Nosebleeds Abound in Winter. Here’s What to Do
Nosebleed Prevention and Treatment
By Beth Coopman PharmD., pharmacist at Network Health
Originally published on 03/05/2021 at 1:15 p.m.
Whether it’s a legitimate appreciation for the somber and contemplative nature of the season or simply a version of “Stockholm Syndrome,” there’s a lot to like about winter. Whether it’s snowshoeing, quiet walks in a blanketed winter forest, the lack of mosquitos, you can learn to love the November – March season. Winter gets a bad rep, but there is a charm and reflective quality that disappears with the longer days and more active energies of warmer seasons.
For your skin, however, winter presents unique hazards that need to be prepared for and mitigated. This season, after all, is a time for crackling fires, thermostats being dialed up, frequent washing to avoid infections and freezing cold exposure to our skin. This skin, both outside skin and the inside surfaces like your nose, can react to these factors.
Many of us know how to handle dry hands, elbows and other areas of your body by lathering up on moisturizer. But how do we handle the more delicate and sensitive dry nostrils and prevent nosebleeds that can occur when the nose is too dry?
What causes a nosebleed?
Also known as epistaxis, in medical terms, nosebleeds are caused when the small blood vessels near the surface of the skin in your nose crack and bleed as the skin dries out.
Luckily, there are home remedies to provide comfort to already damaged tissue and tricks to avoid future skin and nose irritation.
How can I make a nosebleed stop?
The first steps to treat an active nosebleed include, breathing through your mouth, sitting upright and leaning slightly forward to avoid blood dripping down your throat. This dripping can cause choking or vomiting, so first aid involves eliminating the risk for complication.
Now, let’s look at what not to do. Although it’s gained notoriety as a common at-home treatment, packing your nose with cotton, tissue or even tampons can further aggravate blood vessels and lacks the amount of pressure needed to stop the bleeding.
Instead, pinch the fleshy part of the nostrils below the bone for about 10 minutes. Be sure to watch the clock closely and go with all ten minutes. Releasing the pinched nose too early may cause bleeding to resume, starting the 10-minute period over again.
Use a tissue or damp washcloth to catch the blood as it comes out of the nose instead. If the nosebleed doesn’t stop after 10 minutes of pinching, reapply pressure for 10 more minutes. In addition, decongestant nasal sprays like oxymetazoline (Afrin®) can shrink or tighten blood vessels in the nose and slow or stop the bleeding. Using an oxymetazoline soaked cotton ball in the bleeding nostril and pinching for 10 minutes is another option to stop bleeding.
Another remedy is applying a cloth-covered ice pack to the outside of the nose. The ice pack can help shrink the blood vessels and relieve inflammation. Keep the ice pack application time to 10 minutes or less to avoid damaging the skin. Avoid bending down, lifting heavy objects or straining activities that can retrigger a nosebleed. Keeping activities light for a day or two after can give the tissue time to heal.
What types of nosebleeds are there?
A nosebleed can start in two areas of the nose, determining the type and severity. Occurring in a small blood vessel toward the front of the nose, anterior nosebleeds are more common and less severe. Children are more likely to have an anterior nosebleed.
Posterior nosebleeds tend to be more serious with heavy bleeding because they occur in a large blood vessel towards the back part of the nose near the throat. Posterior nosebleeds are more common in adults.
Can nosebleeds be severe or life-threatening?
Like any symptom, nosebleeds can indicate a range of conditions, spanning from simple dryness to a more serious issue. Call a doctor if a nosebleed has any of the following characteristics.
- Lasts more than 20 minutes with applied, direct pressure
- Has blood loss of over one cup
- Occurs after a blow to your head/nose or a serious injury
- Causes you to have difficulty breathing
Additionally, frequent nosebleeds may also denote an issue for which you should see your personal doctor. Call your doctor if frequent nosebleeds have any of the following characteristics.
- Symptoms of anemia, including weakness, fainting, fatigue (tiredness), coldness, shortness of breath or pale skin
- Are happening alongside you taking blood thinners, such as aspirin, warfarin, Eliquis or Xarelto
- Occur with the start of a new medication
- Occur in children under two years of age
- Are accompanied by bruising anywhere on your body, which can indicate a blood clotting disorder
What will a doctor ask about my nosebleed?
Should you feel your nosebleed could be more serious than simply a product of dry skin, your doctor may ask any or all of the following questions.
- How many minutes did the nosebleed last?
- How much blood was lost?
- \How often do you get nosebleeds?
- Did the nosebleed involve one or both nostrils?
Nosebleed prevention
Nosebleeds are both messy and uncomfortable. Luckily, there ways to prevent them.
- Avoid common causes of nosebleeds like blowing too hard, picking at sensitive nasal tissue and do your best to avoid hard hits to the nose.
- Blow your nose gently and avoid picking at or scratching the area. Forceful nose blowing or picking can open or reopen the small blood vessels in your nose. Sneeze through an open mouth. Always sneeze into a tissue or into the bend of your arm.
- Other ways to prevent nose bleeds include using a humidifier in your home, over-the-counter saline nasal sprays, drops or ointments (Ayr Gel®) daily to keep nasal surfaces moist.
- With nasal ointments use a cotton swab to apply and do not insert swab more than 1/4t inch into the nose.
- Quit smoking, in addition to its myriad health liabilities and risks, smoking dries out the nose and can irritate it.
- If you’re involved in activities that could result in an injury to your face or nose, be sure to wear protective gear.
- Cut fingernails short, especially for children who may pick inside their noses.
- Over-the-counter medications like aspirin, ibuprofen and naproxen can increase bleeding risk. Acetaminophen (Tylenol®) does not cause bleeding and may be a better choice for some.
- Allergy nasal sprays, like fluticasone (Flonase®), can cause nosebleeds and may require stopping for a short period of time or permanently for others.
Wisconsin is a wonderful place to live, but winter can bring discomfort through persistent dryness. For more information on how your Wisconsin-based health plan can help you enjoy health and wellness year-round, contact us today.
