When to see a doctor if a child has a nosebleed

Children
Nosebleeds are common in children but are usually short-lived and rarely a cause for concern. Persistent, recurring, or very heavy bleeding may, however, require medical attention.

Doctors refer to nosebleeds as epistaxis. Approximately 60 percent of people will experience a nosebleed at some point during their life. However, nosebleeds occur most commonly in children aged between 2 and 10 years and in older people aged 50 to 80 years.

Although the bleeding can sometimes be alarming, only about 10 percent of nosebleeds are serious enough to require medical treatment.

In this article, we explain what to do when a child’s nose starts bleeding and when to see a doctor. We also discuss medical treatments, causes, and tips for prevention.

What to do

Child with nosebleed being comforted by mum
People can treat most nosebleeds at home.

A person can usually treat a child’s nosebleed at home. It is important to stay calm because most nosebleeds are short-lived and do not indicate a serious problem.

To treat a child with a nosebleed:

  • Start by sitting the child down and reassuring them. Have them sit upright and leaning slightly forward.
  • Do not lean the child back or lie them down because this can cause them to swallow the blood and may lead to coughing or vomiting.
  • Gently pinch the tip of the child’s nose between two fingers using a tissue or clean towel and have them breathe through their mouth.
  • Continue to apply pressure for around 10 minutes, even if the bleeding stops.

Do not fill the child’s nose with gauze or tissue and avoid spraying anything into the nose.


When to see a doctor

Children with nosebleeds do not typically require medical attention. Most nosebleeds are short-lived, and it is usually possible to treat the child at home.

However, talk to a doctor if the nosebleeds:

  • occur frequently
  • change from a familiar pattern to a new one
  • occur alongside chronic congestion or other signs of easy bleeding or bruising
  • begin after the child starts taking a new medication
  • regularly require a trip to the emergency room

A nosebleed requires urgent medical attention if:

  • it continues after 20 minutes of applying pressure to the child’s nose
  • it occurs following a head injury, fall, or blow to the face
  • the child also has an intense headache, a fever, or other concerning symptoms
  • the child’s nose appears misshapen or broken
  • the child shows signs of having lost too much blood, such as looking pale, having little energy, feeling dizzy, or passing out
  • the child begins coughing up or vomiting blood
  • the child has a bleeding disorder or is taking blood thinners

Medical treatment

Children with severe nosebleeds should see a healthcare professional, who will try to stop the bleeding.

Treatment options for nosebleeds include:

  • applying silver nitrate to blood vessels to seal them
  • cauterizing, or burning, the blood vessels to seal them
  • packing the nose with medicated gauze to constrict the blood vessels

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


Causes

Kids playing football with their dad in a park
An injury or blow to the face can irritate blood vessels in the nose.

Most nosebleeds are anterior nosebleeds, which means that the bleeding occurs in the front, soft part of the nose. This area of the nose contains many small blood vessels that can rupture and bleed if they become irritated or inflamed.

Posterior nosebleeds develop in the rear of the nose and rarely occur in children. This type of nosebleed tends to be heavier, and it can be more difficult to stop the bleeding.

Irritation of the blood vessels is a common cause of anterior nosebleeds. Several things can irritate the blood vessels in the nose, including:

  • dry air
  • picking the nose
  • nasal allergies
  • an injury or blow to the nose or face, for example, from a ball or fall
  • sinusitis, common colds, the flu, and other infections that affect the nasal passages
  • nasal polyps
  • overuse of nasal sprays

Less common causes of nosebleeds in children can include:

Prevention tips

Although it may not be possible to prevent all nosebleeds in children, a person can take steps to help reduce their occurrence. These include:

  • treating allergies to prevent inflammation in the nose
  • using saline (saltwater) nasal sprays to keep the child’s nose moist
  • running a humidifier or vaporizer in the child’s bedroom to prevent the air from drying out
  • keeping children’s nails trimmed to prevent injuries due to nose picking
  • encouraging children to wear appropriate protective equipment during sports or other activities where injury to the nose is possible


Summary

Nosebleeds are a common occurrence in young children and rarely a cause for concern. A person can usually treat the bleeding at home by applying continuous, gentle pressure to the soft part of the child’s nose for around 10 minutes.

Call 911 or take the child to the emergency room if they seem dizzy or weak or if they pass out. It is also necessary to seek immediate medical attention if the bleeding is very heavy, does not stop after 20 minutes, or occurs after a fall or head injury.

Most nosebleeds in children are due to dry air, nose picking, nasal allergies, or other factors that irritate the delicate blood vessels in the front of the nose.

A person should consult a doctor or pediatrician if the child has frequent nosebleeds or has recently started taking a new medication.

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