Nosebleed (epistaxis) A&E leaflet

Download and print as a PDF (219kB pdf)

What causes a nosebleed?

A nosebleed (also known as epistaxis) happens when small blood vessels inside your nose burst. It can occur at the front or back of the nostrils. 

Most nosebleeds are mild and stop on their own. More serious nosebleeds are rare and usually affect older people or those with medical conditions. 

We do not always find a reason for every nosebleed. 

The most common area for bleeding is Little’s Area. This is just inside the front of your nose on the middle part (nasal septum). This area is very delicate and can bleed easily, especially in children. 

Common triggers include: 

• Nose picking 
• Colds or blocked noses (like from hay fever) 
• Blowing the nose 
• Minor bumps to the nose 
• Sudden temperature changes .

These bleeds are usually short and easy to manage.

Less often, bleeding comes from deeper in the nose. This may be caused by: 

• Serious injury 
• Rare nose conditions 
• High blood pressure 
• Blood clotting problems 
• Medicines like warfarin or aspirin

In these cases, the bleeding may be heavier and harder to stop. 

How is a nosebleed treated?

Initial care 

• A healthcare worker will check your vital signs (observations). 
• If the bleeding is heavy or has not stopped, we may move you to a different area for closer monitoring. 

You may be treated by: 

• Pinching the soft part of your nose 
• Using gauze to absorb blood 

Nasal cautery

• If bleeding continues, a doctor may use a silver nitrate stick to seal the bleeding area. 
• It may sting for a moment. 
• If this works, you can usually go home. 
• If not, you may need to stay for more treatment. 

Nasal packing.

If cautery does not work, we may need to pack your nose using: 

• A sponge or ribbon dressing 
• In more serious cases, an epistaxis balloon 
• Packing blocks the nostril completely, so you will have to breathe through your mouth. 

If packing is used, it will usually stay in for 24–48 hours. You may experience:

• Headache 
• Dry mouth 
• Less appetite or taste 
• Trouble swallowing 
• Watery eyes 

Depending on your condition, you may be sent home with a follow-up ENT appointment, or you may need to be admitted for further care. 

What should I do when I go home?

Your nose may bleed again. To reduce the chance of this happening, for at least 3 days avoid: 

• Heavy lifting or exercise 
• Straining during bowel movements (constipation) 
• Stressful situations 
• Hot baths or sunbathing 
• Alcohol and smoking 
• Picking, blowing, or cleaning your nose 
• Spicy food or hot drinks 

How can I avoid another nosebleed?

To avoid another nose bleed please follow the advice given below for at least three days:

• Heavy lifting or exercise 
• Straining during bowel movements (constipation) 
• Stressful situations 
• Hot baths or sunbathing 
• Alcohol and smoking 
• Picking, blowing, or cleaning your nose 
• Spicy food or hot drinks 

Helpful tips: 

• Sneeze with your mouth open to reduce pressure on the nose 
• Use Vaseline or prescribed nasal cream 4 times a day for 1 week (especially after nasal cautery) 
• You may see dark red or brown discharge. This is normal and part of healing 
• If your nose bleeds slightly, sit upright and: 
  • Pinch the soft part of your nose for at least 10 minutes 
  • Use an ice pack on your nose 
  • Spit out any blood. Swallowing it may make you feel sick 

Further support

For general medical advice please use the NHS website, the NHS 111 service, walk-in-centres, or your GP.

• The NHS website provides online health information and guidance.

• There are walk-in and urgent treatment services at Brighton Station, Crawley Urgent Treatment Centre, Lewes Victoria Hospital, Horsham Minor Injuries Unit and Bognor Regis War Memorial Hospital.