Nosebleeds are common and frightening, but most are minor and stop with simple first aid. They are especially
frequent in children and in hot, dry weather. Ayurveda classes nosebleeds under Raktapitta — bleeding
caused by overheated blood — and focuses on cooling food, routine and moisture for the nasal lining.
First aid
Sit up, lean forward, pinch the soft part of the nose, and hold for 10–15 minutes by the clock.
Sit upright and lean slightly forward, so blood runs out of the nose rather than down the throat.
Firmly pinch the soft, lower part of the nose — below the bony bridge — closing both nostrils. Breathe through the mouth.
Keep pressing for a full 10–15 minutes without letting go to check. Spit out any blood in the mouth.
A cold pack or ice wrapped in a cloth on the bridge of the nose, or sucking an ice cube, may help.
If it is still bleeding, repeat for another 10–15 minutes.
Don't tilt the head back or lie flat (blood is swallowed, causing vomiting and hiding how much is lost), and don't stuff cotton or paper deep into the nose. For 24 hours afterwards, avoid blowing or picking the nose, hot drinks, heavy lifting and bending.
When it's an emergency
Go to an emergency department or call 108 / 112 if:
Bleeding continues after 20–30 minutes of firm pressure, or is very heavy
The person feels faint, dizzy, pale, breathless or has a racing heart
Blood is pouring down the back of the throat from both nostrils (a posterior bleed)
It follows a head injury or a blow to the face
The person takes blood thinners (warfarin, apixaban, clopidogrel, aspirin) or has a bleeding disorder
See a doctor soon for frequent nosebleeds, easy bruising or bleeding gums, or — in a teenage boy — repeated one-sided nosebleeds with a blocked nose, which need an ENT check.
What causes a nosebleed?
About 9 in 10 nosebleeds come from a network of small blood vessels at the front of the nasal septum (Little's
area), just inside the nostril. These vessels lie close to the surface and bleed easily when the lining dries or
cracks. Less common posterior bleeds come from deeper vessels, are heavier, and usually affect older adults.
Dry air — summer heat, winter heating, air-conditioning
Nose picking and forceful nose-blowing — the most common cause in children
Colds, sinusitis and allergies; overuse of steroid nasal sprays
Injury to the nose
Blood-thinning medicines, heavy alcohol use
High blood pressure can make bleeds heavier and harder to stop
Rarely: bleeding disorders, liver disease, dengue with low platelets, or growths in the nose
Warm drinks such as ginger–tulsi tea are a traditional comfort for the throat and chest. They ease symptoms but do not replace inhalers, antibiotics or other prescribed treatment.
Medical treatment
If first aid fails, a doctor may apply a vessel-narrowing spray, cauterise (seal) the bleeding vessel with a
chemical stick or electric current, or pack the nose. Recurrent bleeds are often cured by cautery. Heavy or
posterior bleeds may need hospital care. Blood pressure, blood counts, clotting and medicines are reviewed
as needed.
Ayurvedic view
Cool aggravated Pitta → calm the blood (Rakta) → moisten the dry nasal passage → stop bleeding with astringent, cooling measures.
Raktapitta is bleeding caused by Pitta overheating the blood. When the bleeding comes through
the upper openings — nose, mouth, ears — it is called Urdhvaga Raktapitta; nosebleeds
(Nasagata Raktapitta) are its most common form. Hot, spicy, sour, salty and fermented food, alcohol,
exposure to sun and heat, and anger are listed causes. Classical remedies use cooling, astringent herbs and
foods: Amalaki, Durva grass, pomegranate, Vasa, Yashtimadhu and sandalwood.
Drops of fresh Durva juice in the nose are a traditional remedy, but should only be used on a
practitioner's advice — nothing should be put into a bleeding nose except firm pressure.
Preventing repeat bleeds
Keep the nasal lining moist: saline spray or drops, and a thin smear of petroleum jelly or ghee just inside the nostrils at night (pratimarsha nasya with plain ghee is a gentle traditional equivalent).
Use a humidifier or a bowl of water near heaters and air-conditioners.
Keep children's nails short and discourage nose picking; sneeze with the mouth open.
Drink plenty of water; in summer favour cooling foods — cucumber, coconut water, amla, pomegranate, milk, rice.
Cut down on very spicy food, alcohol and long hours in direct sun.
Keep blood pressure controlled; don't stop prescribed blood thinners on your own — ask your doctor.
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