Doctor Warns of the Dangerous Mistake You're Making During a Nosebleed
When a nosebleed hits, we often go into panic mode. We frantically reach for tissues and may try shoving them up in our nostrils in an effort to plug the leak. Hey, we might throw our head back for good measure too, to keep blood from dripping down on our clothes. The whole ordeal may earn us an A+ for effort (and dramatics), but there’s an easier, calmer and safer way to deal with nosebleeds.
Here’s everything you need to know about caring for a bloody nose, according to an ear, nose and throat specialist.
What is a nosebleed, exactly?
Don’t worry, even if you see a big gush of blood coming from your nose, your brain isn’t bleeding. “The lining of the nose has a latticework of small blood vessels running through it,” says Thomas S. Edwards, M.D., a rhinologist with Emory Healthcare and Assistant Professor, Department of Otolaryngology Head and Neck Surgery with Emory University School of Medicine. “When someone has a nosebleed, it is usually from these small vessels in the lining at the front of the nose.” It turns out those vessels are small but mighty!
What makes those vessels to bleed?
“The most common causes of nosebleeds are nasal dryness and trauma to the nose,” says Dr. Edwards. “When the lining at the front of the nose dries out and cracks — like dry knuckles in the winter — or is traumatized by cleaning out the inside with tissue or a finger, the nose will bleed.” And yes, things like your home’s heat or air conditioning can worsen nasal dryness, but medicated nasal sprays can as well (even if they’re useful for some nasal issues).
To prevent dryness, consider using an over-the-counter nasal saline spray or gel. “They are like lotion for a dry or irritated nose,” says Dr. Edwards. “Saline is helpful for most nasal problems and can be used several times per day and long term.” Plus, he says, the salt in these products will not impact blood pressure or interact with other medications.
Why is tipping your head back a bad idea when your nose is bleeding?
“The only two places that blood can go when you have a nosebleed are from the front of the nose or down the back of the nose and into the throat,” says Dr. Edwards. “Tipping the head back when you have a nosebleed makes more blood go down into the tthroat,which is then usually swallowed. Swallowing blood can irritate the stomach and lead to nausea and vomiting.” A bloody nose is bad enough, no one wants to deal with an upset stomach, too!
What’s the safest way to handle a bloody nose?
Pinch the soft parts of your nose — not the firm nasal bones that are higher up — between your thumb and index finger. Then, while it may go against your instincts, tilt your chin down toward your chest. “This will reduce the amount of blood that goes down the back of the nose and into the throat,” explains Dr. Edwards.
“Pinching the nose will put pressure on the small blood vessels in the lining of the nose that are usually the source of bleeding. You may need to pinch the nose for 5 to 10 minutes, or more if you take aspirin or blood thinners.” Just don’t stuff anything up your nose — even soft things like tissues — because it can traumatize the lining of the nose and make another bleed more likely to happen.
Can decongestant nasal sprays help?
Yes, but they must be used carefully. “Decongestant nasal sprays (like Afrin, phenylephrine or oxymetazoline) can make the blood vessels in the nose close off,” says Dr. Edwards. “These medications are available over the counter, but they are the sprays that noses can get ‘hooked’ on and have side effects, so always follow the instructions on the package closely.”
If your nosebleed is heavy, he says you can spray several squirts of a decongestant nasal spray in your nostrils and then apply firm pressure on the soft parts of your nose for 10 minutes. If the bleeding continues, you can safely try it one more time.
At what point should you get emergency care for a bloody nose?
If the bleeding is so heavy that you’re soaking dish towels, and it won’t stop even with firm pressure on the soft parts of your nose or two rounds of decongestant nasal sprays with pressure, it’s time to get professional medical care, advises Dr. Edwards. And if you have frequent nosebleeds, you should schedule an appointment with an ear, nose and throat doctor (ENT/otolaryngologist) to figure out the root cause and come up with an appropriate treatment plan.
Should you give your nose any special care afterward?
“Be gentle with the nose and avoid blowing it or cleaning it out aggressively,” says Dr. Edwards. “Clots in the nose are the body trying to help stop the bleeding — blowing these out can make a nosebleed start again. Once the bleeding has been stopped for at least an hour or more, you can try to gently blow the nose.” Also, the same saline products that can help keep the lining of your nose moisturized before a bleed happens are helpful in the aftermath. “They can soften clots, help the lining of the nose heal and make it easier to breathe through the nose after a nosebleed,” says Dr. Edwards.
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