Nosebleeds are something most of us will experience at some point. While they're often no cause for alarm, frequent episodes—especially those that happen without clear cause—deserve closer attention. At Sangdo Woori Internal Medicine in Seoul, we often see patients worried by recurrent nosebleeds, especially during Korea’s dry winter months.

Most nosebleeds are minor and stop on their own, but repeated incidents may point to underlying health concerns. In this guide, we’ll explore why nosebleeds happen, when they become concerning, and how you can prevent them—based on both medical insight and practical patient experiences.

The Nasal Anatomy Behind a Nosebleed

Inside your nose lies a network of delicate blood vessels just beneath the surface of the mucous membrane. One especially vulnerable area is Kiesselbach’s plexus, located in the front of the nasal septum. This is the source of most nosebleeds.

Posterior nosebleeds, though less common, are more serious. These originate deeper inside the nose, often from larger arteries, and may require emergency care—particularly in older adults or those with high blood pressure. These bleeds can be harder to control and sometimes go unnoticed initially because the blood drains down the throat rather than out the nostrils.

The nasal cavity is a high-traffic zone: it warms, moistens, and filters the air we breathe. Because of this constant exposure, the mucosa is especially sensitive to environmental changes, physical trauma, and medical conditions.

Why Do Nosebleeds Happen?

Common Triggers

• Dry air: Indoor heating, especially during winter, dehydrates the nasal lining.

• Frequent nose picking or blowing: Damages fragile vessels, a common habit in children and allergy sufferers.

• Colds and allergies: Chronic nasal inflammation from rhinitis leads to fragile blood vessels.

• Medications: Nasal decongestants, corticosteroids, and anticoagulants increase bleeding risk.

• Nasal trauma: Even minor injuries like bumping your nose or inserting objects can rupture vessels.

Dr. Yoo Du-yeol, internal medicine physician at Sangdo Woori, explains, “We often see seasonal spikes in nosebleeds during late fall and winter due to the drastic drop in humidity. Patients using heaters or radiators without humidifiers are especially affected.”

Why Some People Get Them Repeatedly

• Chronic irritation from pollutants, smoke, or allergens

• Structural abnormalities like a deviated septum or nasal bone spurs

• Underlying health issues, including high blood pressure or bleeding disorders

• Hormonal changes, such as during pregnancy, which increase blood flow to the mucosa

• Frequent use of oxygen therapy or CPAP machines for sleep apnea, which dry out the nose

When to See a Doctor About Nosebleeds

Dr. Yoo Du-yeol advises, “A single nosebleed usually isn’t worrisome. But if you’re bleeding several times a week, or the bleeds are difficult to stop, medical evaluation is warranted.”

You should seek medical advice if your nosebleeds:

• Occur more than once a week

• Last longer than 20 minutes despite pressure

• Involve large blood loss or clots

• Are accompanied by fatigue, easy bruising, or other unexplained symptoms

• Occur while on blood thinners or after a recent change in medication

Persistent or severe nosebleeds can also indicate a more serious problem like a tumor, an autoimmune condition, or vascular malformation.

What Conditions Can Cause Recurring Nosebleeds?

• Blood clotting disorders like hemophilia, von Willebrand disease, or low platelet count

• Uncontrolled high blood pressure: Elevated pressure damages small vessels

• Nasal tumors or growths: Especially if bleeding is one-sided and persistent

• Hereditary hemorrhagic telangiectasia (HHT): A rare but important genetic disorder

• Chronic sinusitis or fungal infections: Prolonged inflammation leads to vascular fragility

• Autoimmune diseases: Conditions like granulomatosis with polyangiitis can affect nasal vessels

People undergoing chemotherapy or radiation for head and neck cancers may also experience recurrent nosebleeds due to mucosal thinning and vascular damage.

Diagnosing the Root Cause

Your physician may ask about:

• Frequency and severity of nosebleeds

• Other symptoms like bruising, gum bleeding, or fatigue

• Medication use, including supplements like fish oil or ginkgo biloba

• Family history of bleeding disorders or vascular conditions

Diagnostic tools may include:

• Nasal endoscopy to identify bleeding points or structural problems

• Blood tests to evaluate clotting and platelet function

• Imaging scans (CT or MRI) for tumors, polyps, or deep infections

• Allergy testing if inflammation is a suspected factor

Treatment: From First Aid to Advanced Options

First Aid Tips You Can Use at Home

1. Sit upright and tilt your head forward slightly to prevent swallowing blood

2. Pinch the soft part of your nose just below the bridge

3. Hold pressure for 10 to 15 uninterrupted minutes

4. Apply a cold compress to the bridge of your nose and cheeks

5. After bleeding stops, avoid blowing your nose for several hours

You can also use over-the-counter saline sprays and nasal gels to keep your nose moisturized. Avoid petroleum jelly if you're using oxygen therapy, as it can be flammable.

In-Clinic Treatments

• Cauterization: Silver nitrate or electrocautery is used to seal off vulnerable vessels

• Nasal packing: Absorbent materials or inflatable balloons may be inserted to stop bleeding

• Surgical options: For persistent or severe cases, artery ligation or endoscopic surgery may be necessary

Preventing Future Episodes

Preventing nosebleeds means protecting the delicate nasal lining. Dr. Yoo often advises patients to:

• Use a humidifier, especially during winter months

• Apply saline nasal spray 2–3 times daily

• Avoid overuse of nasal decongestants or corticosteroid sprays

• Stay hydrated to maintain mucosal integrity

• Manage underlying conditions such as allergies or hypertension

• Use protective gear during sports or construction work

Patients prone to bleeding should also be cautious with medications like aspirin, NSAIDs, or herbal supplements known to affect clotting.

Children and Older Adults: Special Considerations

Children

Nosebleeds are common in children due to nose picking, dry indoor air, and frequent infections. If a child has recurrent nosebleeds, check for:

• Lodged foreign objects

• Hematologic issues

• Unaddressed allergies or sinus infections

Teach gentle nose hygiene, maintain humid environments, and trim fingernails to reduce trauma risk.

Older Adults

Older adults are more susceptible to posterior bleeds and are often on medications like anticoagulants. They may also suffer from age-related vascular fragility. In this group, a full workup for systemic conditions and medication review is critical.

When Is It an Emergency?

Seek urgent medical care if:

• Bleeding doesn’t stop after 30 minutes of pressure

• Blood is dripping down the throat causing choking

• There are signs of anemia or shock (weakness, pale skin, fast heartbeat)

• Nosebleed occurs after a fall or facial trauma

• There is trouble breathing due to blood in the airway

What’s New in Nosebleed Treatment?

Modern medicine offers new techniques:

• Endoscopic cauterization for deep or persistent bleeding points

• Laser therapy minimizes surrounding tissue damage

• Fibrin sealants and absorbable hemostatic sponges aid clotting

• Genetic counseling for families with inherited bleeding disorders

• Balloon catheter embolization, a minimally invasive way to block bleeding arteries

Final Thoughts

Recurring nosebleeds can range from harmless to indicative of serious health concerns. With attentive care and proper diagnosis, they can usually be managed effectively.

At Sangdo Woori Internal Medicine, Dr. Yoo Du-yeol and our team specialize in uncovering the cause behind recurrent nosebleeds and tailoring treatments to the patient’s lifestyle and health status. Whether it’s seasonal dryness, medication side effects, or an undiagnosed condition, we provide compassionate, evidence-based care.

If nosebleeds are affecting your quality of life, don’t wait. Reach out to Sangdo Woori Internal Medicine and breathe easier with expert help.