Nosebleeds can signify something serious

The Associated Press
Friday August 17, 2001

DALLAS — Nosebleeds can be a nuisance. Or something more serious. 

While some nosebleeds have transient causes, others may be caused by injury or high blood pressure, says Dr. J.R. Williams, assistant professor of otolaryngology-head and neck surgery at University of Texas-Southwestern Medical Center. 

“There is not just one fix-all,” he said. “It is important to determine which type of nosebleed you are having so it can be properly treated.” 

A nosebleed that starts from the front part of the nose and only exits one nostril probably is an anterior type – most often caused by lack of humidity. Other possible causes include chronic nose picking, sinus infection, or reactions to such medications as inhalants, aspirin, ibuprofen or anticoagulants. 

A posterior nosebleed comes from deep in the nose and flows down the back of the mouth and throat, even if the patient is upright. It could have been caused by by a sports- or accident-related injury, or the person could have high blood pressure. Either possibility calls for treatment. 

Williams has this advice for handling a nosebleed: 

“To stop a nosebleed, pinch the soft parts of the nose together, and slightly tilt the head back for five minutes. If bleeding has not stopped, gently blow the nose to evacuate all clots. Then spray a decongestant-nasal spray quickly into both nostrils, followed by another five minutes of pinch-pressure. Applying ice to the nose and cheeks may also help slow bleeding.” 

After bleeding slows, you may pack your nose lightly with tissue, first tipping the tissue with a bit of petroleum jelly. That will prevent the resumption of bleeding when the tissue is removed. 

“Resumed bleeding after the above fails at home should more than justify seeing a physician,” Williams said. 

Get to a doctor or emergency room if the bleeding cannot be stopped or recurs, if bleeding is rapid or blood loss is large, the person feels weak or faint, or if blood goes down the back of the throat instead of through a nostril. 


The emergency room doctor will first try to cauterize by applying silver nitrate to the bleeding site. If it can’t be controlled this way or if bleeding is too brisk, electrical cautery will be used. In severe cases, a radiologist may put a catheter into the affected blood vessel and insert gelfoam to control the bleeding.