Care and Prevention
Most nosebleeds are mere nuisances; but some are quite frightening, and a few
are even life threatening. Physicians classify nosebleeds into two different
1. Anterior Nosebleed: The nosebleed that comes from the front part of the
nose and begins with a flow of blood out one or the other nostril if the patient
is sitting up or standing.
2. Posterior Nosebleed: The nosebleed that comes from deep in the nose and
flows down the back of the mouth and throat even if the patient is sitting
up or standing.
Obviously, if the patient is lying down, even the anterior nosebleeds seem
to flow in both directions, especially if the patient is coughing or blowing
Nevertheless, it is important to try to make the distinction since posterior
nosebleeds are often more severe and almost always require the physician's
care. Posterior nosebleeds are more likely to occur in older people, persons
with high blood pressure, and in cases of injury to the nose or face.
Nosebleeds in children are almost always of the anterior type. Anterior nosebleeds
are common in dry climates or during the winter months when the dry air parches
the nasal membranes so that they crust, crack, and bleed. This can be prevented
if you will place a bit of lubricating cream or ointment about the size of
a pea on the end of your fingertip and then rub it up inside the nose, especially
on the middle portion (the septum).
Many physicians suggest any of the following lubricating creams or ointments.
They can all be purchased without a prescription: Borofax Ointment, A and
D Ointment, Mentholatum, Vicks Vaporub, and Vaseline. Up to three applications
a day may be needed, but usually every night at bedtime is enough.
If the nosebleeds persist, you should see your doctor, who may recommend cautery
to the blood vessel that is causing the trouble.
To Stop An Anterior Nosebleed
If you or your child has an anterior nosebleed, you may be able to care for
it yourself using the following steps:
1. Pinch all the soft parts of the nose together between your thumb and two
2. Press firmly toward the face - compressing the pinched parts of the nose
against the bones of the face.
3. Hold it for 5 minutes (timed by a clock).
4. Keep head higher than the level of the heart - sit up or lie with head elevated.
5. Apply ice (crushed in a plastic bag or washcloth) to nose and cheeks.
To Prevent Re-bleeding After Bleeding Has Stopped
6. Do not pick or blow nose (sniffing is all right).
7. Do not strain or bend down to lift anything heavy.
8. Keep head higher than the level of the heart.
If Re-bleeding Occurs
9. Clear nose of all blood clots by sniffing in forcefully.
10. Spray nose four times on both sides with decongestant spray (such as Afrin,
Duration, Neo-Synephrin, etc.)
11. Pinch and press nose into face again, as in steps 1-3 above.
12. Call your doctor.
When to Call The Doctor or Go To the Emergency Room
If bleeding cannot be stopped or keeps reappearing.
If bleeding is rapid or if blood loss is large.
If you feel weak or faint, presumably from blood loss.
If bleeding begins by going down the back of the throat rather than the front
of the nose.
If you have further questions about Nose Bleeds, please
feel free to contact our office.
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