Nosebleeds: Causes, Risks, and When to Worry

When your nose starts bleeding, it’s easy to panic—but most nosebleeds, also known as epistaxis, are minor and stop on their own. Also known as epistaxis, they happen when tiny blood vessels in the front of your nose break, often from dry air, picking, or irritation. You don’t need to be sick to get one. Even healthy people get them after flying, using nasal sprays, or sleeping in a heated room. But if they happen often, last longer than 20 minutes, or come with dizziness, that’s when you need to look closer.

Some medications, especially blood thinners and nasal steroids can make nosebleeds more likely. Think of aspirin, warfarin, or even long-term use of Flonase. These don’t cause bleeding directly, but they lower your body’s ability to seal off small breaks. High blood pressure, particularly if uncontrolled is another hidden player. It doesn’t cause nosebleeds by itself, but it increases the pressure in those fragile vessels, making them pop more easily. And if you’re on diuretics like hydrochlorothiazide—often prescribed for hypertension—you’re also at higher risk because they dry out your mucous membranes.

It’s not just about what’s in your medicine cabinet. Chronic allergies, frequent nose-blowing, or even living in a dry climate can wear down the inside of your nose until it cracks. Kids get them from picking; older adults from thinning skin and brittle vessels. And while rare, nosebleeds can signal deeper issues like clotting disorders, nasal tumors, or even hereditary conditions like HHT (hereditary hemorrhagic telangiectasia). If you’re on multiple meds, have a history of high blood pressure, or notice bleeding from other spots like gums or skin, it’s not just a nuisance—it’s a clue.

What you’ll find below isn’t just a list of articles. It’s a practical guide to spotting what’s normal and what’s not. You’ll see how certain drugs like thiazide diuretics or opioids can quietly increase your risk. You’ll learn how to tell if a nosebleed is just dry air—or a warning sign tied to something bigger. And you’ll get real advice on when to call your doctor instead of just reaching for a tissue.