Nosebleeds – causes, treatment


Nosebleeds is the colloquial term for the medical term epistaxis . Nosebleeds are not dangerous in most cases. But bleeding from the nose can also be life-threatening and difficult to treat. Dangerous bleeding often originates from the back of the nose.


The causes of nosebleeds are different. There are local nosebleeds and nosebleeds as a symptom of a general disease. In about 80% of cases, there is bleeding from vessels in the front area of ​​the nasal septum. Blood vessels emerge from the depths of the nasal septum to the surface. They are particularly sensitive and vulnerable as they progress close to the mucosal surface.

Deviations in the nasal septum also promote bleeding in this area due to deviations. This can lead to increased turbulence in the breathing air, which can then lead to dehydration and crusting of the mucous membrane.

Rarely is the cause of nosebleeds found in the back and upper section of the nose or in the paranasal sinuses. Diseases such as high blood pressure or blood clotting disorders also increase the risk of nosebleeds.

diseases with this symptom

Local nosebleeds

Localized nosebleeds are common in young children. It is usually not dangerous and quickly disappears on its own. It is largely caused by personal injuries (e.g. picking your nose too hard) or external injuries while playing.

Especially when playing, children often injure their heads and noses through small scuffles. Furthermore, children have often ingested foreign objects through their noses through direct contact with sand and earth, which can lead to nosebleeds through further friction and irritation.

However, an allergy , dehydration of the nasal mucous membranes (e.g. due to air conditioning) and a cold (acute rhinitis) can also lead to nosebleeds.

Nosebleeds as a symptom of illness

Nosebleeds can occur as a symptom of infectious diseases such as influenza , typhoid or measles . Furthermore, also by vascular and circulatory diseases, such as arterial hypertension and arteriosclerosis . Blood thinners also often cause nosebleeds. Nosebleeds due to vitamin C deficiency ( scurvy ), pregnancy and hormonal changes are less common.

Diagnosis & History

If blood (light, dark, clots) comes out of the nose, the doctor has various methods available to diagnose the cause. This allows him to perform a nasal examination to determine the exact location of the bleeding.

X-rays of the head are another way to detect or rule out injuries caused by blunt blows or the like. Blood tests are also possible.

Nosebleeds usually come on suddenly. However, it is possible that the nosebleed is unintentionally initiated by vigorously blowing your nose or picking your nose. With countermeasures (cold in the neck), however, the intensity can be reduced and stopped, so that the nosebleed usually does not last long.



Nosebleeds are mostly harmless and will go away on their own after a short time. However, if the nosebleed persists for a long period of time, it can lead to anemia . This occurs through blood loss and leads to fatigue , deficiency symptoms and other complications. The anemia can also lead to poor circulation with other symptoms such as chills and dizziness .

In the event of possible unconsciousness , there is a risk of blood entering the trachea or esophagus. Blood in the trachea can cause pneumonia or respiratory arrest , while blood in the esophagus travels to the stomach, often causing nausea and vomiting. Arterial nosebleeds carry the risk of bleeding to death. In addition, home remedies can lead to complications.

The typical tilting of the head, for example, can cause blood to enter the airways, while cooling the forehead and nose often increases the bleeding. Depending on the underlying disease, nosebleeds can cause other symptoms that require separate treatment. During therapy, the prescribed medication can lead to an allergic reaction, but normally the specialist treatment of nosebleeds proceeds without further complications.

When should you go to the doctor?

Epistaxis is not a concern for a healthy person. If the nosebleed cannot be stopped after 20 minutes, the result is excessive blood loss. In this case, consulting a doctor is recommended. A doctor should be consulted after five to ten minutes if the nose is noticeably bleeding, if you are pregnant or if you are frail.

If arterial bleeding occurs in the upper part of the nose, immediate medical attention is required. The bleeding runs down the throat.

Bleeding from the nose often occurs after a fall. If there is a visible injury, it is advisable to have it clarified and treated in a hospital.

If clear fluid escapes from the nose after a skull injury, it may be cerebral fluid. The immediate notification of an emergency doctor is essential!

If you have frequent nosebleeds, it is advisable to make an appointment with your doctor. Your family doctor can carry out an initial examination (blood pressure check) . Since special instruments are required for further examination, it makes sense to go to the ENT doctor .

Treatment & Therapy

First of all, diseases such as high blood pressure and blood clotting disorders must be ruled out as the cause of nosebleeds . Medications can also affect blood clotting in the nose. Likewise, tumors of the nose and paranasal sinuses, as well as vascular diseases should be ruled out before treatment.

Acute nosebleeds should first be stopped by tilting the head forward so that the blood is not swallowed. Placing a damp, cold washcloth on the back of the neck constricts the blood vessels and the bleeding usually stops on its own.

If the nose bleeds are severe or if the bleeding does not stop, you should see a doctor immediately. For further medical treatment, electrical or chemical sclerotherapy can be applied to the source of the bleeding. If this procedure is not promising either, a tamponade is inserted into the nose to stop the bleeding. This should remain in the nose for about two to three days and is usually very uncomfortable for the patient.

↳ More information: Home remedies for nosebleeds

Outlook & Forecast

As a rule, nosebleeds are only a temporary symptom and do not necessarily have to be treated by a doctor. The nosebleed often stops after a few minutes and can easily be stopped with a handkerchief, for example. However, the affected person should not lie on their back or lean their head back, as this will cause the blood to flow back. This should be prevented.

If the nosebleed occurs after a blow to the nose or after an accident, a doctor must be consulted urgently. It could be that the nose is broken, which is often not noticed by patients. In the case of a broken nose, the nose can only be straightened properly in the first few days after the break. In this case, a visit to the doctor is mandatory. Even if the nose was not directly affected in an accident, a doctor should also be consulted in the event of a nosebleed.

Nosebleeds are relatively common in children. However, if it goes away after a few minutes, this symptom is not a problem. If the nosebleeds persist, you should see a doctor. In this case, the nosebleeds may indicate another serious illness that needs to be treated by a doctor.

You can do that yourself

Self-care methods for nosebleeds depend greatly on the cause of the bleeding. Should the nosebleed occur after an accident or after a severe blow to the nose, it is advisable to consult a doctor. Especially with other symptoms such as dizziness , pain in the nose or in the head, it can be a broken nose . In this case, the patient must act quickly so that the bones do not grow crookedly.

Under no circumstances should the person concerned lie on their back or lean their head back. That would only cause the blood to flow backwards. It is helpful to stuff a piece of tissue paper into the nostril to stop the bleeding. Usually, nosebleeds stop after a few minutes and do not cause any further problems or complications.

Nosebleeds are particularly common in children because they often pick their nose and their sinuses are not yet well developed. However, if nosebleeds occur frequently and are not associated with specific activities, a doctor should be consulted. In this case, it may be a chronic problem that needs to be treated.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.