Causes of Frequent Bloody Noses

"What causes frequent bloody noses?"

Healthcare providers hear this question a lot, especially from parents. They may report that their children sometimes bump their noses or fall down and get nosebleeds. While this can be distressing, at least these parents know the cause.

More concerning are nosebleeds that seem to happen without a cause. Sometimes children will wake up in the morning with blood on their pillows or dried blood around their nose or face. While the causes of this are numerous, the simple fact is that some people are more prone to frequent bloody noses, particularly during dry weather or as a result of habits they may not even be aware of.

Causes

The following conditions or illnesses make developing a bloody nose more likely:

• Dry mucous membranes from low humidity or dehydration
• Very cold air
• Allergies
• Chemical irritants
• Frequent nose picking or rubbing
• Blowing your nose or sneezing too hard
• Overuse of nasal decongestant sprays
• Nasal infections
• Deviated septum
• Colds and other upper respiratory infections
• Inserting a foreign object into the nose
• Injury or trauma

Less common but often more serious causes of nosebleeds include:

• High blood pressure
• Blood-thinning medications such as aspirin or warfarin
• Blood-clotting diseases, such as hemophilia
• Hereditary hemorrhagic telangiectasia (HHT), a genetic disorder that leads to abnormal blood vessel formation
• Nasal or sinus tumors

Children tend to get bloody noses more than adults because they are more likely to pick or rub their noses or put foreign objects into their nostrils. Elderly people are also more susceptible because their mucous membranes are thinner. With that being said, people of all ages can get bloody noses and need to be treated appropriately to stop the bleeding.

If a nosebleed doesn't stop after 20 minutes, see a healthcare provider immediately or go to your nearest emergency room. This is especially true if the bleeding is profuse, was caused by a blow to the face, or is causing dizziness or fainting.

Treatment

Managing the underlying causes of frequent bloody noses is likely to be the most effective way to keep them from recurring. Sometimes this approach may need to be combined with other treatments.

There's limited research on the treatment of frequent bloody noses. However, researchers at Harvard Medical School published a study reviewing different treatment options. The research shows that chemical cauterization (spraying a chemical into the nose to shrink blood vessels), surgical ligation (tying-off a burst blood vessel in the nose), embolization (blocking bleeding blood vessels) were most likely to keep bloody noses from recurring long-term.

Patients who underwent these procedures had better results and shorter hospital stays than patients with bloody noses who were treated with, for example, nose packing.

Prevention

Not all nosebleeds can be prevented. But, if you're experiencing frequent bloody noses, here are some things you can try that may reduce their number and/or severity:

• Use a cool mist humidifier placed near the bed while you sleep.
• Try an over-the-counter saline nasal spray (but avoid inserting the tip too far up the nose as this can further damage tissues).
• Use a neti pot.
• Treat any underlying allergy or nasal infection.
• Try not to rub or pick your nose.
• Clip your child's fingernails regularly.

Although rare, nosebleeds can sometimes be a sign of a serious medical condition such as a tumor. If nose bleeds perists or recurs, one should consult with their healthcare provider.