Nosebleeds, medically known as epistaxis, occur when the delicate blood vessels lining the inside of the nose rupture and bleed. Because the nasal lining is rich with tiny blood vessels close to the surface, it is a frequent site of minor injury and subsequent bleeding. Most nosebleeds are not serious and originate from the front part of the nose, specifically a network of vessels called Kiesselbach’s plexus. Knowing the correct steps to manage this common event can stop the bleeding quickly.
Addressing the Penny Myth
The notion of placing a cold coin, like a penny, on the forehead or the bridge of the nose to stop a nosebleed is a long-standing folk remedy that lacks any scientific basis. This misconception often stems from the idea that cold temperatures on the skin will somehow reflexively constrict the bleeding vessels deep inside the nose. The skin on the forehead is far removed from the actual site of bleeding within the nasal septum. Any perceived effectiveness is likely due to the natural tendency of most nosebleeds to stop on their own. Furthermore, tilting the head back, a position often associated with this myth, is counterproductive as it directs blood down the throat, potentially causing nausea or vomiting.
Medically Recommended Steps for Immediate Relief
Applying Pressure
When a nosebleed begins, remain calm, as anxiety can raise blood pressure. Immediately sit upright and lean slightly forward to prevent blood from draining down the back of the throat. Swallowing blood can lead to vomiting, and the strain of vomiting may restart or worsen the bleeding. Use your thumb and index finger to firmly pinch the soft part of the nose, just above the nostrils, where the cartilage meets the nasal bone. This pressure directly compresses the fragile blood vessels of the anterior septum, which is the source of approximately 90% of all nosebleeds. Maintain continuous pressure for a full 10 to 15 minutes without releasing it, breathing steadily through your mouth.
Post-Bleeding Care
After the bleeding has fully stopped, it is important to avoid any activity that could dislodge the newly formed clot. Do not blow your nose, pick at the nose, or engage in strenuous activity for several hours. If a clot has formed in the nostril, gently blowing the nose may be necessary to clear it before applying pressure, but this should be done with extreme care.
Common Causes and Prevention Strategies
Causes
Nosebleeds are most frequently caused by the drying and cracking of the nasal lining, often due to low humidity from dry air, particularly during winter or in high-altitude environments. Frequent nose picking or forceful nose blowing can also traumatize the delicate vessels, leading to rupture. Certain medications, such as blood thinners or even over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), can increase the likelihood and severity of bleeding.
Prevention
Long-term management focuses on maintaining a moist nasal environment and minimizing irritation. Using a humidifier, especially in the bedroom at night, helps to combat the effects of dry air on the nasal mucosa. Applying a thin layer of petroleum jelly or an antibiotic ointment just inside the nostrils, especially on the nasal septum, can keep the lining supple and prevent cracking. Daily use of a saline nasal spray can also help hydrate the nasal passages and reduce dryness. Refrain from repeated nose blowing and avoid placing fingers or objects deep inside the nasal cavity.
Warning Signs Requiring Professional Care
While most nosebleeds stop with simple home care, certain signs suggest the need for immediate medical attention. Seek emergency care if the bleeding continues heavily for more than 20 minutes, despite correctly applying continuous pressure. A nosebleed that results in a large volume of blood loss, causing dizziness, weakness, or feeling faint, also requires urgent medical evaluation. Any nosebleed following a significant head injury, facial trauma, or a blow to the nose should be assessed by a healthcare professional immediately. Recurrent nosebleeds, even if they stop quickly, warrant a consultation with a doctor to investigate potential underlying causes, such as blood clotting disorders or the effects of prescription medications.