One of the most frightening sights as a parent is to see your child bleed from the nose. Nosebleeds are common in children 3 to 10 years old, and most are caused by nose-picking or dry air. In most cases, it is not serious and can be treated at home. It occurs due to bleeding from small vessels of your child’s nose. It happens as a result of a break in the tissue lining of the nose (mostly in the front part or “anterior” of the nose).      

The medical word for nosebleed is epistaxis. In simple words, it is the loss of blood from the tissues lining your child’s nose. Most often, nosebleeds are differentiated from the site of the bleed. There are two main types in adults as well as children:

  • Anterior nosebleed starts in the front of the nose, on the lower part of the wall that separates the two sides of the nose (called the septum). Capillaries and small blood vessels in the front area of your nose are weak and can easily break and bleed. This is the most common type of nosebleed and is usually treated at home.

  • Posterior nosebleed is more serious than an anterior nosebleed. It occurs deep inside the nose, caused by a bleed in larger blood vessels in the back part of your nose. Heavy bleeding due to this can cause blood to flow down the back of your throat. More common in adults, this type of nosebleed requires immediate medical attention.

Causes of Nosebleed in Children

  • Irritation and lack of moisture in the nasal membrane (tissues lining your child’s nasal passages).

  • Dry air or warm air can lead to crusting of membranes inside your child’s nose and it may cause itching, which can lead to scratching or nose picking. As a result, it leads to bleeding.

  • Allergic conditions like sinusitis (infection of your child’s sinuses), the flu, or the common cold.

  • Repeated nose blowing.

  • Excessive use of antihistamines (medications to stop allergic symptoms) and decongestant medicines (medicines used to relieve congested or blocked nose).

  • A serious head injury.

  • Bleeding disorders, such as hemophilia (a rare disorder in which your child’s blood doesn't clot normally).

  • In some cases, bleeding can occur from the posterior part of your child’s nose which can be dangerous. It can cause blood to flow down the back of your child’s throat.

Less common causes of nosebleeds in children can include:

  • Certain medications, including blood thinners (medications that are taken to prevent a blood clot)

  • Heart diseases

  • High blood pressure (hypertension)

  • Cancer

Symptoms of Nosebleed in Children

The main symptom of a nosebleed is blood dripping or running from your child’s nose. Other symptoms include:

  • Irritation or swelling in the nose

  • Faster heartbeat (palpitations)

  • Shortness of breath

  • Pale skin

Most often, nosebleeds can be treated at home. If your child’s bleeding does not stop after trying the following tips, then your paediatrician will have to examine your child.

Treating Nosebleed at Home

  • Do not panic and remain calm.

  • Make your child sit in your lap and tilt his/her head slightly forward.

  • Gently pinch your child’s nose with a clean cloth.

  • Keep applying pressure on his/her nose for about 10 minutes. If you stop too soon, bleeding may start again.

  • Make sure your child is not leaning back; it may cause blood to flow down the throat of your child which may, in turn, cause gagging (choking), coughing, or vomiting.

  • Discourage your child to blow his/her nose, picking, or rubbing it too hard.

  • Applying an ice pack on your child’s forehead might help. You can also apply an ice pack on the nose, upper lip, or back of your child’s neck. This may help to constrict the blood vessels and reduce the bleeding.

When to Call Your Doctor?

  • Frequent nosebleeds in your child.

  • If bleeding does not stop for more than 15 to 20 minutes or it is difficult to control the bleeding.

  • A foreign body in your child’s nose.

  • Bleeding from any other site as well.

  • Associated symptoms like fever, rashes, etc.

  • Bruises on your child’s nose.

  • Side-medication that your child would have recently started or any long-term medications that your child might be taking.

Urgent Attention is Needed When

  • Bleeding is heavy

  • Associated with weakness or dizziness

  • Head injury or history of fall

  • Bleeding continues after two attempts of applying pressure for 10 minutes each  

Treatment of Nosebleeds in Children

Your child’s doctor will try to stop his/her bleeding using the following methods:

  • Applying silver nitrate (can induce blocking) to blood vessels to seal them.

  • Cauterizing (burning) the blood vessels to seal them.

  • Packing the nose with medicated gauze to constrict the blood vessels.

After stopping the bleeding, the doctor will examine your child to determine the cause. In rare cases, your child may require surgery to fix a problem with the blood vessels in the nose.

Prevention of Nosebleeds in Children

  • Avoid nose picking (keep fingernails trimmed most of the time)

  • Use saline nasal spray frequently during illnesses like fever, cold, or flu

  • Steam inhalation helps to reduce mucous membrane inflammation

  • Protective gears while playing or driving to prevent injury 

Even after taking all the precautions, sometimes your child starts bleeding without any obvious reason. Do not panic as most of them are harmless and can be stopped easily. Consult your paediatrician/ENT specialist immediately.


Disclaimer: This article is written by the Practitioner for informational and educational purposes only. The content presented on this page should not be considered as a substitute for medical expertise. Please "DO NOT SELF-MEDICATE" and seek professional help regarding any health conditions or concerns. Practo will not be responsible for any act or omission arising from the interpretation of the content present on this page.