Usually harmless and easily stopped, provided you do it the right way round. Most people are taught wrongly.
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Most nosebleeds come from a cluster of fragile blood vessels just inside the nostril, close enough to the surface that pressure can stop them. They look alarming and are usually harmless.
The first aid most people were taught is wrong, and it matters. Tipping the head back sends blood down the throat, which is swallowed and causes vomiting, and it hides how much you are actually losing. The correct position is leaning forward.
What makes a nosebleed worth a consultation is not the bleed itself but the pattern — how often, which side, what medication you take, and whether anything else is bleeding too.
The overwhelming majority come from Little's area — a patch of fragile vessels just inside the nostril on the septum, close enough to the surface that dry air, a knock or a fingernail is enough.
That is the sort you can stop yourself, and it needs no tests.
Where nosebleeds are frequent or heavy, a full blood count and clotting screen are reasonable, and ferritin if there has been enough blood loss to matter.
Where anticoagulation is involved, checking that the dose and monitoring are right is often the whole answer.
Recurrent bleeding from the same side, particularly with blocked nose or facial numbness in an adult, warrants a look with a scope.
Cautery of a visible vessel is straightforward and often curative — it is a small procedure that stops years of recurrence.
A consultation is for recurrent or unexplained nosebleeds rather than an active one — if you are bleeding now, stop and apply pressure as above.
Go to A&E or call 999 if:
Book a routine consultation for: frequent nosebleeds, bleeds that are always from the same side and come with persistent nasal blockage, hearing changes or a neck lump — that particular combination needs ENT assessment to exclude a growth. Also for nosebleeds alongside easy bruising, heavy periods or a family history of bleeding disorders.
Most nosebleeds are stopped by technique alone, and most people do it wrong.
The clot is fragile, and most repeat bleeds are the first clot being dislodged.
Nosebleeds cost nothing to manage correctly, and correct technique is the whole treatment. Sit up, lean forwards, pinch the soft part of the nose for a full ten minutes without releasing to check. Almost everyone does at least one part of that wrong — usually leaning back, which sends blood down the throat and makes the bleeding impossible to judge.
Petroleum jelly or a saline gel from a pharmacy costs a couple of pounds and prevents the crusting that causes the next bleed. Your NHS GP treats nosebleeds free, and A&E is the right place for a bleed that will not stop.
Where a consultation is worth it is recurrent nosebleeds — and the useful work is finding the cause rather than treating the episode. A nasal steroid spray aimed at the septum is a very common and entirely fixable culprit that almost nobody is warned about. Aspirin, anticoagulants, and dry indoor air all contribute.
The definitive treatment for a persistent bleeding point is silver nitrate cautery — a quick in-person procedure that resolves it properly. We cannot do that remotely, and repeated courses of cream are not a substitute. Where that is what you need, we will say so and refer.
Recurrent bleeding from one side only in an adult, or nosebleeds alongside unexplained bruising, needs examining rather than treating.
NICE Clinical Knowledge Summary, Epistaxis (nosebleeds), is the principal reference — covering first aid technique, the use of topical antiseptic cream such as Naseptin as an alternative to cautery, and the indications for referral.
ENT UK guidance covers the management of epistaxis including nasal cautery and packing, and defines when hospital assessment is needed.
NICE CKS specifies the correct first aid — sitting upright, leaning forward, and continuous firm pressure on the cartilaginous part of the nose for 10 to 15 minutes — which is the basis for the technique described above.
CKS also identifies intranasal corticosteroid technique as a contributing factor, and recommends directing the spray away from the septum.
NICE NG12 underpins the advice on persistent unilateral symptoms, and CKS advises investigation where nosebleeds occur alongside features suggesting a bleeding disorder or in anyone on anticoagulation.
No — lean forwards. Tipping back sends blood into the throat and stomach, which causes nausea and vomiting, and makes it impossible to judge how much you have lost.
It is the most widespread piece of wrong first aid there is.
Ten minutes without releasing. Letting go at three minutes to see whether it has stopped is why bleeding restarts.
Time it rather than guessing.
If bleeding continues beyond 20 to 30 minutes of correct pressure, if it is heavy enough to make you feel faint, if it follows a significant head injury, or if you are taking an anticoagulant and cannot stop it.
Blood running down the back of the throat rather than out of the nostril also needs assessment.
It makes bleeding harder to stop and lowers the threshold for getting help.
Do not stop the medication on your own. Stopping anticoagulation carries its own risks, and the right approach is to be reviewed rather than to make that decision alone.
Usually not. Nosebleeds are common in children, typically come from the front of the nose, and generally settle with age.
Worth reviewing if they are frequent, heavy, or come with easy bruising or bleeding elsewhere.
In a child, usually not — it is a prominent vessel.
In an adult, repeated bleeding from one side is worth an ENT look, particularly alongside a persistently blocked nose, facial numbness or hearing change.
Very possibly, and it is one of the easiest things to fix. Steroid sprays aimed straight up at the septum irritate exactly the area that bleeds.
Aim outwards towards the ear on the same side, using the opposite hand.
The link is weaker than most people assume. High blood pressure can make a bleed harder to stop, but it is rarely the cause.
It is still worth having checked, since it is often the first time anyone measures it.
Often, yes. Where a single visible vessel is responsible, cautery in an ENT clinic is quick and frequently ends years of recurrence.
August 24, 2026
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
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