Frequent Nosebleeds: Reason for On/Off Nosebleeds from One Nostril

Question:  What could be the cause/reason for on/off frequent nosebleeds from one nostril?


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