Nosebleeds (epistaxis) are common when experiencing a cold and are usually not a sign of a serious underlying illness. The cold itself does not directly cause the bleeding. Instead, temporary environmental and physiological changes associated with the infection create conditions for a nosebleed. The delicate lining of the nasal passages becomes vulnerable during a respiratory infection, making blood vessels prone to rupture from minor irritation. Most nosebleeds originate from the front part of the nose, specifically Kiesselbach’s plexus, a collection of blood vessels near the surface of the nasal septum.
How Cold Symptoms Irritate Nasal Lining
A cold infection triggers an inflammatory response that causes the nasal lining (mucosa) to swell and become congested. This inflammation brings more blood flow to the area, causing small blood vessels near the surface to become temporarily fragile. The viral infection compromises the lining, which is typically moist and resilient.
This physiological change is often compounded by the surrounding environment, particularly during the winter months when colds are most frequent. Cold air holds less moisture than warm air, and indoor heating systems further dry out the air inside our homes. This low-humidity environment dehydrates the nasal membranes, causing them to crack and crust, which exposes the underlying blood vessels to damage.
Mechanical trauma from managing cold symptoms is a primary factor leading to nosebleeds. When a person repeatedly or forcefully blows their nose to clear mucus, the increased pressure can rupture the already weakened vessels. Actions like rubbing or picking at the nose, often done to remove dry crusts, also cause minor trauma to the vessel-rich Kiesselbach’s plexus. This combination of inflammation, dryness, and physical irritation explains why nosebleeds are a common complication of the common cold.
Immediate Steps to Stop a Nosebleed
If a nosebleed begins, remain calm, as anxiety can increase blood pressure and worsen the flow. Immediately sit down and lean your head slightly forward. Leaning forward ensures the blood drains out of the nostrils instead of running down the back of the throat, which can cause nausea.
Use your thumb and index finger to firmly pinch the soft, lower part of the nose, compressing both nostrils. This pressure directly targets the Kiesselbach’s plexus, the site of most anterior nosebleeds. Maintain this continuous pressure for 10 to 15 minutes to allow sufficient time for a clot to form. During this time, breathe steadily through your mouth.
Once the bleeding has stopped, rest quietly for a few hours and keep your head elevated above the level of your heart. For several hours afterward, avoid blowing your nose, picking at the area, or engaging in strenuous activity that could dislodge the clot. If the bleeding restarts, repeat the pinching process for 10 to 15 minutes.
Recognizing When Medical Care Is Needed
While most nosebleeds resolve with simple home care, certain signs indicate the need for professional medical attention. Seek emergency care if the bleeding continues actively after 20 minutes of continuous, firm pressure. Bleeding that is extremely heavy or involves substantial blood loss, suggesting a more serious posterior bleed, also warrants immediate evaluation.
Seek care if the nosebleed is accompanied by other concerning symptoms, such as feeling dizzy, faint, or experiencing difficulty breathing. Any nosebleed following a head injury, fall, or trauma to the face requires prompt medical assessment to rule out an underlying fracture or internal injury. Recurrent nosebleeds, even minor ones that stop quickly, should be discussed with a doctor to investigate potential contributing factors.