Treating Nose Bleeds: When to See a Doctor

Nosebleeds can happen unexpectedly from a minor injury, dry air, or an underlying health condition. While they can often be managed at home, some require medical attention. Understanding the causes, types, and appropriate treatments for nosebleeds can help you manage them effectively and know when to seek professional care.

If you’re experiencing severe nosebleeds, you might feel surprised or scared. It can be a traumatic event and especially shocking if one lasts a long time or starts for unknown reasons. 

What Kinds of Nosebleeds Are There?

Anterior Nosebleeds

Anterior nosebleeds make up about 90% of cases. They originate from the front of your nose, specifically the Kiesselbach’s plexus, a network of tiny blood vessels near the septum. This highly vascular and delicate area makes it prone to bleeding, especially when irritated or injured.

These nosebleeds are usually easy to control. They are often caused by dry indoor air, frequent nose blowing, or mild trauma like nose-picking. Seasonal colds and allergies can also contribute, as excessive nasal congestion leads to inflammation and irritation.

For most individuals with an anterior nosebleed, the bleeding has stopped within a few minutes with proper first-aid measures. These include applying direct pressure and using a nasal spray to constrict the blood vessels. 

However, repeated occurrences might indicate underlying issues, such as chronic nasal dryness, frequent use of decongestant sprays, or exposure to environmental irritants.

Posterior Nosebleeds

Posterior nosebleeds are far less common but significantly more serious. They originate from larger arteries in the nasal cavity's back portion. These blood vessels are deeper within the nose, making the bleeding more difficult to control and often requiring medical intervention.

Anterior nosebleeds usually produce a slow trickle. Posterior nosebleeds, however, can result in heavy bleeding that flows down the throat, leading to coughing or swallowing blood. Individuals on blood thinners, those with high blood pressure, or people with blood clotting disorders are at a higher risk for posterior nosebleeds.

Since posterior nosebleeds rarely stop independently, professional treatment is often necessary. This may involve nasal packing, cauterization, or, in severe cases, hospitalization for more advanced intervention. If you suspect a posterior nosebleed, seek immediate medical attention, especially if you experience dizziness, lightheadedness, or difficulty breathing.

If you’re experiencing a posterior nosebleed, you may need to stay in a hospital or see an ear, nose, and throat specialist to determine the underlying cause. 

If you lose a large amount of blood or bleeding lasts longer than expected, seek medical care at The Urgency Room.

What Causes a Nosebleed?

While there are only two types of nosebleeds, there are many causes for them. Reasons a nosebleed shows up in your life range from irritation to disease – minor to serious. For minor causes, your nosebleed can most likely be treated right at home. However, more serious causes could land you in the hospital.

The most common reasons for nosebleeds are nose-picking or cold weather. Both reasons cause inner-nose trauma. Nose-picking can obviously tear, scratch, or irritate the inside of your nose to the point of bleeding. 

Common reasons

Cold weather, on the other hand, is less controllable. When the air is cold and dry, the inside of your nose tends to dry out, leaving the fragile capillary walls susceptible to breaking and bleeding. 

Both of these causes are minor. However, they could lead to a severe nosebleed that should be seen by a professional to ensure proper treatment and recovery.

Other environmental factors, such as low indoor humidity, exposure to allergens, or frequent use of nasal sprays, can also dry out the nasal lining, making it more prone to bleeding. People who work in dusty or chemical-laden environments may also be more susceptible to nasal irritation that leads to frequent nosebleeds.

Less common reasons

Less common but very severe causes for nosebleeds include potential disease. If it is difficult for your body to clot blood due to blood-thinning drugs or liver disease, you could experience frequent and severe nosebleeds. 

You may also have abnormal blood vessels or cancers in your nose. Some signs that an inability to clot blood may be the cause of your nosebleed and may include bleeding from other parts of your body, too, such as your gums.

Additionally, individuals with high blood pressure or certain autoimmune disorders may be at greater risk of experiencing prolonged or spontaneous nosebleeds. If nosebleeds occur frequently without an obvious trigger, it's essential to check in with a healthcare provider to rule out any underlying conditions.

When to Go to the Doctor for a Nosebleed

Nosebleeds may be a common occurrence in your life, or they may be a rare event. No matter the frequency, getting your nose looked at could be a good idea if you have unchecked medical conditions. 

These include blood disorders, clotting issues, or even structural abnormalities in the nasal passages. In some cases, frequent nosebleeds may indicate an underlying condition, including cancer or a tumor, that requires medical attention.

Severe nosebleeds can be especially frightening and may cause significant blood loss. If you experience a severe nosebleed, get to your nearest Urgency Room for prompt care.

Other reasons to see a healthcare provider after enduring a nosebleed include:

• Excessive occurrence – If you experience frequent nosebleeds, especially with no apparent cause.
• Excessive duration – If your nose continues to bleed for more than 10 minutes despite applying firm pressure.
• Easy bruising – If you bruise easily, it may indicate a clotting disorder that requires evaluation.
• Blood thinners – If you are taking a blood thinner like Warfarin or aspirin, and the bleeding is difficult to stop.
• Blood in urine or stool – If you notice bleeding in other areas of your body, such as your gums, urine, or stool, which could signal a more systemic issue.

You should also seek immediate medical attention if:

• You cough up blood during or after a nosebleed.
• You feel weak, lightheaded, or dizzy – signs that you may be losing too much blood.
• You have trouble breathing due to blood obstructing your airways.
• You develop a fever above 101.4°F, which could indicate an infection requiring treatment.

Once you are in the hands of a healthcare provider, they may want to examine your nose to determine the cause of the bleeding. This could involve numbing the nostril before looking inside to check for anterior bleeding sources. 

Suppose an obvious anterior source is not found. In that case, a posterior nosebleed may be assumed, requiring specialized medical intervention such as nasal packing, cauterization, or further assessment by an ear, nose, and throat (ENT) specialist.

What Does an ER Do for a Nosebleed?

When you visit an urgent care or emergency room for a severe nosebleed, medical professionals will take steps to assess and control the bleeding. Treatment may include:

• Applying nasal spray or medication to constrict blood vessels and slow the bleeding.
• Packing the nose with gauze or a special balloon device to put pressure on the bleeding area.
• If necessary, cauterization to seal off a bleeding blood vessel.
• Identifying and treating underlying conditions that may contribute to recurring nosebleeds.

If an underlying medical issue is suspected, further testing or specialist referrals may be recommended.

Can Urgent Care Cauterize a Nose?

Yes, advanced urgent care facilities like The Urgency Room can perform cauterization for nosebleeds. This procedure involves using a chemical agent (like silver nitrate) or an electrical device to seal a bleeding blood vessel and prevent further bleeding. 

Cauterization is typically recommended for patients who experience frequent, prolonged, or severe nosebleeds that do not respond to standard first-aid measures.

The process is quick and relatively painless, as a topical anesthetic is usually applied before treatment. After the procedure, mild discomfort or temporary nasal congestion may occur, but these symptoms typically resolve quickly. 

Aftercare at The Urgency Room

After treatment, be sure to follow proper aftercare to prevent recurrence. Key steps include:

• Try not to blow your nose or sneeze forcefully for at least 24 hours.
• Use a humidifier to add moisture to indoor air and prevent nasal dryness.
• Apply petroleum jelly inside your nostrils to keep them from drying out.
• Avoid blood thinners unless prescribed by your doctor.

For a step-by-step guide on nosebleed recovery, watch this helpful aftercare video provided by The Urgency Room, part of our aftercare library.