Nose bleeds
Disclaimer: This information is meant to improve the interaction between you and your doctor. It is NOT meant to replace this interaction! There is no substitute for a history and physical examination administered by a competent physician. If you inappropriately use this information to treat yourself, you may be endangering your health.
The most common reasons for nose bleeds are (1) trauma — for example, by picking or rubbing your nose, and (2) excessive dryness, typically from dry weather, which may chap the nasal tissues.
Tumors of the nasal cavity and tumors of the sinuses can also cause nose bleeds. Danger signs that suggest the possibility of tumor include:
- Nose bleeds which recur over the course of a few months (usually NOT due to a tumor, but it does raise our suspicions)
- Nose bleeds associated with any of the following:
loose teeth, numb facial skin, a change in vision, a change in occlusion (the way your teeth meet), or any change of the facial contour
If any of these symptoms are present, bring this to your doctor’s attention at once!
If a doctor has determined that your nose bleeds are due to one of the common benign reasons, you can help prevent further nose bleeds by observing the following precautions:
Needless to say, don’t pick your nose.
Do not lift any heavy objects (more than 20 pounds); do not strain or bend over for long periods. Do not strain at bowel movements; take a fiber supplement or a laxative, if necessary.
Do not forcefully blow your nose.
Sneeze with your mouth open (this will reduce the force of the sneeze).
Keep your nose moist. A salt water solution (Ocean, Ayr or NaSal are easily obtainable brands in the USA) may be sprayed in each nostril every 2 to 3 hours, or as often as necessary. Ayr Gel is an excellent product as well.
NasalCease and QR Powder are two products available without prescription which can be useful for stopping a nosebleed. Like any other health care product, sometimes they work, sometimes not. They’re certainly worth a try for the patient with less aggressive nose bleeds.
Consider buying a humidifier for your bedroom, especially if your house is very dry. Use it at night. For added moisture, you could spray with nasal saline or use Ayr Gel.
Do not use Vaseline (petroleum jelly) in the nose on a regular basis. Microscopic droplets of the jelly become lodged in the lungs. This can lead to lipoid pneumonia — an uncommon problem (pdf), but why take the chance when better products (like Ayr Gel) are available?
If you develop a nose bleed, rest quietly* while applying firm, gentle pressure to your nose. Do this by pinching your nose between your thumb and forefinger. Pinch below the nasal bones. Hold pressure for 5 to 7 minutes. If the bleeding continues, gently blow the clots from your nose, then spray each nostril with Afrin (generic: oxymetazoline) or Neosynephrine (generic: phenylephrine). This assumes your doctor has cleared you to use these medications. These sprays can also be used to moisten a small wad of cotton, which is then placed in the nose and held against the bleeding tissue. Hold pressure again for 5 to 7 minutes. If necessary, you may repeat the spray 15 minutes after the first spray.
If the bleeding continues, seek medical attention at once.
D.
*Some folks prefer to lean forward, so that the blood will come out of the nose and not drip into the throat. In any event, you don’t want to swallow that blood. It’s nauseating.
