A nosebleed, medically termed epistaxis, is a common experience that can be alarming when it occurs during a cold. This type of bleeding is typically anterior, meaning it originates from the front part of the nose, and while messy, it is rarely a medical emergency.
Why the Nasal Lining Becomes Fragile During a Cold
The common cold virus triggers a significant inflammatory response within the nasal cavity, known as infectious rhinitis. This inflammation causes the blood vessels in the nasal lining (mucosa) to dilate and swell. The resulting engorgement and tissue swelling push the delicate blood vessels closer to the surface.
Most of these anterior bleeds originate from a highly vascularized area called Kiesselbach’s plexus, located on the front portion of the nasal septum. This collection of blood vessels is already thin and fragile, and the swelling from the cold makes them even more susceptible to rupture. The presence of a cold also frequently coincides with dry indoor air, which further dehydrates the nasal membrane. This dryness causes the lining to crack and become crusty, exposing the underlying vessels.
Forceful nose blowing or repeated sneezing increase mechanical stress on this compromised tissue. The sudden pressure from aggressively clearing the nose can easily break the already exposed capillaries in Kiesselbach’s plexus. Some individuals use decongestant nasal sprays to alleviate congestion, but these products can paradoxically contribute to the problem. Decongestants cause excessive dryness in the nasal passages, which compounds the fragility and irritation of the lining, increasing the likelihood of a bleed.
Immediate Relief and Prevention Measures
When a nosebleed occurs, the immediate response should be to remain calm and apply direct pressure to the source of the bleeding. Sit upright and lean your head slightly forward to prevent blood from dripping down the back of your throat, which can cause nausea. Use your thumb and index finger to firmly pinch the soft part of your nose shut, just above the nostrils.
Maintain this continuous pressure for a full 10 to 15 minutes, breathing steadily through your mouth during this time. Do not check if the bleeding has stopped before the time is up, as this can dislodge the forming clot and restart the flow. After the bleeding has stopped, avoid blowing your nose, bending over, or strenuous activity for several hours to allow the vessel to properly seal.
To prevent future episodes while you are sick, focus on keeping your nasal environment moist. Using a saline nasal spray several times a day helps to hydrate the nasal passages and prevent the lining from drying out and cracking. Running a cool-mist humidifier in your bedroom at night also adds moisture to the air, which is especially beneficial in dry, heated environments. When clearing your nose, always blow gently, one nostril at a time, to minimize the physical stress on the delicate nasal septum.
When to Consult a Healthcare Provider
While most nosebleeds linked to a cold are minor and stop with simple home care, certain signs suggest the need for professional medical attention. Seek care if a nosebleed persists beyond 15 to 20 minutes despite continuous, proper pressure on the nose. A medical evaluation is also warranted if the blood loss is rapid or heavy, such as if you estimate losing more than a cup of blood.
Accompanying symptoms that prompt a visit include feeling dizzy, lightheaded, or weak during the bleeding episode. If the nosebleed started after a significant fall or injury to the head or face, seek emergency care immediately. Recurring, frequent nosebleeds that happen even when you do not have a cold should also be discussed with a doctor to investigate potential underlying causes.