Why do I bleed when I blow my nose?

An estimated 60% of people have experienced a nosebleed, but only around 10% of cases require medical attention.

It can be hard to determine what causes broken blood vessels in the nose. However, there are several factors that may contribute to or cause the nose to bleed when blowing it.

In this article, we explore what causes bleeding when a person blows their nose and how to treat it.

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Blood can appear when blowing the nose due to:

• blowing the nose too hard or too frequently
• inflammation or mucosal irritation caused by infection or allergies
• very dry nasal cavities or sinuses
• nose picking
• foreign object in the nose
• prolonged inhalation of very dry or cold air
• antibiotic medications
• blood thinning medications, such as warfarin, aspirin, and clopidogrel
• injury to the nose or face
• environmental factors, such as humidity or being at a high altitude
• abnormalities in the septum, which is the wall that separates the nostrils

Nose bleeds are more common in children and older people.

Other causes of nosebleeds include:

• nasal, sinus, face, or eye surgery
• foreign bodies in the nose
• nasal polyps or tumors
• inflammatory conditions
• high blood pressure
• holes in the septum
• blood disorders, such as low blood platelet levels and anemia
• conditions affecting the blood vessels, such as arteriosclerosis
• leukemia, a type of blood cancer condition affecting the immune system
• liver or kidney problems
• scurvy, or severe vitamin C deficiency
• chemotherapy
• congestive heart failure
• chronic use or overuse of certain herbal supplements, most commonly vitamin E and gingko biloba
• exposure to toxic chemicals
• snorting illegal drugs, especially cocaine
• being on chronic oxygen via nasal cannula

Some hereditary or genetic conditions that cause atypical bleeding can also lead to blood appearing when the nose is blown. These include:

• von Willebrand disease
• hereditary hemorrhagic telangiectasia
• factor VIII deficiency (hemophilia A)
• factor IX deficiency (hemophilia B)
• factor XI deficiency

In most cases, a nosebleed or minor bleeding from the nose eventually stops on its own after a few minutes.

Some at-home remedies, however, may encourage nosebleeds to stop earlier or reduce the amount of bleeding.

Treatments at home

The following steps can help stop a bleeding nose:

• sit down
• relax and breathe through the mouth
• lean forward slightly so blood does not drip to the back of the throat
• gently but firmly pinching the nose, down by the nostrils and not up by the nasal bones

Do not pick the nose after bleeding ceases.

Around 90 percent of nosebleeds occur in the front bottom portion of the septum, the fleshy wall that divides the nostrils.

Prolonged or repetitive nosebleeds, or those caused by an underlying medical condition, require medical attention and treatment.

If nosebleeds are severe, a person may require more aggressive treatment to prevent extensive blood loss.

Medical treatment

Medical treatment options include:

• nasal packing, where sterile cotton pads or dressings are packed into the nostril to limit bleeding
• topical medications to limit bleeding, known as local hemostatic agents
• topical antiseptic and antibiotic ointments and creams
• sealing a blood vessel shut using an electrical device or chemical, such as silver nitrate
• surgery where the blood vessel is packed with sterile materials to block it off
• surgery where the blood vessel is tied together to seal it shut
• clotting medications
• blood transfusions

In many cases, there is no specific way to avoid nosebleeds, but there are some things that may help prevent or reduce the risk of them.

Blowing the nose gently and not picking at the skin can usually prevent minor bleeding.

Other tips for preventing bleeding when blowing the nose include:

• applying over-the-counter nasal lubricants or petroleum jelly in the nostrils to prevent dryness
• using saline sprays to prevent dryness
• avoiding picking the nose, especially scabs
• avoiding blowing the nose aggressively or too frequently
• protecting the nose from cold or dry air by using a scarf
• not overusing or misusing nonsteroidal anti-inflammatory medications (NSAIDs) and antibiotics
• reducing inflammation and nasal congestion by using a nasal or sinus rinse
• avoiding exposure to toxic chemicals
• not using illegal drugs, especially cocaine

One example of a nasal rinse is a Neti pot. These are commonly available online and can be used at home.

People should seek medical attention anytime a nosebleed does not stop within 20 minutes of applying pressure to the nose.

Seek medical attention if the nosebleed:

• is long lasting, heavy, or recurrent
• there is accompanying dizziness or weakness
• is keeping a person from their usual activities

It is important to talk with a doctor about chronic or repetitive nosebleeds.

Chronic nosebleeds can be a sign of underlying medical conditions, such as blood or inflammatory disorders. Prominent blood vessels tend to be the underlying cause.

Repetitive nosebleeds, especially when they only involve one nostril, can also be a sign of nasal deformities or tumors.

People should also seek medical attention if nosebleeds are accompanied by any of the following symptoms:

• pain or tenderness around the eyes
• stuffy nose that continues to get worse and will not clear
• mucus that drips in the back of the throat
• change in the appearance of the nose or surrounding area
• pus in the nose
• chronic watery eyes
• reduced sense of smell
• change in vision
• enlarged lymph nodes in the neck
• pain or pressure in the ears
• hearing loss
• numbness in the face
• loosening, numbness, or pain in the teeth
• difficulty opening the mouth
• headache

Bleeding from the nose when blowing is a common experience and tends to affect young children and older adults more often.

It can occur due to inflamed or damaged nasal tissues and blood vessels. Nosebleeds are generally harmless and stop on their own or after applying gentle pressure to the area.

Severe or repetitive nosebleeds can be a sign of an underlying medical condition, such as blood disorders or obstructions, that may require treatment.

People should speak with a doctor about severe or repetitive nosebleeds, especially when it accompanies additional symptoms.