided.

Posterior bleeding

Posterior bleeding comes from a deeper area of the nasal cavity close to the throat. While rarer, this type of bleeding is often more abundant and harder to stop. Primarily occurring in elderly people and those with underlying health problems, it often requires rapid medical attention.

The following signs may indicate posterior bleeding:

• Sensation that blood is coming from the throat
• Taste of blood in the mouth
• More bleeding than usual
• Continuous bleeding despite pressure on the nose
• Blood flowing from both nostrils
• Dizziness, fatigue, or discomfort

If one or more of these signs are present, it is advisable to consult a doctor as soon as possible.

What causes a nosebleed?

Nosebleeds can be attributed to a number of often benign causes. The small blood vessels in the nose are fragile and can rupture easily. Certain factors, such as excessively dry air or repeated nose-blowing, may trigger a bleeding episode. Learn more about these causes to help prevent nosebleeds.

✔ Dry air

In winter, indoor heating dries out ambient air, while air conditioning can do the same in summer. In both cases, the nasal mucosa becomes more fragile, cracks, and can bleed, especially in young children and the elderly.

✔ Minor trauma

Blowing your nose too vigorously, scratching your nose or a minor blow to the face is sometimes enough to burst the small blood vessels at the front of the nose.

✔ Infections and inflammation

Colds, rhinopharyngitis, and sinusitis trigger local inflammation, frequent sneezing, and irritation, all of which increase the risk of bleeding.

✔ Allergies

Allergic rhinitis weakens the nasal mucosa. Constant irritation, sneezing, and repeated use of tissues or nasal sprays can be aggravating factors.

✔ Hypertension (high blood pressure)

While high blood pressure does not directly cause nosebleeds, it does increase pressure in the blood vessels, making them more vulnerable. It may also be more difficult to stop any bleeding.

✔ Clotting disorders

Certain medical conditions, such as hemophilia and von Willebrand disease, interfere with blood clotting. These conditions increase the frequency of bleeding and make it harder to control.

Increased risk factors

Certain habits or conditions can weaken the nasal mucosa or slow down blood coagulation, thus increasing the frequency or duration of nosebleeds.

• Anticoagulants thin the blood and may prolong bleeding.
• Smoking dries out and irritates nasal passages.
• Excess alcohol consumption weakens blood vessels, disrupts coagulation and can raise blood pressure.
• Chronic stress can increase blood pressure and encourage risky actions such as nose-scratching.
• Exposure to environmental irritants, such as smoke, pollution or chemicals, can attack the nasal mucosa.
• Poor nostril hydration dries out mucous membranes and makes them more vulnerable.

How do I stop a nosebleed?

1. Assume the proper position

Sit with your back straight and your head tilted slightly forward. This enables blood to flow outwards rather than down the throat, limiting discomfort and the risk of nausea.

2. Blow your nose gently (if necessary)

Before applying pressure to the nose, gently blow your nose to expel accumulated blood clots.

3. Pinch the nostrils

Using your thumb and forefinger, firmly pinch the soft part of the nose just below the bone. Maintain this pressure for 10 to 15 minutes, without releasing, even if the bleeding appears to stop.

4. Stay calm and breathe slowly

Try to remain relaxed. Slow, regular breathing through the mouth can help lower blood pressure and reduce bleeding.

5. Apply cold as needed

You may apply a cold compress or ice pack (wrapped in a cloth) to the bridge of the nose. Cold helps constrict blood vessels and reduce bleeding.

When should you see a health care professional?

Seek advice from a healthcare professional under the following circumstances:

• Bleeding lasts longer than 20 minutes, even after pinching your nose as described above.
• You suspect posterior bleeding.
• You are taking blood thinners, have high blood pressure or suffer from a coagulation disorder.
• You have nosebleeds frequently or with no obvious cause.

How do I prevent nosebleeds?

A few simple measures can protect the nasal mucosa and limit bleeding episodes.

• Stay well hydrated, especially on hot days and in winter when the air is drier.
• Use a saline spray as needed to keep your nasal passages moist.
• Avoid blowing your nose too hard and scratching the inside of your nose.
• Humidify ambient air with a humidifier if necessary, especially at night.
• Protect your nose if you have seasonal allergies (with appropriate treatment or by limiting exposure).
• Reduce exposure to irritants, such as smoke, dust, chemicals and air conditioning.

These small actions can help keep your nose healthy and prevent bleeding.

Advice from your pharmacist

Your pharmacist can assist you in finding the right products and determining next steps based on your situation. They can help you do the following:

• Choose an appropriate product: saline solution, nasal lubricant gel or specific products to moisturize the mucosa
• Consider your profile: age, allergies, medications (such as anticoagulants) and medical conditions
• Avoid common mistakes: blowing your nose forcefully, tilting your head back, using irritating products

Feel free to drop by your pharmacy and ask questions or discuss your symptoms. Your pharmacist is there to help.

Last updated on August 11, 2025