Nosebleeds occur when there is damage to blood vessels in the nose, and blood flows out. In response to this damage, the body forms a blood clot, which may come out of the nose. Blood clots following a nosebleed are normal.
Nosebleeds are very common and rarely harmful. When a nosebleed occurs, a blood clot forms to prevent excessive bleeding from the vessels. In most cases, the body will start to repair the blood vessels causing the nosebleed, and no specific treatment is necessary.
The blood clot that forms can vary in size depending on how much blood is present.
The blood clot may come out when removing tissue from the nose, but it can stay there for longer. It is possible to remove a blood clot by gently blowing the nose when the nosebleed stops.
This article discusses the causes of nosebleeds with clots and how to manage a nosebleed.
Allergies and sinusitis cause inflammation in and around the nose, which may lead to nosebleeds.
These conditions can cause nasal congestion. Congestion dilates blood vessels, making them more vulnerable to damage and further increasing the risk of a nosebleed. The same applies to other conditions that cause congestion, such as a cold.
A blocked nose can also lead to increased blowing, picking, and rubbing, which increases the risk of a nosebleed.
People should avoid clearing mucus or a blood clot from the nose by blowing or picking it. It is better to use a nasal spray or inhale vaporized water to manage congestion.
The best method of dealing with these types of nosebleeds is to treat the underlying cause. For example, antihistamines are useful for treating nasal allergies.
If a person finds a nasal spray drying to the inside of the nose, they can try an alternative method of relieving congestion. A pharmacist or doctor can suggest an alternative.
Read more about allergies and congestion.
Very dry environments may increase the risk of nosebleeds and the resulting clot. These conditions can cause the inner lining of the nose to dry out and crack. This can damage blood vessels in the nose and lead to a nosebleed.
For example, a nosebleed may be more likely to occur in a dry, heated room. These types of nosebleeds are common during the winter months. They can also occur at high altitudes, as the air is drier.
Using a humidifier will reduce the dryness of a room and may help prevent nosebleeds. A saline nasal spray can also reduce dryness inside the nose.
The septum is a thin wall of cartilage separating the nostrils. A deviated septum occurs when the nasal septum has an abnormal shape or position. It can occur from birth or as a result of sustaining an injury to the nose.
A deviated septum can limit airflow into one of the nostrils. It can also expose the other nostril to dry air when the septum is shifted to one side. This can cause the skin inside the nostril to become dry and cracked, increasing the risk of damage to blood vessels.
Another symptom of a deviated septum is congestion, which can also increase the risk of nosebleeds.
Nasal sprays and decongestant medication may reduce congestion. However, the only permanent solution is septoplasty surgery to correct the septum.
Medications that thin the blood, or anticoagulants, can increase the likelihood of nosebleeds. Nonsteroidal anti-inflammatory drugs can also increase the risk of nosebleeds.
These medications increase the risk of prolonged nosebleeds because they increase the time it takes for a clot to form.
If the bleeding does not stop, it may be necessary to seek medical attention. A healthcare professional can seal the damaged blood vessels or use medication to stop the blood leaking.
Physical trauma is a
Several types of trauma can cause a nosebleed, including:
- nose picking
- pushing an object into the nose
- sustaining a blow to the face
- improper use of nasal sprays
- insufflation, one example of which is snorting a substance or a drug into the nose
Trauma to the nose can damage the small blood vessels lining the inside, causing blood to leak out.
The most common type of nosebleed that results from trauma is an anterior nosebleed. These can occur when trauma causes damage to the blood vessels in the lower portion of the septum.
As the blood clot forms during a nosebleed, it may be helpful to stop blood from leaking out of the nose. This will speed up the clot formation and prevent additional blood loss.
To stop a nosebleed, follow these three steps:
- Lean forward so that the head tilts just in front of the chest. This will prevent blood from running down the throat.
- Gently pinch the soft parts on either side of the nose with two fingers to stop blood from leaking out.
- Hold this position for at least 10 minutes and wait until the blood stops leaking. If blood is still leaking after this, keep applying gentle pressure to either side of the nose for a further 10 minutes. Repeat until the bleeding stops completely.
If the blood clot is blocking air from passing through the nose, gently blow it out. It is best to wait for at least 15 minutes to give the clot a chance to stabilize.
To loosen dried blood clots in the nose, use a saline nasal spray or nasal drops. Wait a few minutes before blowing the nose and avoid picking it.
Treatment for prolonged or recurrent nosebleeds
If a person experiences regular nosebleeds or a nosebleed does not stop on its own, a doctor may advise the following treatments:
- Cautery: If first aid management does not stop an anterior nosebleed and a doctor can see the source of the bleeding, they may recommend cautery. During cautery, a doctor will apply anesthesia to the affected nostril and either apply a silver nitrate stick to the source of bleeding or use an electric device to cauterize and seal the specific blood vessel.
- Nasal packing: If cautery is unsuccessful after two attempts, a doctor may suggest nasal packing. During this procedure, a doctor applies anesthesia to the nostril before inserting resorbable packing, an expandable sponge, or a small balloon. The doctor will follow up with the person within 5 days to monitor the nose’s healing and remove the nasal packing if necessary.
For recurrent posterior nosebleeds that do not respond to the treatments above, doctors may recommend endoscopic surgery. This procedure isolates and repairs the specific blood vessel causing the bleeding.
Certain tumors, such as juvenile nasopharyngeal angiofibromas, and blood vessel abnormalities, such as hereditary haemorrhagic telangiectasia, may also cause nosebleeds, and these will require specific treatments.
Learn more about how to stop a nosebleed.
In most cases, nosebleeds are not serious and do not require medical attention.
However, if the bleeding does not stop after 30 minutes, see a doctor immediately. It is also necessary to see a doctor if the nosebleed occurs with other symptoms, including:
- very heavy bleeding that is leaking down the throat
- high blood pressure
- lightheadedness
- chest pain
- elevated heart rate
Is it normal to have big blood clots during a nosebleed?
Yes, large blood clots are normal. Blood clots following a nosebleed can vary in size depending on the size of a person’s nasal cavity and the amount of blood loss.
When should you go to the ER for a nosebleed?
If the bleeding does not stop after 30 minutes, visit the local emergency room or call 911. It is also necessary to see a doctor if the nosebleed occurs with other symptoms, including:
- very heavy bleeding that is leaking down the throat
- high blood pressure
- lightheadedness
- chest pain
- elevated heart rate
Nosebleeds occur when the blood vessels in the nose burst, allowing blood to leak out.
The body usually forms a blood clot to stop the bleeding and repair the damage. Dry air and trauma are common causes of nosebleeds, but they can also occur in people with allergies or sinusitis.
Most nosebleeds are not harmful, but it is important to see a doctor if they last more than 30 minutes or occur alongside other symptoms, such as chest pain.