Nosebleeds: Causes, What to Do and When to Worry

For nosebleeds, sit down, lean forward and pinch the soft part of your nose for 10 to 15 minutes without letting go, breathing through your mouth. This nearly always stops it. If it bleeds for more than 15 minutes, bleeds heavily or started after a head injury, go to A&E. This guide is by Dr. Pedro Yelamo Vera, an English-speaking GP licensed in Spain (Colegiado No. 484814280) who sees patients by video in English and Spanish.

What should I do when my nose bleeds?

• Sit down and lean your body and head forward. This stops blood running down your throat.
• Pinch the soft part of your nose, just above the nostrils, with two fingers.
• Keep pinching for 10 to 15 minutes in a row. Do not let go to check.
• Breathe through your mouth and spit out any blood.
• You can hold something cold on the bridge of your nose, though it helps only a little.

Do not tip your head back or lie down. You swallow the blood, it can make you sick, and you cannot see if it is still bleeding.

Why does my nose bleed?

The inside of the nose has many thin blood vessels close to the surface. They break easily because of:

• dry air, heating or air conditioning;
• picking your nose, or blowing it hard;
• colds, sinusitis and allergies;
• using nose sprays often;
• a knock to the nose.

Less often, medicines that thin the blood play a part, such as Sintrom, other anticoagulants or aspirin, as can clotting disorders. Children, adults over 45, pregnant women and people with high blood pressure get nosebleeds more often. In Spain a nosebleed is a sangrado de nariz, and doctors write epistaxis.

Why does my nose bleed at night or when I wake up?

Nearly always from dryness. Dry bedroom air dries the lining, and it breaks when it rubs the pillow or you scratch in your sleep. A humidifier and a moisturising nasal gel from the pharmacy often help.

Why is there blood in my mucus?

A few streaks of blood in mucus are common with colds, sinusitis and allergies. This is more likely if you blow your nose a lot or the air is dry. It is not usually serious and goes when the cause clears.

See a doctor if it lasts more than two weeks, is always on the same side, or comes with crusts, face pain or a nose blocked on one side.

Is a nosebleed with high blood pressure dangerous?

High blood pressure is linked to more frequent and sometimes longer nosebleeds. If you get them often and do not know your blood pressure, have it checked. Read about blood pressure readings.

What if I take blood thinners?

Do the same: lean forward and pinch firmly. If you take Sintrom or another blood thinner and bleed often, see a doctor, as your treatment may need a review. Do not stop it yourself. Read about Sintrom in Spain.

How do I stop it starting again?

For the next 24 hours:

• do not blow or pick your nose, or pick off scabs;
• avoid hot drinks and alcohol;
• avoid hard exercise and heavy lifting;
• do not lie flat.

What about nosebleeds in children?

They are very common and rarely serious. The usual cause is nose picking or a cold. Sit the child leaning forward and pinch in the same way. A child under 2 with a nosebleed should be seen by a doctor.

What do I ask for at a Spanish pharmacy?

Say me sangra la nariz a menudo. You can ask for suero fisiológico (saline) or a pomada hidratante nasal (moisturising nose ointment) for dryness.

When to see a doctor

• Nosebleeds keep coming back.
• You take blood thinners or have a clotting disorder.
• A child under 2 has had a nosebleed.
• You feel tired, look pale, have palpitations or feel short of breath, which may mean anaemia.
• You bruise for no reason or your gums bleed.
• It always bleeds on the same side and that side is blocked.

When to go to A&E or call 112

• It bleeds for more than 10 to 15 minutes despite firm pinching: go to A&E (urgencias).
• You lose a lot of blood, or swallow so much that you vomit.
• It started after a blow to the head.
• You feel dizzy, very weak, faint or find it hard to breathe: call 112.

Do not drive yourself. Ask someone to take you or call 112, and bring a list of your medicines.

Frequently asked questions about nosebleeds

Getting a medical assessment

If you are in Spain and keep getting nosebleeds, you can book a video consultation with Dr. Pedro Yelamo Vera, a physician registered in Spain. You can also read about our online urgent care service. A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.

This guide is general information. It does not replace the package leaflet or the advice of your doctor or pharmacist.