Nosebleeds

What causes nosebleeds in children?

Though incredibly common in children, nosebleeds often create unnecessary confusion and anxiety for parents. Most cases resolve themselves quickly and have no further health implications for the child. Nosebleeds generally result from dry nasal linings and excessive picking or scratching. Occasionally, a persistent case or serious damage to the nasal lining may require specific treatment. In extremely rare cases, a nosebleed may be the presenting symptom of a serious local or generalized disease.

The most common causes of nosebleeds are:

  • Dry, irritated mucus membranes in the nose (usually the result of dry, heated, indoor air)
  • Severe colds or allergies (with lots of sneezing, coughing, nose blowing, etc.)
  • Excessive picking and scratching
  • Bleeding disorders

Any of these slight traumas can irritate the fragile blood vessels of the nasal lining and cause bleeding. Nosebleeds are most common in the winter, when air from central heating combines with an increase in colds to inflame, dry and crack the nasal lining.

How to treat your child's nosebleed

If your child has a nosebleed, here are some steps to help you calm the child and stop the bleeding:

  1. Have the child lean forward slightly, being sure the head is higher than the heart. Leaning back may make the child swallow the blood (causing nausea) or cough or choke on the blood.
  2. Pinch the soft parts of the nose (the tip and portion of the nostrils just below the bone) together between your thumb and the side of your index finger OR soak a cotton ball with Afrin, Neo-Synephrine, or Dura-Vent spray and place this into the nostril.
  3. Maintain the hold on the soft parts of the nose and pinch the thumb and index finger together firmly.
  4. Hold that position faithfully for a full eight to ten minutes. Avoid releasing the pressure intermittently to check to see if the bleeding has stopped. Continue for another eight to ten minutes if the bleeding hasn't stopped.
  5. Do not pick, rub or blow the nose once the bleeding has stopped. This could dislodge the newly formed blood clot and cause the bleeding to start again.
  6. Apply an icepack to the bridge of the nose and cheeks.
  7. Contact a doctor if bleeding doesn't stop or is accompanied by dizziness, weakness, fainting, or other unusual symptoms. Contact a doctor immediately if there has been a significant loss of blood.

Although nosebleeds are rarely serious, a doctor’s attention may be required if:

  • There is recurrent bleeding
  • There is considerable blood loss
  • It is caused by an injury to the nose, face, or head

In such rare cases, doctors commonly employ a chemical cauterization (usually with silver nitrate) of the enlarged blood vessels. If bleeding persists, more aggressive treatments may be necessary, including electrical cautery or surgery to tie off the injured blood vessel. Surgery is very rarely necessary in children.