Topic Overview

Nosebleeds that recur often are commonly caused by bleeding from the front of the nose (anterior epistaxis). Common causes of this type of nosebleed are:

• Blowing or picking the nose.
• Structural problems in the nose, either present from birth (congenital) or caused by an injury.
• Low humidity.
• Minor health problems, such as colds or allergies.
• Minor injuries to the nose.
• Medicines. Examples include:
  • Aspirin, warfarin (such as Coumadin), enoxaparin (Lovenox), clopidogrel (Plavix), or nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Antihistamines, decongestants, and medicated nasal sprays that dry the tissue of the nose and sinuses.

Recurring nosebleeds can also be caused by:

• Rupture of the blood vessels that are very close to the surface of the lining of the nose.
• An abnormal growth (polyp or tumor) in the nose or sinuses.
• Health conditions that affect normal blood clotting.
• Abnormal blood vessels in the nose, such as with Osler-Weber-Rendu syndrome. This syndrome is passed in families (inherited). The abnormal blood vessels make it hard to control a nosebleed.

A nosebleed that recurs 4 times or more in a week needs medical evaluation to determine the seriousness of the problem. A nosebleed that recurs 2 to 3 times in a month may mean that a chronic condition such as allergies is causing the nosebleeds.

When nosebleeds cannot be controlled by home treatment, you need to see your doctor.