Allergy, Nose & Sinus

Uh Oh There’s Blood: When To Worry About Nosebleeds

February 1, 2020

Epistaxis, commonly known as nose bleeding, is one of the most common reasons for visiting the ER. Seeing blood dripping down the face from a bloody nose can look scary but they are usually not a serious condition.


We’ll help you understand what causes nose bleeds, know what to do if you encounter a nosebleed, when it is dangerous and how ENT specialists in Singapore can treat the condition.



What causes nose bleeds




Nose bleeds occur when the blood vessels in the nasal area rupture. It can occur spontaneously and easily because these blood vessels are tiny and fragile. Common causes include blowing your nose too hard, picking your nose, or dry nasal passage.


There are two categories of causes of nose bleeds: anterior and posterior.


An anterior nosebleed occurs from the front of the nose, specifically the wall in between both nostrils. In a posterior nosebleed, they originate from the back of the nose and are more likely to occur in those with high blood pressure, had a face injury or older people in general. Trauma, such as an injury to your nose, harsh or repeated nose-blowing from nasal allergies, continued exposure to dry air and certain medications like blood thinners are the most common reasons behind nosebleeds.



What to do during a nosebleed?


Nose bleeds are mostly minor, short-lived episodes that are self-limiting – so it can be stopped without medical assistance.


  1. Sit up and lean forward to prevent the blood from entering the throat and being swallowed. Stay upright to reduce the blood pressure on the nose.
  2. Gently pinch the soft part of the nose tip using your thumb and index finger
  3. Hold this position for 10-15 mins and check if the bleeding has stopped
  4. If it persists for more than 20 minutes, see a doctor



Is nosebleed a worry?



Most nosebleeds are spontaneous and happen unexpectedly, but they can also be easily self-treated by directly applying manual pressure to the nostrils. Over-the-counter nasal sprays and nasal decongestants can work to constrict the blood vessels in the nose and stop nosebleeds.


You can repeat the steps to continue applying pressure, placing an ice pack on the nose and staying upright. But, if there is prolonged bleeding along with symptoms like dizziness, vomiting, trouble with breathing, please seek medical attention immediately.



When should I be worried about nosebleeds?


You should have your nose examined by a doctor if you have nosebleeds:


  1. From a severe trauma (e.g. from a road traffic accident)
  2. That is more frequent or that last longer than usual
  3. That does not stop after pinching your nose for 10-15 minutes
  4. That results in dizziness
  5. That results in blood flowing down your throat



Treatment for nosebleeds


The treatment approach is determined by the cause of the nose bleeds. Your doctor will ask you about the amount, frequency and potential triggers of the nosebleed. The use of blood thinners and a very high blood pressure are common reasons for nosebleeds in the elderly.


You will need to undergo a thorough ear, nose and throat examination, which may include a nasoendoscopy (“nose scope”) for the ENT Specialist to look for the source of bleeding in your nasal cavity.


The most common cause of nosebleed is ruptured blood vessels in the nasal septum. This can be easily treated with silver nitrate cauterization to help seal the blood vessels. This is a quick and relatively simple procedure that ENT specialists in Singapore can perform in their clinics.



Medically reviewed by Dr Gan Eng Cern



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