What's the best way to stop nosebleeds? Dr Mark Porter explains

Dr Mark Porter's reply

Nosebleeds can occur at any age, but are most common in younger children and people over 70. Common causes are infection (often evident as crusting inside the nostril), drying out of the lining of the nose (particularly during winter) and leaky blood vessels, but I suspect your past stroke may be a clue.

A standard treatment for stroke is to take an anti-platelet type drug – typically aspirin in the past but mostly clopidogrel these days – to reduce the blood ‘stickiness’. Unfortunately, these make nosebleeds more likely.

However, I can only guess from here, so this is one to discuss with your own GP, who can examine you and your nose. This check-up will probably include measuring your blood pressure, but if it is raised this is often an incidental finding rather than the actual cause.

If they can’t identify the problem, you may be referred to your local ENT department, who can do a more detailed check with cameras. However, this isn’t necessary in most cases.

In the meantime, don’t stop any of your medicines.

What to do if you have a nosebleed

If you have a bleed, make sure to lean forwards (not back as many do) and pinch the lower fleshy part of your nose – not the upper bony part – for at least 10-15 minutes without letting go, however briefly.

If the bleed hasn’t stopped, repeat for 10-15 minutes more, then call for help if it hasn’t settled.

Treatment depends on the cause and severity, but for most people, it might include a short course of antibiotic cream or cauterising a leaky blood vessel.

And try not to worry: the amount of blood can cause alarm, but it typically looks much worse than it is, and it is very unusual to lose a dangerous amount through a nosebleed alone.

Although, as always in medicine, you can never say never.