12 Well-Known Causes of Nasty Nosebleeds in Children

Nasty nosebleeds can be alarming, especially when they occur in young children. The blood vessels in the nose are close to the surface; therefore, blood easily flows and collects in the nasal cavity. Large blood clots readily form which makes parents afraid that excessive bleeding is occurring.

The fact that nasty nosebleeds in kids often happen at night causes parents to become alarmed when they see blood on sheets, pillows, and their kids’  pajamas.

As a Pediatric ENT surgeon, I have had more than my share of parents bring blood stained sheets to my office so I can see how much bleeding has happened.

I also have been given containers with blood clots. Umm, I don’t need that!  I know it was “a lot” of blood, but slow bleeding over hours while asleep is different from massive bleeding quickly.

Nosebleeds can happen any time of the day and are particularly bothersome when they occur during school or during sporting events.  I  have always said that people tolerate kids blowing yellow or green mucus out of their noses, but they do not tolerate blowing or sneezing out blood!

The good news is that most causes for nasty nosebleeds in kids can be readily treated.  Physicians need parents to be able to provide a great past medical history because this is extremely important to help us decide what to do next.

Most nasty nosebleeds have had smaller episodes that have occurred over months to years. These episodes are important.

Questions your physician may ask you about your child’s nasty nosebleeds

• When did they first start happening?
• Do they occur throughout the year or during certain seasons?
• How long do the episodes last?
• What have you done to control them? Have you had to go to the emergency room for treatment?
• Does your child have excessive bleeding in other areas of the body? Or have easy bruising?
• Are there any family members with bleeding problems?

I ask other questions depending on the age of your child and the answers that are provided to the first list of questions.  Although there are many causes of nasty nosebleeds in kids, I am sharing some of the most well-known causes. Parents may be more able to share important information if they have a better idea of some of the causes we are looking for.

Once physicians understand the cause of nosebleeds, appropriate treatment can be recommended. Hopefully, you have read the reason Vaseline should never be part of your nosebleed treatment. No one needs to add a possible chance for worsening health because of repeated use of Vaseline for nosebleeds! You can also find the best alternative to Vaseline to avoid unnecessary risks. 

I recognize that it is rare for there to be a complication from placing vaseline inside the nose. However, why take the chance? Many experienced physicians share excellent posts about nosebleeds, such as this one by Dr.Kristen Stuppy, but I maintain we need another lubricant inside of the nose with no risk.

Home care tips for relieving nosebleeds: 

• Pinch the nose
• Lean head forward (not lift up chin)
• Use Afrin to help clamp blood vessels (but avoid overuse and Afrin addiction!)
• Do not blow out blood clots
• Pinch nose MUCH longer than you think you need to. Do not pinch and release repeatedly.
• If the nosebleeds are recurrent see your physician to find out the cause.

12 well-known causes of nasty nosebleeds in kids

The Common Cold

This is the number one cause of nosebleeds in kids! Why? Because kids under age 6 often get 4-6 colds each year.

What is a cold? It is just a viral infection that mostly impacts the nose and upper airway.  A cold typically lasts 7-10 days and goes away. If it lasts longer, and you have used all the Momma Medicine that you have at home, you may need to see your child’s pediatrician because a viral infection complication may be present.

Many different viruses can cause cold symptoms, and these viruses are usually not the aggressive viruses that cause more serious problems. In general, I like to say that if we give the virus a name, it is an uglier more aggressive virus! That’s just my thoughts but I have found this to be true more often than not!

 

Allergies

Allergies can affect most parts of the body, but we commonly think about nasal allergies.  In my previous post, I discussed the allergy reaction and its impact on the body. The bottom line is that an allergy leads to nasal swelling which makes blood vessels more like to burst with aggressive nose blowing and nose rubbing.

Symptoms from a cold often look similar to allergies, but your pediatrician may notice differences that require a changed treatment plan. Check out this post to learn the best nasal allergy treatments.

If you find that you are repeatedly saying that your child has allergies, you may want to consider a visit to a physician to discuss your concerns. There are several methods to determine if allergies are present and this is important to determine how to control them and prevent complications.

Remember, food allergies may also lead to nasal swelling which leads to those nasty nosebleeds.

 

Sinus Infections

Just as it can be difficult to know if your child has a cold or an allergy, it can also be difficult to know when the cold has progressed to a sinus infection.

Good thing you have your child’s pediatrician to monitor and determine when that change has happened. This is the beauty of having a primary care physician who knows your child instead of repeatedly going to a convenient immediate care walk-in clinic.  Just because the nasal mucus is green does not mean it is a bacterial infection.

When bacterial infections occur, there can be a greater reaction and more swelling. Which means that there is a greater chance for a nosebleed. I have had parents tell me that they know when a sinus infection is coming because their child will have nosebleeds for a few days before the more serious sinus infections symptoms show up.

 

Deviated Septum

Well, aren’t these some fancy words? The nasal septum is the tissue made of bone and cartilage that divides your nose into two openings. The openings should be equal size but if the septum is crooked, there can be problems.

Yes, the best way to describe a deviated septum is by saying the nose is crooked….on the inside! Many children (and adults) have a  deviated septum, but the outside of the nose does not look crooked. There are different bones involved with the outside of the nose compared to the inside.They do not have to be crooked together.

Several blog posts can (may in the future?) be dedicated to problems associated with a deviated septum.  For today’s purpose, I want to highlight that a crooked septum may allow the delicate lining of the nose to become dry. The lining should be moist with mucus and if it becomes dry, it can crack and lead to a nasty nosebleed.

 

Enlarged adenoid

Oh my, look at this topic that I have not addressed yet. So many ENT topics coming your way. Well, let’s just say that most of us have heard about enlarged tonsils. Tonsils are lymph nodes located in the back of the throat.

I call the adenoid a NOSE TONSIL because it is a lymph node in the back of the nose. The adenoid swells due to infection or inflammation, and if it stays enlarged, the nose does not drain properly. Then, chronic nasal swelling occurs. By now you know that this swelling leads to nasty nosebleeds.

 

Nose picking

Who has not seen a child aggressively picking the nose? It is indeed common and can lead to recurrent nosebleeding.

However, I encourage a deeper look at why the nose is causing irritation which leads to the picking. Treating the underlying problem will often then fix the nose picking.

 

Foreign body

The stories I can tell about things I have removed from the nose! Kids know they made a mistake when shoving something in their nose so they hide it from parents. Often for weeks or months.

Key tips to suspect a nasal foreign body include nasal drainage with a bad odor and bloody discharge from one nostril. Unless there is a crooked nose or other known anatomy problem, these symptoms should be evaluated by an ENT surgeon for possible removal of the object.

 

Trauma

An injury to the nose can lead to nosebleeds that are usually self-limited. These injuries tear the lining of the nose or even break the delicate nasal bones.

Rarely, an injury tears an important blood vessel located in the back part of the nose which leads to severe bleeding that must be treated in the emergency room by packing the nose. Sometimes surgery is required to stop this bleeding.

 

Dry environments

The nasal cavity should be moist with mucus lining the tissues. If you live in the desert or have repeated exposure to dry environments, the nasal tissues can crack and bleed.

I have previously written posts about the benefits of nasal saline washes as well as tips to successful use them in kids.  Adding moisture to the nose can be invaluable in reducing nosebleeds.

 

Acid reflux

Acid reflux disease is commonly overlooked if vomiting and stomach problems are not present. However, silent acid reflux can occur which allows harsh acid to bathe the upper airway tissues.

Many ENT symptoms can be caused or worsened by undiagnosed acid reflux. Stay tuned for upcoming posts about this problem that I often only find after all my medical and surgical treatments have failed. The lack of clear symptoms makes this a difficult problem to diagnose and treat.

 

Bleeding disorders

Severe recurrent bleeding that requires the attention of physicians often represents a more serious medical problem. Many blood problems can lead to trouble forming clots and may need to be seen by a specialist who deals with these problems.

Please let your pediatrician know if bleeding occurs in the nose but also in other areas. When basic cuts bleed longer than normal or bruises last a long time, there may be an underlying problem that lab work may help diagnose.

 

Blood vessel tumors

Last but not least, tumors can cause nosebleeds. In fact, almost every problem that I treat can also be caused by tumors.

It is best to keep in mind that tumors are generally not common in kids, but of course, they are possible. The most common tumor associated with severe nosebleeds is called Nasopharyngeal Angiofibroma. 

These tumors are very rare but will be considered in the patients most at risk. Most of these blood vessel tumors occur in adolescent boys. These nosebleeds may have a history of being much more severe than other types.

Now I hope that everyone is highly educated on the many causes of nasty nosebleeds in kids.  There are a variety of blogs which summarize nosebleed causes and treatments in one post. Just remember to ignore their suggestions about using Vaseline inside the nose! Please substitute gels that are made of nasal saline to avoid any potential lung complications.

As always, much love for supporting my work. I will be adding many more posts to highlight parenting and healthcare tips, so be sure to consider subscribing to my podcast or to my blog to avoid missing a post!