What does nosebleed mean?

With a nosebleed (technical term also: epistaxis ) blood suddenly runs out of the nose. Sometimes it drips on both sides with the nosebleed, sometimes only from one nostril. This often creates a moment of shock, sometimes a few stains on clothing or the table top, and is generally not very pleasant. In most case, there is no serious cause behind it, nosebleeds are usually harmless.

The fact that the nose is bleeding at all is because the nasal mucous membrane is well supplied with blood. The fine blood vessels are very sensitive and can easily tear - especially if the mucous membrane is dry and irritated, for example from cold winter or dry heating air or from a cold . Since several blood vessels meet in the front part of the nose, this is where the nose bleeds most often.

If that happens, you usually don't need to worry. Dangerous nosebleeds usually come from the back of the nose. If this is the case or if the nosebleed cannot be stopped after approx. 20 minutes, you should have a doctor clarify the cause.

Nosebleeds: these can be the cause

There are several reasons for a nosebleed. The harmless ones are mostly so-called local causes . This means that the cause of the bleeding is in the nasal area itself. There are also systemic causes . In this case, the nosebleed has an organic cause, i.e. it is a sign of an underlying disease or a side effect of certain medications. If you have never had a nosebleed before and now suddenly, or if you get nosebleeds very often, a doctor should clarify why.

Local causes of nosebleeds

• The reason why there is bleeding from the nose is often simply because the person affected has blown or puffed in the nose and damaged the blood vessels in the nasal mucous membrane. For example, nosebleeds from a cold are not uncommon. In this case, the nosebleed can also occur during sleep, namely when the sinus lining is bleeding due to a strong runny nose.
   
• It is even more likely that the nasal lining will bleed if it was previously irritated or damaged. This explains, for example, why nosebleeds can result from dry air: if the nasal mucous membrane dries out, it makes it “more prone to bleeding”. Furthermore, nosebleeds can occur due to an allergy, because hay fever , for example, also irritates the nasal mucous membrane.
   
• Quite an obvious and immediate reason for a nosebleed is a fall or a blow on the nose.
   
• In addition, deformities and injuries to the nasal septum can also cause nosebleeds.

Systemic causes of nosebleeds

• Stress can make your nose bleed. This is probably dues to the fact that more blood then flows through the vessels, making them more likely to burst.
   
• A nosebleed can also be a symptom of an illness, especially if it occurs often and for no apparent reason. It can be a sign of kidney disease or it accompanies measles , flu, and other febrile infections.
   
• In addition, nosebleeds can accompany leukemia ( blood cancer ) if the disease causes too few blood platelets. In rare cases, there is also a tumor behind the nosebleed.
   
• High blood pressure can also make the nose bleed, because the increased pressure stresses the sensitive vessels and makes them more likely to burst. Symptoms that may indicate this cause include nosebleeds and headaches .
   
• Nosebleeds and iron deficiency are also often associated. Here, both the iron deficiency can cause the nosebleed and the nosebleed (due to the loss of blood) the iron deficiency.
   
• Sometimes certain medications can also increase the likelihood of nosebleeds. Epistaxis from blood thinners is an example of this. If the person concerned does not tolerate the drug or if the dose is too high, a blood thinner can trigger unwanted bleeding, such as one in the nose.
   
• In addition, nosebleeds are a common but harmless phenomenon during pregnancy. It arises simply because the mucous membranes are more supplied with blood during this time.
   
• Excessive consumption can cause nosebleeds from alcohol. Because it disrupts blood clotting, which can affect the function of the vessels.

Stop nosebleeds: here's how

If blood drips from the nose all of a sudden, the first reflex for many is to lean your head back. But that's exactly what you shouldn't do, as this can cause the blood to run into your stomach and make you feel sick. But there are plent of other things you can do yourself to stop the nosebleed.

Nosebleed, what can you do by yourself?

Instead of tilting your head back if you have a nosebleed, it is better to let your head hang forward . You should also not lie down, as this could cause the blood to enter the airways. Instead, sit down, which will help lower your head blood pressure, or at least elevate your head in case your nosebleed makes you drowsy.

A first aid measure that you can use as a support is a cold compress (cool pack or wet towel) on the neck. The cold will cause the blood vessels in your nose to contract and the bleeding should stop. You can also pinch the front of the nostrils for a few minutes to stop the nosebleed. In this way, you squeeze the blood vessels shut.

Since the nostrils in the mostly harmless front nosebleed can be stuck together with blood clots, which may cause the nose to bleed again if you pluck it off, you should carefully remove it with a damp cloth.

In addition to these remedie, there are some home remedies for nosebleeds that some sufferers swear by. But: Their effect has not been scientifically proven and it has not been said whether they work.

For example, a halved onion that you hold under your nose is said to stop bleeding thanks to its essential oils. The acidity of a cotton ball soaked in vinegar and lemon juice is supposed to cause the tissue to contract and the bleeding to stop, and a short footbath in cool water is supposed to cause the blood vessels to collapse and the bleeding to stop.

Treat nosebleeds at the doctor's

If you have frequent nosebleeds or if it comes on suddenly even though you have never had one, you should see a doctor. He clarifies the cause and can undertake appropriate treatment.

• If the source of the bleeding can be clearly seen, the doctor can obliterate the blood vessels that are responsible for the nosebleed. He does this, for example, with acid etching or laser.
   
• If the doctor can't tell exactly where the nosebleed is coming from, tamponade is one way to stop the red trickle. He usually uses gauze strips soaked in ointment or foam tamponades for this. By the way: The tamponade always goes into both nostrils, even if there is bleeding from one. This is the only way to create enough pressure on the blood vessels.
   
• If the bleeding cannot be stopped and / or is very heavy, the doctor can close the blood vessels with a clip or with an operation. If the cause is a bleeding disorder , appropriate medication can also stop the nosebleed.
   
• If an underlying disease such as high blood pressure triggers the nosebleed, this must also be treated.

Most of the time, nosebleeds are harmless and you do not have to see a doctor. In certain situations or with certain additional symptoms, a visit to the practice is useful and necessary. These include the following:

• The nosebleed does not stop or is very severe. If it is not stopped after 20 minutes in adults, the blood loss can sometimes become too high.
• The nosebleeds are common . Here it is advisable to have the cause clarified.
• The origin of the bleeding is in the upper part of the nose . If so, the blood is mainly going to the throat and not the nose. Such bleeding can be serious and should be investigated.
• If you have fallen or sustained a skull injury and light-colored liquid runs out of your nose, you should call the emergency doctor (emergency number: 112) and have yourself driven to the hospital. It could be cerebral fluid!