Question: What could be the cause/reason for on/off frequent nosebleeds from one nostril?
Answer:
First of all, thank you for your question. Frequent nosebleeds (epistaxis in medical terms) is quite a common problem. We see this most often during the winter when the heat is on. If we heat room air from 30 to 65 degrees, the humidity drops down to levels one sees in the desert. The mucous membrane lining of the nose then can dry out and crack, causing a nose bleed. It there is a prominent blood vessel on one side- or if the septum- (center wall of the nose) is deviated (twisted)- then there can be a prominent point on the wall that the air hits and dries out faster. Both of these will cause nose bleeds to be more common on one side.
If you are taking aspirin (even baby aspirin) or a blood thinner- then the bleeding can often become more problematic- as these medications delay the forming of a clot- or scab.
When the lining of the nose is more swollen (from a cold, allergies or a sinus infection- among other causes)- then there is greater blood flow to the nasal lining, and that also makes people more susceptible to nose bleeds.
Lastly, and thankfully least commonly, there can be a growth- benign or malignant tumor- in the nose that causes bleeding.
Try to keep the nasal passages moist in the winter- use topical saline sprays, ointments to the tip of the nose, humidifier if you can keep clean,-
If you have a nose bleed- put some cotton in the nose- with Afrin(oxymetazoline 0.05%) if you have- and find a clock. Then pinch the bottom of your nose for 5 minutes (about the time it takes to form a clot in most people)- but longer if you are taking a blood thinner.
If the bleeding persists, you need to seek medical care, and if you continue to have bleeding from one side of the nose, even if it stops. It is important to have your nasal cavities evaluated to make sure there is no worrisome cause and to see if there is a blood vessel that needs to be cauterized.
I hope this clears things up.
Robert Pincus MD
Co-Director NY Sinus Center
Frequently Asked Questions
Frequent nosebleeds from one nostril often occur due to dryness of the nasal mucous membrane, especially in winter when indoor heating reduces humidity drastically. Structural factors like a deviated septum or a prominent blood vessel on one side can lead to more frequent bleeding on that side. Additionally, nasal inflammation from colds, allergies, or infections increases blood flow and susceptibility to bleeding.
Indoor heating during winter significantly lowers humidity levels, drying out the nasal mucous membranes. This dryness causes the lining to crack and bleed more easily. Using humidifiers and nasal moisturizers can help maintain proper moisture and reduce the risk of nosebleeds caused by dry air.
Yes, aspirin and blood thinners can make nosebleeds more frequent or severe because they interfere with the blood's ability to clot. Even low-dose aspirin, such as baby aspirin, can delay clot formation, making it harder to stop nasal bleeding.
To stop a nosebleed, insert cotton into the nostril optionally soaked with Afrin (oxymetazoline 0.05%), then firmly pinch the bottom part of your nose and hold for at least five minutes, or longer if you are on blood thinners. This pressure allows a clot to form and typically stops the bleeding.
You should seek medical care if nosebleeds persist despite home treatment or if bleeding continues or recurs from one nostril. Persistent unilateral bleeding requires evaluation to rule out serious causes like tumors or to identify blood vessels that may need cauterization.
Prevent nosebleeds by keeping nasal passages moist with saline sprays, applying ointments to the inside of the nose, and using a humidifier to increase air moisture. Avoiding nasal trauma and managing allergies or colds promptly also helps reduce bleeding episodes.
Although uncommon, benign or malignant tumors in the nasal cavity can cause frequent bleeding from one nostril. This possibility highlights the importance of medical evaluation if unilateral nosebleeds are recurrent, especially if they do not respond to usual treatments.
