What Parents Need To Know About Bloody Noses

The most common reason for bloody noses in kids is dryness and irritation inside the nose (1).

The inside of the nostrils (especially near the front) is lined with delicate blood vessels that are close to the surface. These vessels are prone to breaking, especially when the air is dry, your child picks their nose, or there’s some inflammation from allergies or illness.

Young children in particular tend to have thinner nasal linings and more fragile blood vessels, which can make them more susceptible to nosebleeds. Add in common behaviors like nose picking and it’s no surprise that bloody noses can be a regular part of early childhood!

It’s completely normal for children, especially between the ages of 2 and 10, to experience the occasional bloody nose (2). A nosebleed once every few weeks, particularly during dry seasons or when your child has a cold or allergies, usually isn’t cause for concern. Some kids may even have several nosebleeds a month during certain times of year, and that can still be considered within the range of normal.

However, if your child is having multiple gushing nosebleeds per week or having severe bleeding that’s hard to stop, it’s a good idea to check in with your pediatrician or an ENT.

Here’s how to calmly and effectively handle your child’s bloody nose:

1. Stay calm and reassure your child.
   Most nosebleeds look worse than they are. Help your child stay still and calm. Remember, your reaction will influence your child’s reaction, so it is important for you to react calmly.
2. Sit them upright.
   Have your child sit down and lean forward slightly. Do not have them lean back, this can cause blood to run down the throat, which may lead to coughing, gagging, or vomiting.
3. Pinch the soft part of the nose.
   Using your thumb and index finger, gently pinch the soft part of your child’s nose shut (just below the bony bridge). Hold for at least 5 minutes without checking. This gives time for the blood to clot. For kids that have frequent nosebleeds, I really like these nose-pinchers available on Amazon. Many kids find them easier to tolerate compared to manual nose-pinching and they can continue to play while gentle pressure is applied.

Tip: Avoid blowing the nose.
After the bleeding stops, try not to let your child blow their nose or pick at dried blood, it could dislodge the clot and restart the bleeding.

If nosebleeds are becoming a recurring issue, here are some tips to help prevent them:

1. Humidify the air. Using a cool-mist humidifier in your child’s room (especially at night during dry seasons) can keep nasal passages from drying out.
2. Moisturize inside the nose: A dab of coconut oil or saline nasal spray applied gently inside the nostrils can keep tissues moist. Do this especially during winter or when running the heater.
3. Trim fingernails and discourage nose picking: Teach your child not to pick their nose, and keep their nails short to minimize damage if they do.
4. Treat underlying allergies: If your child has allergies, trying to stay on top of management may reduce sneezing and irritation that can lead to bleeding. This article may help: A Natural Approach To Seasonal Allergies

Help your child stay hydrated: Drinking plenty of fluids helps keep mucous membranes well-lubricated.

Most nosebleeds are harmless and resolve on their own, but it’s worth getting medical advice if:

• Bleeding lasts longer than 20 minutes, even with pressure,
• Your child has very frequent nosebleeds (more than once a week for several weeks),
• The bleeding is very heavy or comes from both nostrils,
• There are other signs of easy bruising or bleeding gums,
• The nosebleed follows a serious injury or head trauma,
• Your child appears pale, dizzy, or weak afterward.

Very frequent nose bleeds are associated with anemia. If that is a concern, your doctor can perform a simple blood test.

If your child continues to have frequent nosebleeds despite using humidifiers, saline sprays, and other preventive measures, your pediatrician may refer you to an ear, nose, and throat (ENT) specialist.

One potential treatment option your doctor may recommend is nasal cauterization, a quick in-office procedure that seals the small blood vessel causing the bleeding. This is often done with a chemical agent like silver nitrate or, in some cases, with heat (electrocautery).

Cauterization is typically well-tolerated and can significantly reduce or even stop recurrent nosebleeds (3). It’s generally considered when nosebleeds are frequent, happen from the same nostril, and are clearly coming from a visible vessel near the front of the nose.

Bloody noses in kids can be scary, but they’re usually not a sign of anything serious. Most are caused by dry air, nose picking, or irritation from allergies or colds. Occasional nosebleeds in children are normal, but frequent or severe episodes should be discussed with your child’s doctor. 

If your child is prone to nosebleeds, you may be able to reduce the frequency or prevent them entirely by using a humidifier in their bedroom, moisturizing the inside of the nose with some coconut oil, and/or treating underlying allergies. If nosebleeds persist despite home care, your pediatrician may recommend cauterization to stop the bleeding at its source. You’ve got this!

1. Alruwaili TAM, Alazmi YM, Alenzi MM, Tashkandi NF. Clinical Presentation and Treatment Patterns of Pediatric Epistaxis: A Single-Center Study. Cureus. 2024 Feb 16;16(2):e54309. doi: 10.7759/cureus.54309. PMID: 38496159; PMCID: PMC10944313.
2. Yan T, Goldman RD. Recurrent epistaxis in children. Can Fam Physician. 2021 Jun;67(6):427-429. doi: 10.46747/cfp.6706427. PMID: 34127465; PMCID: PMC8202740.
3. Qureishi A, Burton MJ. Interventions for recurrent idiopathic epistaxis (nosebleeds) in children. Cochrane Database Syst Rev. 2012 Sep 12;2012(9):CD004461. doi: 10.1002/14651858.CD004461.pub3. PMID: 22972071; PMCID: PMC11625497.