Nosebleed – causes, symptoms, and how to manage it

Nosebleeds are a common occurrence with many possible causes. While most nosebleeds are harmless and stop on their own, frequent nosebleeds should not be ignored, as they may signal more serious health issues. Why does blood come from the nose? How to stop a nosebleed? Frequent nosebleeds and headaches - what could be causing them?

Nose anatomy - nasal septum

The nose is the beginning of the respiratory tract and plays a key role in warming, filtering, and cleaning the air we breathe. It is a prominent facial feature and also serves as the organ of smell. Along with the paranasal sinuses, it can influence the tone and timbre of the voice.

The nose is made up of several parts, including the nasal cavity, which is divided into two sections by a cartilaginous and bony septum that acts like a framework supporting the soft tissues. The nasal septum consists of three parts:

• the membranous part, formed by a double layer of skin, which limits the entrance to the nasal vestibule.
• the cartilaginous part, made of septal cartilage.
• the bony part, which includes the vomer and the perpendicular plate of the ethmoid bone.

Why does the nose bleed?

The nasal cavity is richly supplied with blood vessels to support its functions. Because of the dense network of tiny, superficial blood vessels, nosebleeds are among the most common types of bleeding. These delicate vessels are easily damaged – for example, by forceful nose blowing – leading to bleeding from one nostril and, less commonly, both.

Two vascular plexuses exist in the nasal cavity: Kiesselbach’s plexus, located on the anterior-inferior part of the septum, and Woodruff’s plexus, found on the posterior part of the lateral nasal wall. Since Kiesselbach’s plexus is particularly prone to drying and injury, most nosebleeds occur there as anterior bleeds. Posterior nosebleeds are less common but more serious, usually affecting older adults.

Deviated nasal septum: symptoms

Some people have structural abnormalities in their nose and nasal cavity that can disrupt airflow. Studies suggest that up to 80% of the population may have a deviated nasal septum, which can cause breathing difficulties, reduced sense of smell, recurring middle ear infections, and repeated upper respiratory infections. A deviated septum can also lead to frequent nosebleeds.

Causes of nosebleeds

Nosebleeds can stem from local or systemic causes. About one-third of cases arise from local factors such as direct trauma, minor injuries from nose picking, dryness of the nasal mucosa, upper respiratory infections, overuse of nasal decongestants, foreign objects in the nose, or septal perforation and deviation.

In adults, most nosebleeds are related to systemic conditions, including high blood pressure, atherosclerosis, clotting disorders, and metabolic diseases. Nosebleeds may also occur in liver failure, inherited bleeding disorders, hormonal imbalances, or acute infections like measles or typhoid fever.

Additional causes of nosebleeds

Viral infections, allergies, and dry air – especially in air-conditioned environments – can weaken blood vessels, making them more prone to rupture and nosebleeds. Sinusitis can also contribute to nosebleeds due to frequent nose blowing, which weakens the nasal blood vessels.

Nosebleeds and body weakness

General weakness can result from chronic diseases, vitamin deficiencies, anemia, or stress. It can also be caused by infections that reduce the flexibility and strength of blood vessels in the nasal cavity, increasing their fragility and risk of rupture. Weakness may contribute to nighttime nosebleeds and can be worsened by ongoing bleeding.

Blood clots in the nose

During or after a nosebleed, blood clots may form inside the nose. These clots, made up of blood components including fibrin, can cause discomfort or headaches. Clots may form due to dried blood or damage to the nasal mucosa caused by irritation, allergies, dry air, or even head trauma.

Dried blood clots in the nose

Blood clots in the nose usually aren’t a cause for concern, but they should not be picked at, as this can reopen healed wounds and trigger new bleeding. The best approach is to let any existing wounds heal naturally, allowing clots to fall off on their own. Gently blowing the nose can sometimes help clear clots that block airflow.

Nasal discharge with blood and sinus issues

People with sinus infections may notice nasal discharge mixed with blood, a symptom often linked to sinusitis. While most sinus infections are viral, some may be bacterial. Inflammation of the nasal and sinus mucosa can cause bleeding that leads to blood-streaked mucus.

Although nasal discharge with blood usually isn’t alarming, recurrent nosebleeds or persistent bloody discharge should be evaluated by a doctor, as they may signal a more serious condition.

Nosebleeds and vitamin deficiencies

Frequent nosebleeds can have various causes, including vitamin deficiencies. Proper intake of essential nutrients supports overall body function, including blood vessel health. Research points to vitamins C and K as particularly important for preventing nosebleeds.

Nosebleeds and lack of vitamins C and K

Vitamin C is vital for collagen synthesis, which strengthens and seals blood vessels. It also helps lower blood pressure and speeds wound healing, including in the nasal cavity. A deficiency in vitamin C can make blood vessels fragile and prone to rupture, causing nosebleeds.

Vitamin K plays a crucial role in blood clotting. Low vitamin K levels can disrupt clotting processes and lead to excessive bleeding, including nosebleeds.

Which vitamins help prevent nosebleeds?

To reduce the risk of nosebleeds, ensure adequate intake of vitamin C and vitamin K. A balanced diet rich in leafy greens, citrus fruits, legumes, seeds, nuts, fermented foods, blackcurrants, and red bell peppers can help. Supplements containing vitamins C and K, like OstroVit Pharma Vitamin K2 MK-7 spray or OstroVit Vitamin C 1000 mg capsules, may also support blood vessel health and clotting.

Frequent nosebleeds - when to see a doctor?

Most nosebleeds stop within a few minutes on their own. However, heavy or prolonged bleeding, especially after a serious injury, or recurrent episodes (such as daily nosebleeds) require medical attention.

A doctor will perform a physical exam and may order further tests, including blood work or imaging studies. In severe cases, nasal packing (tamponade) might be necessary to stop bleeding. There are two types: anterior packing, which fills the front part of the nasal cavity, and posterior packing, used for bleeding at the back of the nose.

Less commonly, a doctor may perform coagulation by sealing leaking blood vessels with chemicals or heat, but this is used less often than packing.

First aid - how to stop a nosebleed

To stop a nosebleed, sit the person down and keep them calm. Have them lean slightly forward and pinch the soft parts of their nose until the bleeding stops. For injuries, a cold compress on the nose bridge can help reduce bleeding.

Avoid swallowing blood or letting it run down the throat. Do not tilt the head backward or insert cotton or tampons into the nose to stop bleeding.

How to stop a child’s nosebleed

Treat a child’s nosebleed the same way as an adult’s: have them lean forward so blood can drain freely, then gently pinch the nostrils until the bleeding stops.

Preventing nosebleeds

People prone to nosebleeds should avoid forceful nose blowing and long-term use of nasal decongestants. Using saline sprays or seawater solutions to moisturize the nasal mucosa can help, as can humidifiers and avoiding air-conditioned rooms. During illness, avoid aspirin, as it can thin the blood.

Staying well-hydrated supports nasal mucosa health, and a nutritious diet rich in leafy greens and citrus fruits provides essential vitamins K and C. Dietary supplements with these vitamins may also help strengthen blood vessels and improve clotting to prevent nosebleeds.

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