A nosebleed that won’t stop can be alarming, but most nosebleeds improve with the right first-aid technique. The key is to sit up, lean slightly forward, and firmly pinch the soft part of the nose continuously for 10 to 15 minutes without checking too soon. If bleeding remains active after that, is very heavy, follows a serious injury, or causes dizziness or weakness, seek medical care promptly. [1]

Nosebleeds, also called epistaxis, usually come from small blood vessels near the front of the nasal septum, the wall between the nostrils. Dry air, colds, allergies, forceful nose blowing, and minor irritation can make these vessels bleed. Less often, a nosebleed is related to an injury, medication that affects clotting, or another medical problem. [2]

What to do right away for an active nosebleed

Use these steps if blood is coming from the nose and the person is awake and breathing normally:

1. Sit upright. Do not lie flat unless you feel faint and need to avoid falling.
2. Lean slightly forward. This helps keep blood from running down the throat, where it can cause coughing, nausea, or vomiting.
3. Blow once gently only if needed to clear clots. Do not repeatedly blow the nose, since that can restart bleeding.
4. Pinch the soft lower part of the nose. Use your thumb and index finger to press both nostrils shut below the hard bony bridge. Pinching higher on the bony part of the nose will not reliably put pressure on the bleeding area.
5. Hold steady pressure for a full 10 to 15 minutes. Set a timer and do not release your grip to check early. Breathe through your mouth.
6. Check after the full time has passed. If bleeding has slowed but has not completely stopped, repeat firm pressure for another 10 to 15 minutes while arranging medical advice if needed.

First-aid guidance recommends sustained pressure to the soft part of the nose while leaning forward. A nosebleed that continues after 15 minutes of correct, uninterrupted pressure or causes lightheadedness should receive medical attention. [1]

What not to do

• Do not tilt the head backward. Blood can run into the throat and stomach.
• Do not stuff tissues, cotton, gauze, or other objects deeply into the nostril.
• Do not repeatedly remove clots or keep checking every minute.
• Do not pick the nose, forcefully blow the nose, or strain while bleeding is active.
• Do not put tools, tweezers, or cotton swabs into the nose to look for a bleeding spot.

When a nosebleed needs emergency care

Call 911 or seek emergency care now if any of the following happen:

• Bleeding is heavy, rapidly flowing, or does not slow with firm pressure.
• The person faints, is confused, has trouble breathing, has chest pain, or is too weak or dizzy to stand safely.
• The nosebleed happens after a serious head, face, or nose injury, especially after a fall, car crash, sports collision, or assault.
• There are possible signs of a serious head injury, such as loss of consciousness, repeated vomiting, seizure, severe or worsening headache, new weakness, or unusual behavior.
• The nose looks clearly crooked or deformed after an injury, there is significant facial swelling, or clear fluid is leaking from the nose after head trauma.
• Blood is pouring into the throat or mouth, or the person is vomiting a large amount of swallowed blood.
• The person has a known bleeding disorder, is receiving cancer treatment that can lower blood counts, or takes a blood thinner and bleeding is heavy or ongoing.

Severe bleeding that continues despite direct pressure or causes symptoms such as drowsiness, dizziness, chest pain, or loss of consciousness can be life-threatening and needs emergency help. [1]

When urgent care may be appropriate

Urgent care or an emergency department may be appropriate when bleeding has not stopped after about 15 to 20 minutes of correct continuous pressure, even if it is not dramatic. Some locations may be able to manage a persistent front-of-the-nose bleed, but an emergency department is the safer choice if bleeding is brisk, blood is going down the throat, you feel unwell, or the urgent care center cannot manage nosebleeds.

Seek same-day medical advice if:

• The bleed stopped but was difficult to control or returns several times in one day.
• You take an anticoagulant or antiplatelet medicine, sometimes called a blood thinner, such as warfarin, apixaban, rivaroxaban, dabigatran, clopidogrel, or daily aspirin prescribed by a clinician.
• You have a known bleeding or platelet disorder.
• You have frequent nosebleeds, especially if they are becoming more common or occur mainly from one nostril.
• You have unexplained easy bruising, bleeding gums, unusually heavy menstrual bleeding, blood in urine or stool, or other unusual bleeding.
• The nosebleed followed nasal or sinus surgery.
• A young child has put an object in the nose, or there is a bad-smelling discharge from one nostril that could suggest a retained object.

Do not stop, skip, or change a prescribed blood thinner on your own because these medicines are often used to prevent serious conditions such as stroke or blood clots. Contact the clinician who prescribed it for individualized advice. People taking anticoagulant or antiplatelet medicines may be more likely to need professional treatment if bleeding does not stop. [1][3]

Common reasons a nosebleed happens

Most nosebleeds start in the front of the nose, where many fragile blood vessels sit close to the surface. Common triggers include:

• Dry indoor air: Heated indoor air and dry climates can dry and crack the nasal lining.
• Colds, allergies, or sinus irritation: Sneezing, congestion, rubbing, and frequent blowing can injure small blood vessels.
• Nose picking or minor trauma: Even a fingernail can damage the delicate lining inside the nose.
• Forceful blowing or repeated sneezing: This can break a superficial blood vessel.
• Nasal sprays or irritants: Overusing decongestant sprays, using irritating substances, or inhaling smoke can irritate nasal tissue.
• Injury: A hit to the nose can cause bleeding, swelling, or a fracture.
• Medicines that affect bleeding: Anticoagulants, antiplatelet medicines, aspirin, and some anti-inflammatory pain relievers can contribute to or worsen bleeding.

Repeated nosebleeds can occasionally be associated with a bleeding disorder, structural issue inside the nose, or another condition that deserves evaluation. That does not mean a frequent nosebleed is automatically serious, but it is a good reason to make a routine appointment with a primary care clinician or ear, nose, and throat specialist. [2][3]

Could it be a deeper nosebleed?

Most nosebleeds are anterior, meaning they begin near the front of the nose and respond to pressure. Less commonly, bleeding starts farther back in the nasal passage. A deeper, or posterior, nosebleed may send blood down the throat even while sitting forward and may be difficult to control with external pinching.

You cannot reliably diagnose the bleeding location at home. However, prompt medical evaluation is important when bleeding is persistent, blood is mainly flowing into the throat, or the person is older, has had prior nasal surgery or facial injury, or takes medicines that affect clotting. Clinicians may use a lighted examination, nasal endoscopy, packing, cautery, or other treatment depending on the situation. [3][4]

Can a nasal decongestant spray help?

Some clinicians may recommend a short-term topical decongestant spray containing oxymetazoline or phenylephrine as an additional measure for certain uncomplicated nosebleeds. These medicines narrow blood vessels temporarily. If you use one, follow the product label and continue firm pressure afterward. It is not a substitute for emergency evaluation when bleeding is heavy or does not stop.

Ask a pharmacist or clinician before using a decongestant spray if you have high blood pressure, heart disease, thyroid disease, diabetes, glaucoma, prostate-related urinary symptoms, take certain medicines, are pregnant, or are considering it for a child. Do not use it more often or for longer than the label allows, because overuse can worsen nasal congestion and irritation. [4][5]

After the bleeding stops

The first several hours after a nosebleed are important because the clot can be disturbed easily. For the rest of the day, and longer if a clinician advises it:

• Do not blow, pick, or vigorously rub the nose.
• Sneeze with the mouth open if possible.
• Avoid strenuous exercise, heavy lifting, bending far forward, and hot showers or hot drinks for at least 24 hours if these seem to restart bleeding.
• Avoid smoking and exposure to smoke, which can irritate the nasal lining.
• Use acetaminophen for pain if it is safe for you and you need it. Ask a clinician or pharmacist before using aspirin, ibuprofen, or naproxen for pain after a nosebleed, particularly if bleeding was difficult to stop or you take a blood thinner.

If a clinician packed your nose or treated a blood vessel, follow their instructions carefully. Do not pull packing out early or use nasal products unless the treating clinician says they are safe.

How to prevent repeat nosebleeds

Keeping the nasal lining moist and avoiding irritation can reduce many recurring nosebleeds:

• Use saline nasal spray or saline gel to moisturize the inside of the nose.
• Consider a clean cool-mist humidifier during dry months. Follow the manufacturer’s cleaning instructions to reduce mold and germ buildup.
• Apply a small amount of saline gel or another moisturizer recommended by a clinician just inside the nostrils; avoid inserting applicators deeply.
• Keep fingernails short, especially for children who pick their noses without realizing it.
• Treat allergies with guidance from a clinician or pharmacist, especially if frequent sneezing and rubbing are triggers.
• Use nasal sprays only as directed and review persistent congestion with a clinician rather than relying on decongestant sprays repeatedly.
• Wear appropriate protective gear during sports or work where facial injury is possible.

Dry air, nasal irritation, and forceful blowing are common contributors to nosebleeds. Saline products and appropriate humidification may help reduce dryness-related irritation. [2][4]

What a clinician may do for a persistent or recurring nosebleed

A clinician will ask about the amount and pattern of bleeding, recent injuries, nasal symptoms, medications, medical conditions, and other signs of abnormal bleeding. They may look inside the nose for a visible bleeding source or a foreign object. Depending on your history and exam, they may recommend blood tests, treatment for allergies or nasal dryness, cautery to seal a bleeding vessel, or nasal packing.

People with repeated one-sided nosebleeds, recurrent bleeding despite prior treatment, or a history that raises concern for a structural problem may need an examination with a small camera called nasal endoscopy. [3]

When to make a routine appointment

Make a non-urgent appointment with a primary care clinician if you have recurrent nosebleeds, repeated bleeding from one nostril, chronic nasal congestion, or frequent crusting and irritation. Bring a list of your prescription medicines, over-the-counter products, vitamins, and supplements. It can also help to note how often bleeding occurs, how long it lasts, whether it starts on one side, and what you were doing before it began.

Most nosebleeds are manageable at home. Still, a nosebleed that does not stop with correct pressure, occurs after a meaningful injury, or comes with dizziness, weakness, or heavy blood loss should never be ignored.

References

1. American Heart Association. 2024 American Heart Association and American Red Cross Guidelines for First Aid [Internet]. Dallas (TX): American Heart Association; 2024 [cited 2026 Sep 28]. Available from: https://cpr.heart.org/en/resuscitation-science/2024-first-aid-guidelines
2. MedlinePlus Medical Encyclopedia. Nosebleed [Internet]. Bethesda (MD): U.S. National Library of Medicine; reviewed 2025 Jul 28 [cited 2026 Sep 28]. Available from: https://medlineplus.gov/ency/article/003106.htm
3. Tunkel DE, Anne S, Payne SC, et al. Clinical practice guideline: nosebleed (epistaxis). Otolaryngol Head Neck Surg. 2020;162(1 Suppl):S1-S38. doi:10.1177/0194599819890327. Available from: https://pubmed.ncbi.nlm.nih.gov/31910111/
4. American Academy of Otolaryngology-Head and Neck Surgery. Nosebleed FAQs [Internet]. Alexandria (VA): ENT Health; [cited 2026 Sep 28]. Available from: https://www.enthealth.org/be_ent_smart/nosebleed-faqs/
5. U.S. Food and Drug Administration. Final administrative order OTC000026: cough, cold, allergy, bronchodilator, and antiasthmatic drug products for over-the-counter human use [Internet]. Silver Spring (MD): U.S. Food and Drug Administration; 2022 Oct 14 [cited 2026 Sep 28]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/omuf/Order/OTC%20Monograph_M012-Cough%20Cold%20Allergy%20Bronchodilator%20and%20Antiasthmatic%20Drug%20Products%20for%20OTC%20Human%20Use%2010.14.2022_0.pdf