For most people, this page is the most significant, because most common nosebleeds are things that can be controlled, and hopefully prevented to the point of making them an infrequent event.

Control is divided into two areas:

prevention in the first place, and stopping a nosebleed when it happens.


Prevention:

Prevention attacks the causes of nosebleeds for most people.

Dry Conditions: At home, control the humidity in your home, particularly in the winter months when it is likely to be dry. Air can only hold a certain amount of moisture, and as temperature lowers outdoors, that possible moisture content outdoors also lowers. This is called "relative humidity".  80% relative humidity for air that is below freezing is not that much moisture. When that air is heated indoors, the air expands and the relative humidity of that volume of air lowers, to the point where that air can be very dry. For comfortable living conditions, we have to add moisture to the indoor air.

Signs of dryness are things like static electricity. I suggest buying a hygrometer, an instrument for measuring the relative humidity of the air in your home. Simple ones that are probably accurate to at least 5% are available for less than $20 at hardware stores.

A common recommendation for indoor humidity is 30 to 50%. I push it to the 50% end because of my nosebleed problem. You may have to monitor this according to any problems like moisture on windows or mildew that can develop in homes with too much humidity.

Get yourself a good console humidifier, unless you have options for adding moisture to your home heat-- though I have never found the typical furnace add-on humidifier very effective.

Be sure to clean the humidifier regularly according to the manufacturer's instructions, and replace things like media pads or wicks on a regular basis. You might also benefit from a small countertop humidifier in your bedroom, particularly if it's a distance from your main one.

You have less control of your work environment. I have a larger countertop humidifier in my office that I found at a clearance sale, and it does seem able to bring up the humidity. Without it, I have gone into my office after a weekend (particularly if the heat was up high) and found the humidity to be 10% or less. Bad!


Nasal Treatments: There are a variety of nasal sprays and creams on the market, and I see it increasing, perhaps an indication of the problem people are having. Some sprays are simply a saline solution, which moistens the nasal passages. Other sprays attempt to mimic the nasal secretions and seem also effective. Creams are also available, and some people find these helpful, particularly when taken before bed. Unless you have strong nasal tissue (which is unlikely if you are having a problem), don't apply these by running a Q-tip up your nose with it-- just put a dab on a fingertip, hold it to the nostril and snuff it up the passage.

Don't use nasal sprays that are decongestants. While these have a possible role in stopping a nosebleed (see below), they shrink the nasal membranes and blood vessels and can dry them further. As well, they frequently have a rebound effect when they are stopped, causing swelling of blood vessels.

Find a suitable cream or spray for you, and use it regularly in dry conditions.   I'm a fan of Rhinaris products (the spray... cheapest at Superstore) which are not medicated and therefore have almost no side effects.  See www.rhinaris.ca


The inside story: Your body's moisture content, the strength of the blood vessels, and the clotting ability of your blood all play roles as well.

Drink water frequently in these dry times to keep your body moisture content up. Caffeinated beverages are "diuretics" that provoke urination and a lower moisture content, so don't count them as helping. Vascular strength is believed to be improved by balanced diets, and I am led to believe that vitamin supplements in the following areas are of help.

Vitamin C is felt to promote stronger blood vessels-- people with lack of this are prone to bruising and depletion leads to scurvy where bleeding from tissues is frequent. I supplement with 500 mg a day, preferable time-release.

Vitamin A is felt to improve tissue and mucus membranes. This is a vitamin where there is an upper limit (generally about 20,000 IU/day for adults) that if exceeded can cause health problems. Many people recommend about 10,000 IU of Vitamin A per day, or its precursor Beta Carotene, which is converted to A.

I have read of the value of Bioflavonoids in strengthening blood vessels. Among the old cures for nosebleeds is the recommendation to eat the white rind of citrus fruits like oranges (Tasty??? I think not.), and it happens that these parts of the fruit are rich in Bioflavonoids. You can probably buy bioflavonoid tablets at health food stores, and I usually take about 200 - 400 mg per day. Numerous other health benefits are attributed to bioflavonoids as well, so they may be a good general bet.

Vitamin K is the prime vitamin for assisting in blood clotting, but because of the need to achieve a balance in clotting (blood too eager to clot can do just that), I would not recommend supplementing it without the recommendation of a doctor who has done blood tests that indicated the need to improve that factor.

While Vitamin E is a necessary vitamin for many reasons, it does thin the blood and should not be taken to excess if you are intent on preventing nosebleeds. Many people recommend 200-400 IU per day.

As mentioned on the causes page, medications like aspirin and N-SAID pain medications (Voltaren, Naproxin, Vioxx, Celebrex, etc.) reduce the clotting of blood and make stopping a nosebleed more difficult.

Stopping a Nosebleed

Stopping a bleeding nose is an area where we can find some science and perhaps some hocus pocus. The general rule for the nosebleed sufferer, however, is go with what works. Certainly there are differences in physiology, and what works for one may not be as effective for others.

I haven't spent much time on things like putting folded brown paper under the upper lip, or even pencil shavings (both believed to contain a chemical that promotes blood clotting). As well, I didn't find that ice on the back of the neck was effective for me, believed to constrict the blood flow.  Some find that ice on the upper lip constricts vessels supplying the nose, but that's a difficult one while you are having a nose bleed as well.

Recommended practice is frequently as follows:

Sit down, keep the head upright in a normal position (don't tilt back-- blood flows more easily to the back and down the throat; better to let it pool in the nose to promote clotting. Certainly don't put head between knees, which I heard suggested years ago.... that increases flow to the head)

Blow the nose gently to remove initial clots before you start pinching it.

Pinch the nose reasonably firmly with thumb and finger on the soft sides of the nose just above the nostrils just short of the facial bone, and push slightly upward and back at the same time (as in "up the nasal passage"). Most people use a pad of tissue or soft cloth to stop seepage from running down on them.  Keep that position and pressure steady until you think the bleeding may be stopped (wait at least 10 minutes before checking, for most people). If blood is running down the back of the throat, lean just slightly forward to help pool it in the forward passage area. A cold cloth or compress on the nose and cheeks may slow blood flow.

Some people suggest that if the bleed is not stopped in about 15-20 minutes to seek medical attention. I would be seeking it most times at that rate. Govern it by whether or not blood is still escaping through the back of the nose. If significant bleeding is taking place there, you can lose quite a bit of blood over time, and should get yourself transported to where help is available if needed-- sometimes in severe bleeds the nose must be packed to stop bleeding or blood vessels must be cauterized (sealed by touching with a long thin stick treated with silver nitrate that produces heat when in contact with fluids). Extreme loss of blood, coupled with the stress of the nosebleed, could lead to passing out, a dangerous situation, particularly if no one is present to assist.

Blood pressure is a factor in bleeding, of course, and you need as much as possible to keep it down. While saying so doesn't make it so, try to remain calm, take slow breaths and try as much as possible to relax. Don't walk around. If you are assisting someone else, try to reassure them and get them as calm as possible.

When the bleeding has stopped, remain still for as long as possible, and don't do any strenuous activity for the next several hours, nothing really strenuous for the next few days (don't go out and play a few rounds of handball!).

Some new ideas:

Certain decongestant nasal sprays like Otrivin or Neo-Synephrine will shrink the nasal blood vessels within mere minutes. Doctors will sometimes use this as a start to stopping a nosebleed, and it is often used to quickly reduce swelling for nasal examinations. Keep a squirt bottle of this on hand, and give the nostrils a few puffs before applying the pinch. There is a caution not to make use of these sprays too frequently. Use over even several days can produce a rebound effect that swells the blood vessels.

A company makes an inexpensive nasal clamp that they say will replace the fingers for pinching the nose. This may be effective for you, freeing the hands (which can become pretty stiff and sore during long bouts).   I tried one (NoseAid Clip) but it didn't have enough pressure for my situation.  It may work for you if you have mild nose bleeds.  They used to have a website, but it doesn't seem to exist anymore, though the device is offered at some online drugstore sites... check with a local drugstore.
 

The latest thing is a product called "Nosebleed QR", at the moment only available in the USA, not yet approved for Canada, but they hope to be soon. I picked up a couple of them, but fortunately have not had the opportunity to try them! A kit that sells for about $10 contains two applications... each being a long swab and a capsule of powder. You break open the capsule, swirl the swab in it, and apply to the nostril. It claims to "instantly stop bleeding". The powder is partially a potassium salt that triggers a fast artificial "clot".

Check out: http://www.biolife.com

 

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