Kids & Nosebleeds: What Parents Need to Know

Why does my child’s nose bleed?

Nosebleeds in kids are very common and usually not serious. They happen because:

• The front of the nose has tiny blood vessels that break easily
• Dry air (especially in winter) makes the inside of the nose fragile
• Nose picking, bumping the nose, or blowing too hard can trigger bleeding
• Once a nose bleed starts, it may occur on and off over a few weeks 

What causes nosebleeds in children?

Most nosebleeds are just part of normal childhood. Kids seem to be a bit more prone to minor nosebleeds than adults. Common triggers include:

• Dry air→ recurrent nose bleeds tend to happen more often in dry winter months.
• Minor trauma → bumps, falls, or even rough play
• Nose picking or rubbing
• Colds & allergies → that make the nose stuffy

Having one or two nosebleeds a year is normal for kids.

When should I be concerned or take my child to the doctor or ER?

Call your doctor (or go to the ER) if:

• Nose bleeds become more frequent than once or twice a year
• They are difficult to stop easily at home
• The nosebleed lasts more than 15–20 minutes despite pressure
• Bleeding is always on the same side
• Your child has trouble breathing through one side of the nose
• You notice other symptoms (easy bruising, bleeding gums, fainting)

Most nosebleeds are routine, but sometimes doctors use treatments like cautery (sealing the vessel) if they keep coming back. Rarely, referral to an Ear, Nose & Throat doctor may be needed.

How do I stop a nosebleed at home?

• Have your child sit up (don’t tilt the head back).
  • Apply firm, steady pressure to the lower part of the nose on the side that is bleeding for at least 5 minutes
  • If the bleeding has not yet stopped, you can use one spray of oxymetazoline nasal spray on each side (in children over 2 years of age) and hold pressure for another five minutes
• Pinch the soft part of the nose(just below the bony bridge) for 5–10 minutes without peeking.
• If the bleeding has not yet stopped  - For kids over age 2, a spray of oxymetazoline (like Afrin) on each side of the nostril can help. Hold pressure for another 5 minutes. For kids under the age of 2, call your doctor
• If the bleeding still doesn’t stop → call your doctor.

How can I prevent nosebleeds in the future?

• Prevent minor trauma to the area - trim fingernails and remind kids not to pick their nose
• Avoid excessive dryness - Use a humidifier in bedrooms during dry winter months.
• Create a barrier - Apply a thin layer of Vaseline or an antibiotic ointment like Neosporin just inside the nose with your fingertip and rub it in gently each night before bed

Winter is the time of year that nosebleeds in kids are most frequent!

How can I look at home first before deciding to go to the doctor?

Having a home otoscope, such as the Deebo® Otoscope, can be extremely helpful to collect information to share with the doctor, if and when you decide to consult them.  It can also give the parent peace of mind to see what’s happening in your kids nose.

• Spot if there’s fresh bleeding or crusts
• See if the blood vessels in the front of the nose look irritated
• Check for drainage or a foreign object (yep, kids do that!)
• Collect info to share with your doctor

When using an otoscope, here are the six questions we suggest you try to answer. And then share these findings with the doctor.  

1. Can you identify basic anatomy in the front of the nasal cavity? (See photos 1A & 1B)
2. Is there any drainage?
3. Can you identify the area of tiny blood vessels along the front part of the nasal septum? (See Photo 2)
4. Is there any active bleeding?
5. Where does the bleeding seem to be coming from?
6. Any foreign bodies in the nose!?

Photo 1A:  View just inside the left nostril showing the nasal septum and interior turbinate

Photo 1B:Expanded outside view of the nose

Photo 2: View just inside the left nostril showing the normal concentrated area of tiny blood vessels.  This is a normal finding, but also a common site of nosebleeds in children.

Disclaimer: This content is for informational purposes only and does not constitute medical advice. It’s not a substitute for professional diagnosis or treatment. Always consult your qualified healthcare provider regarding any medical concerns, tests, or treatments. If you’re dealing with a medical emergency, seek immediate help or call emergency services.

Author: Austin S. Rose, MD, MBA, FARS
Pediatric Otolaryngologist