Hilliard Pediatrics, Inc. - Dr. Tim Teller, MD

Nose bleeds commonly occur among children during the time of other nasal problems (injuries, colds, allergies, and sinus infections). They are more likely with other nasal symptoms because the lining of the nose becomes irritated. Then vigorous nose blowing, overly-dry nasal passages (from dry winter air or from medications used to treat nasal symptoms), smoke exposure, or children bumping or “picking” their nose can cause these irritated nasal passages to bleed.

•  If a nose bleed occurs, put a cold (ice) pack or cold, wet washcloth on the bridge of the nose, hold a tissue over the nostril that is bleeding, and have the child tilt the head back just a bit. The bleeding generally stops after 10-15 minutes.
• It will keep bleeding if the child blows their nose soon after the bleeding stops.
• If the bleeding persists, it is very helpful to spray Afrin® Nasal Decongestant Spray (over-the-counter) on half of a cotton puff and gently place it in the nostril that is bleeding. This quickly shrinks down the irritated lining of the nose and often stops the bleeding. Leave it in the nostril for 15 minutes or so, then gently remove it.

• A vaporizer or humidifier will be helpful.
• Avoiding smoke exposure will be helpful.
• Try to reduce how often the nose is being suctioned or blown.
• Consider decreasing or stopping any antihistamine medicines for the nose, unless the antihistamine is for “allergies” (allergic rhinitis). In that case, it will likely help to continue taking the medication. Someone with untreated allergies who gets nose bleeds on occasion will often have less nose bleeds if they regularly take one of the over the counter Claritin®, Zyrtec®, or Allegra®.
• Trim the child’s fingernails to decrease the chance that any picking of the nose will cause the nose to bleed.
• Place a small “dab” of Vaseline petroleum jelly or saline gel (over-the-counter) in the nostrils before bedtime. 

• If your child has symptoms of a sinus infection and recent nose bleeds, come in for walk-ins at 8 a.m. Monday through Friday or call for an appointment to have your child seen.
• If you have a bloody nose that is still actively bleeding more than 30 minutes later and you have already tried the Afrin® Nasal Spray, your child should be seen at the Nationwide Children’s Hospital Urgent Care or our office for an appointment.
• If your child has easy bleeding beyond the bloody noses (gums bleed after tooth brushing, easy bruising, bleeding from small cuts or scratches takes a while to stop), we should see your child during regular office hours to evaluate and discuss blood work to rule-out a bleeding issue.
• If your child regularly gets nose bleeds 2-3 times a week or more, set up an appointment to see us during routine hours to discuss further treatment. An ear, nose, and throat specialist (ENT or otorhinolaryngologist) can see your child and see if further treatment (often chemical cautery to the blood vessels up in the nose on one or both sides) is needed. 

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