Table: Some Causes and Features of Nosebleeds-Merck Manual Consumer Version

Some Causes and Features of Nosebleeds

Cause*	Common Features† and Tests‡
Common
Blowing or picking the nose A blow or other injury to the nose	Typically evident during a doctor's evaluation
Drying of the moist membranes lining the nose, as may occur in cold weather	Usually dryness that is seen during the examination
Less common
Arteriosclerosis	Usually in older people
Bleeding disorders (coagulopathies)	In people who have had nosebleeds or other bleeding in other areas, such as the gums Blood tests, such as a complete blood cell count and tests to measure how quickly blood clots
A foreign object (body) in the nose, mainly in children	Often recurring nosebleeds and/or a foul-smelling discharge from one nostril
A hole (perforation) in the nasal septum (which divides the interior of the nose in two)	A hole that can be seen during the examination
Nasal infections (such as a cold or sinusitis)	Nasal discharge, sometimes thick or discolored, and crusting in the nostrils Often irritation of the moist membranes lining the nose
Hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber syndrome)	Dilated small blood vessels (telangiectasias) on the face, lips, membranes lining the mouth and nose, and tips of the fingers and toes Usually in people with family members who have the disorder
Systemic disorders, such as severe liver disease or AIDS	In people who are known to have such disorders Changes in the membranes lining the nose
Tumors (noncancerous or cancerous) of the nose or sinuses	Sometimes a mass that can be seen inside the nose Bulging of the side of the nose Sometimes CT
* Conditions that can cause nosebleeds are more likely to cause nosebleeds in people who also have a bleeding disorder or who take medications that interfere with blood clotting. In such people, bleeding is often more severe and difficult to treat.
† Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present.
‡ Although a doctor's examination is always done, it is mentioned in this column only if the diagnosis can sometimes be made by the doctor's examination alone, without any testing.
CT = computed tomography.

Cause*

Common Features† and Tests‡

Common

Blowing or picking the nose

A blow or other injury to the nose

Typically evident during a doctor's evaluation

Drying of the moist membranes lining the nose, as may occur in cold weather

Usually dryness that is seen during the examination

Less common

Arteriosclerosis

Usually in older people

Bleeding disorders (coagulopathies)

In people who have had nosebleeds or other bleeding in other areas, such as the gums

Blood tests, such as a complete blood cell count and tests to measure how quickly blood clots

A foreign object (body) in the nose, mainly in children

Often recurring nosebleeds and/or a foul-smelling discharge from one nostril

A hole (perforation) in the nasal septum (which divides the interior of the nose in two)

A hole that can be seen during the examination

Nasal infections (such as a cold or sinusitis)

Nasal discharge, sometimes thick or discolored, and crusting in the nostrils

Often irritation of the moist membranes lining the nose

Hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber syndrome)

Dilated small blood vessels (telangiectasias) on the face, lips, membranes lining the mouth and nose, and tips of the fingers and toes

Usually in people with family members who have the disorder

Systemic disorders, such as severe liver disease or AIDS

In people who are known to have such disorders

Changes in the membranes lining the nose

Tumors (noncancerous or cancerous) of the nose or sinuses

Sometimes a mass that can be seen inside the nose

Bulging of the side of the nose

Sometimes CT

* Conditions that can cause nosebleeds are more likely to cause nosebleeds in people who also have a bleeding disorder or who take medications that interfere with blood clotting. In such people, bleeding is often more severe and difficult to treat.

† Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present.

‡ Although a doctor's examination is always done, it is mentioned in this column only if the diagnosis can sometimes be made by the doctor's examination alone, without any testing.

CT = computed tomography.