Why Do I Keep Getting Nosebleeds in Winter?

Why do I keep getting nosebleeds in winter? If your nose has started bleeding for the second or third time since the heating went on, the answer is usually not that something is wrong with you. It is that something is wrong with the air. Cold air outside and warm, dry air inside pull moisture out of the delicate lining of your nose until it cracks, and the tiny blood vessels underneath are left with almost no protection. A hard blow, a picked scab or even a sneeze is then enough to set one off.

A nosebleed, known medically as epistaxis, is blood flowing from one or both nostrils. It can be light or heavy, and it can last from a few seconds to 15 minutes or more. The NHS is clear that nosebleeds are not usually a sign of anything serious, and you can often treat them at home. Most people get one every now and again. They most often affect children aged between 2 and 10, older people, pregnant women, and people who take blood thinning medicine such as aspirin or warfarin.

This article explains why winter brings nosebleeds on, what actually causes one, the exact steps that stop one, the mistakes that make one worse, and the warning signs that mean you should speak to a GP, call 111 or call 999. Everything here follows NHS guidance, and where different NHS sources give different timings, that is flagged rather than smoothed over.

What is a nosebleed, exactly?

The inside of your nose is full of tiny blood vessels that can be damaged and bleed quite easily. The most common place for bleeding is a spot just inside the front of your nose, on the septum, the wall that divides your two nostrils. NHS hospital leaflets call it Little’s area. It is close to the surface, it is rich in blood vessels, and it is the first part of the lining to dry out and crack in winter air.

Doctors divide nosebleeds into two kinds. An anterior nosebleed starts at the front of the nose, in or near Little’s area. This is the common kind. It is usually short, the bleeding is usually light to moderate, and it is usually easy to manage at home. A posterior nosebleed starts deeper inside the nose. It is much less common, it usually affects older adults, and the blood flow can be heavy, because the vessels involved are larger and the blood can run down the back of the throat. Posterior bleeds are the ones that more often need hospital treatment.

It is worth knowing that doctors do not always find a reason for every nosebleed. NHS leaflets say this plainly. A bleed can start with no obvious trigger, especially in winter, when the lining is dry and fragile. That does not mean something serious is going on. It means the lining was already damaged and a small knock, a sneeze or a hard blow was enough to break a vessel open.

Why does winter make nosebleeds more likely?

The short answer is dryness, twice over. NHS Inform lists changes in humidity or temperature causing the inside of the nose to become dry and cracked as a common cause of nosebleeds, and winter delivers that change in both directions. Outside, cold air holds very little moisture. Inside, central heating warms the air and dries it further. Your nose moves between the two all day, and the lining never gets a chance to stay moist.

The lining of the nose is supposed to stay damp. It warms and moistens the air you breathe, and it traps dust and germs before they reach your lungs. When the air is dry, the mucus inside the nose thickens, the lining dries out, and small cracks form. Scabs form over the cracks. Those scabs itch, and when you pick at them or blow your nose hard to clear them, the scab comes away and the vessel underneath opens again. That cycle, dry, crack, scab, pick, bleed, is the usual story behind a winter nosebleed, and it explains why the same person can bleed several times in one week and then not bleed at all for months.

Winter adds two more ingredients. The first is colds. A blocked or runny nose means more blowing, and blowing hard is itself a listed cause of nosebleeds. Nasal decongestant sprays, used more often than the instructions allow, can also damage the lining and cause bleeding. The second is alcohol. Drinking is commoner around Christmas and the New Year, and NHS Inform lists recently drinking alcohol among the common causes, because alcohol widens blood vessels and makes bleeding harder to stop. None of this means winter itself is dangerous. It means the season stacks several small risks on top of each other, and the lining of your nose pays for it.

One thing to be clear about: cold weather does not cause nosebleeds on its own. It is the dryness and the swings in temperature and humidity that matter, not the number on the thermometer. A cold, damp winter day is kinder to your nose than a cold, dry one followed by hours in a centrally heated room.

What causes nosebleeds?

Most nosebleeds come from the front of the nose and have an everyday cause. NHS Inform lists the common ones: picking your nose, blowing your nose very hard, recently drinking alcohol, a minor injury to your nose, and changes in humidity or temperature causing the inside of the nose to become dry and cracked. NHS hospital leaflets add colds and stuffy noses, including hay fever, and using nasal decongestants more often than the instructions allow.

Medicines are a common and often overlooked cause. Aspirin and other blood thinners, including warfarin, make it harder for blood to clot, so a small break in a vessel bleeds for longer. Blood clotting disorders such as haemophilia and von Willebrand disease have the same effect. If you take a blood thinner and your nosebleeds have become frequent or hard to stop, that is a reason to speak to your GP, not a reason to stop the medicine yourself. Stopping a blood thinner without advice can be far more dangerous than the nosebleed.

Deeper bleeding, from the vessels further inside the nose, has a different list of causes. NHS Inform names a blow to the head, recent nasal surgery, and hardened arteries, known as atherosclerosis. Hospital leaflets add high blood pressure, which is more often linked to the heavier posterior bleeds seen in older adults. That link is sometimes overstated online, so it is worth being precise: high blood pressure is not a common cause of the ordinary front-of-the-nose bleeds most people get. It is associated with the rarer, deeper kind, and a nosebleed on its own is not a sign that your blood pressure is high.

There are also causes that are less common but worth knowing about, because they change what you should do next. Cocaine use is listed by NHS trusts among the causes of nosebleeds, because it damages the lining of the nose. A nosebleed after a head injury needs urgent assessment, because the bleeding may not be the only injury. And a nosebleed in a child under 2 is a reason to speak to a GP, because nosebleeds are unusual at that age.

How to stop a nosebleed

The steps below follow NHS guidance, and they work for most nosebleeds. The single most important part is the timing: you need to hold pressure for a full 10 to 15 minutes without peeking. Most failed attempts fail because the pressure was released too early, not because the method was wrong.

First, sit down at a table and lean forward, with your head tilted forward and your mouth open. Leaning forward matters. It lets the blood drain out of your nose instead of running down the back of your throat, where it can make you feel sick and where it hides how much blood you are actually losing. Stay upright or seated rather than lying down, because lying down raises the blood pressure in the blood vessels of your nose and can make the bleeding worse.

Second, firmly pinch the soft part of your nose, just above your nostrils, for at least 10 to 15 minutes. Breathe through your mouth while you do it. Use a clock or a phone timer, and do not release the pinch to check whether it has stopped. If you let go early and the clot has not formed, the bleeding restarts and you are back to the beginning. Spit out any blood that collects in your throat or mouth into a bowl. Do not swallow it, because swallowed blood can make you feel sick.

Third, placing an ice pack or a bag of frozen vegetables covered by a towel on your forehead, the back of your neck, or the bridge of your nose may help reduce the blood flow. NHS sources differ slightly on where to put it, and NHS 111 Wales is honest that the evidence for ice is not very strong, but it is harmless and some people find it helps. It is an extra, not a substitute for pinching.

If the bleeding stops, you will not usually need medical advice. Leave the clot alone, do not blow your nose, and read the aftercare section below before you do anything else. If the bleeding carries on, the timings matter. NHS hospital leaflets advise that if your nose is still bleeding heavily after 20 minutes of firm pressure, you should seek medical advice, either by calling NHS 111 or by going to your nearest emergency department. If the person is unwell or has other health conditions, call 999. Do not drive yourself to A and E. Ask someone to drive you, or call 999 and ask for an ambulance.

What not to do when your nose bleeds

The most common mistake is tilting your head back. It is what most of us were taught as children, and it is wrong. Tilting back sends blood down the throat, where it can cause nausea and vomiting, and it stops you seeing how much blood you are losing. Lean forward, not back, every time.

Do not lie down. As with tilting back, lying flat raises the pressure in the vessels of your nose and can keep the bleeding going. Sit up, lean forward, and stay there until the bleeding has stopped and for a little while after.

Do not put anything up your nose to stop the bleeding. NHS hospital leaflets are specific about this: cotton wool and tissue will not work, and they may start the bleeding again when you remove them. The pressure should come from your fingers on the outside of the soft part of your nose, not from anything packed inside it.

Do not keep releasing the pinch to check. Every time you let go before a clot has formed, you break the clot that was forming and the clock starts again. Set a timer for 15 minutes and keep pinching until it goes off. It feels like a long time, and that is the point. A clot needs unbroken pressure to form.

Finally, do not blow your nose to clear the blood or the clot. Blowing dislodges the clot and restarts the bleed. Spit the blood out instead, and leave the inside of your nose completely alone until the bleeding has stopped.

After it stops: the first 24 hours

Stopping the bleed is only half the job. The clot that forms is fragile, and the first day is when most nosebleeds restart. NHS 111 Wales advises that for 24 hours after a nosebleed you should try not to blow your nose, and NHS hospital leaflets extend the careful period to a few days.

For at least the first few days, avoid hot drinks, hot baths, alcohol and smoking, heavy lifting and exercise, and straining on the toilet, because all of these raise blood pressure or blood flow to the head and can dislodge the clot. Avoid spicy food and hot drinks for the same reason. Do not pick at your nose, do not try to remove the clot, and do not use nasal sprays unless a healthcare professional has prescribed them. If you need to sneeze, sneeze with your mouth open, which reduces the pressure inside your nose.

There is one simple step that helps the lining recover. NHS hospital leaflets recommend regularly applying petroleum jelly, such as Vaseline, to the inside of your nostrils to keep the lining moist while it heals. A small amount on a clean fingertip, applied gently just inside each nostril, is enough. This is the same moisture problem that caused the bleed in the first place, so keeping the lining damp while it heals is the most direct fix available.

If the nose bleeds again slightly, repeat the same first aid: sit upright, lean forward, and pinch the soft part of your nose for at least 10 minutes. A small re-bleed after the first day is common and does not usually need medical attention, as long as it stops with pressure. If it keeps coming back, or if it will not stop, use the timings in the next-but-one section.

How to prevent the next nosebleed

Prevention is mostly about keeping the lining of your nose moist and leaving it alone. NHS Inform lists the steps, and they are unglamorous but effective. Avoid picking your nose, and keep your fingernails short so that an absent-minded pick does less damage. Blow your nose as little as possible, and only very gently when you must. Keep your home humidified, which in practice means not overheating rooms and, if the air is very dry, using a humidifier or placing a bowl of water near a radiator. Always follow the instructions that come with nasal decongestants, because overusing them can cause nosebleeds. And wear a head guard during activities in which your nose or head could get injured.

Petroleum jelly is the cheapest preventive step. A thin smear just inside each nostril, once or twice a day through the winter, keeps the lining from drying and cracking. It is particularly useful if you have already had a bleed, because it protects the exact spot that is healing. If you have had cautery treatment from a doctor, your GP or hospital may prescribe an antiseptic cream instead, and you should follow their instructions rather than substituting your own.

Look at the wider picture too. If your nosebleeds started after a new medicine, mention it to your GP or pharmacist rather than stopping the medicine. If they follow heavy drinking, cutting back will help. If they always follow a cold, be gentler with blowing and use saline spray rather than a decongestant spray. And if you often get nosebleeds and cannot prevent them, NHS Inform advises talking to your GP. Frequent bleeds can be treated, for example by sealing the bleeding vessel, but only if a doctor can see where the blood is coming from.

Nosebleeds in children

Nosebleeds are common in children, most often between the ages of 2 and 10, and they usually stop by themselves with basic first aid. They happen when a fragile blood vessel in the nose breaks, for the same reasons as in adults: infection, allergies, trauma, or picking. A child who has had one nosebleed is likely to have another, because the lining stays fragile while it heals, and children are less good at leaving a scab alone.

The first aid is the same as for an adult, with one adjustment to the timing. Sit the child up, lean their head forwards, and apply firm pressure to the soft, fleshy part of the nose for 15 minutes. Sucking on an ice cube or an ice lolly can also help to slow the bleeding. Once the nosebleed stops, make sure the child does not blow or pick at their nose, and does not remove any clots, because that may bring on a further nosebleed.

If the nosebleed has not settled after 15 minutes of continuous direct pressure, the child will need to be examined by a doctor, which may involve looking up their nose and, if needed, stopping the bleeding by cauterisation, which seals the blood vessel, usually under local anaesthetic. There is one age rule to remember: if a child under 2 has a nosebleed, speak to your GP, because nosebleeds are unusual at that age and deserve a proper check.

When to see a GP, call 111 or call 999

Most nosebleeds need no medical attention at all. The NHS lists the situations where you should speak to your GP practice: you are taking a blood thinning medicine such as warfarin; you have a condition that means your blood cannot clot properly, such as haemophilia; you have symptoms of anaemia such as heart palpitations, shortness of breath and a pale complexion; a child under 2 has a nosebleed; or you have nosebleeds that come and go regularly. If your GP practice is closed, phone 111.

Call NHS 111 or go to your nearest emergency department if the bleeding carries on for longer than 20 minutes despite firm pressure, or if it is heavy and shows no sign of slowing down. When you arrive, you will be assessed to find out how serious the bleeding is and what is likely to have caused it. That may involve looking inside your nose, measuring your pulse and blood pressure, carrying out blood tests, and asking about any other symptoms you have. If needed, your doctor will discuss further treatment, for example ointments for your nose, cautery to seal the blood vessels, or nasal packing.

Call 999 if the nosebleed follows a head injury, if the person is having difficulty breathing, if the bleeding is very heavy and the person feels faint or unwell, or if they have other health conditions that make heavy bleeding dangerous. Do not drive yourself to A and E. Ask someone to drive you, or call 999 and ask for an ambulance. The distinction is simple: a nosebleed that stops with pressure is a home problem, a nosebleed that will not stop is a medical problem, and a nosebleed after a head injury is an emergency.

Frequently asked questions

Why do I keep getting nosebleeds in winter?

Why do I keep getting nosebleeds in winter? Because cold dry air outside and warm dry air from central heating pull moisture out of the lining of your nose until it becomes dry and cracked, which NHS Inform lists as a common cause of nosebleeds. The cracks form scabs, and blowing your nose, picking at a scab or even sneezing can break a tiny blood vessel open. Winter colds add more blowing, and decongestant sprays used too often can damage the lining further. Keeping the lining moist with petroleum jelly, blowing gently, and humidifying your home are the steps that break the cycle.

How long should a nosebleed last before I worry?

Most nosebleeds last from a few seconds to 15 minutes, and many stop on their own or with firm pressure. If you have pinched the soft part of your nose for 10 to 15 minutes and the bleeding has stopped, you will not usually need medical advice. NHS hospital leaflets advise seeking advice if the bleeding is still heavy after 20 minutes of firm pressure, either by calling NHS 111 or by going to your nearest emergency department. For a child, seek medical help if the bleed has not settled after 15 minutes of continuous pressure.

Should I tilt my head back during a nosebleed?

No. Tilt your head forward, not back. Leaning forward lets blood drain out of your nose instead of running down the back of your throat, where it can make you feel sick and where it hides how much blood you are losing. Sit down, lean forward, breathe through your mouth, and firmly pinch the soft part of your nose just above your nostrils for at least 10 to 15 minutes. Do not lie down, because lying down raises the blood pressure in the blood vessels of your nose.

Can I stop nosebleeds from coming back?

Often, yes, though not always completely. The steps the NHS recommends are to avoid picking your nose and keep your fingernails short, blow your nose as little as possible and only very gently, keep your home humidified, follow the instructions on nasal decongestants, and apply petroleum jelly just inside your nostrils to keep the lining moist. Avoid alcohol, hot drinks and heavy lifting for a few days after a bleed. If you often get nosebleeds and cannot prevent them, talk to your GP, who can look inside your nose and may offer treatment such as cautery to seal the bleeding vessel.

Are nosebleeds in children something to worry about?

Usually not. Nosebleeds are common in children aged between 2 and 10, they usually stop by themselves, and they do not usually need treatment beyond basic first aid: sit the child up, lean their head forwards, and press the soft part of the nose firmly for 15 minutes. Sucking on an ice cube or an ice lolly can help. Seek medical help if the bleed has not settled after 15 minutes of pressure. Speak to your GP if the child is under 2, because nosebleeds are unusual at that age, or if nosebleeds keep coming back.

Sources

NHS Inform, Nosebleed, https://www.nhsinform.scot/illnesses-and-conditions/ears-nose-and-throat/nosebleed/ (page last updated 14 May 2024)
NHS 111 Wales, Nosebleed, https://111.wales.nhs.uk/encyclopaedia/g/article/gwaedlifo%E2%80%99rtrwyn
Gloucestershire Hospitals NHS Foundation Trust, Discharge information following a nosebleed (epistaxis), https://www.gloshospitals.nhs.uk/media/documents/Discharge_information_following_a_nosebleed_epistaxis_GHPI1452_08_24.pdf (content reviewed August 2024)
University Hospitals Sussex NHS Foundation Trust, Nosebleed (epistaxis) A and E leaflet, https://www.uhsussex.nhs.uk/resources/nosebleed-epistaxis-emergency-department-leaflet/
The Dudley Group NHS Foundation Trust, Nosebleeds patient information leaflet, https://www.dgft.nhs.uk/pil/nosebleeds/ (reviewed September 2025)
Hull University Teaching Hospitals NHS Trust, Epistaxis (nosebleed) patient leaflet, https://www.hey.nhs.uk/patient-leaflet/epistaxis-nosebleed/ (last updated 31 May 2025)