Nose bleeding freaks people out, but the good news is it is very common and will happen to everyone at some point, especially as a child. This article will shed light on why nose bleeding is so common, what steps to take when it happens and when, rarely, a nosebleed may represent a larger concern.

Nose bleeding, or what Dr. Fancy Nancy would call epistaxis, occurs easily because the nose has a large superficial complex of blood vessels that are exposed to the elements of air flow, temperature changes and trauma. This vascular complex, called Kiesselbach’s plexus, runs right below the surface of your inner nasal membrane. If the lining of your nose becomes irritated, inflamed or traumatized then that complex of vessels will bleed. The most common factor that causes nasal irritation is dryness. That is why nose bleeding picks up a little in the winter when the air is drier and the heat is turned on inside. As for inflammation, the most common factors are viral URIs (colds) and environmental allergies. Thus at any point during the congestion triggered by a cold or allergies, it is common for a sneeze or a cough to trigger a nosebleed. Perhaps the most common cause of nose bleeding is from trauma. This of course includes nose picking which is a common and pleasurable pastime for many children (and some adults). And beyond self imposed “digital trauma,” the nose is often hit during sports and recreational activities. Perhaps one of the most important points about nose bleeds is that once you get a nose bleed you are prone to a repeat in the coming weeks. That is because there is a scab and an injured, small blood vessel that can more easily rebleed.

So now that you know why nose bleeding is so common, what do you do when you look up and your child’s face looks like a red Rorschach print? Stay calm and keep your child calm. If available, find something absorbent (clean towel, tissue, shirt) and begin to apply firm pressure where the boney hard part of the nose meets the soft cartilaginous part. Lean your child forward to avoid too much swallowing of blood and do not release the pressure for five minutes (or preferably 10 minutes if you have a tolerant child). Do not stop applying pressure to keep checking on the status of the bleeding because the idea is to create a firm clot.

So now you calmly stopped the bleeding and intelligently explained to your curious child why the nose bleed occurred. Your child then asks if a nose bleed is ever something to worry about? The times you would worry about nose bleeding are when it is not the only type of bleeding. If your child has nosebleeds and often bleeds when they brush their teeth, often has blood on the toilet paper, very easily bruises or has recently developed small broken blood vessels all over the body then it may be necessary to evaluate further.

Now when the next nosebleed occurs you are armed with all the tools in the nosebleed toolkit.

Dr. Darren Saks is a physician with Tenafly Pediatrics.