Why Do I Get Nosebleeds in Winter? Causes and Prevention
Nosebleeds in winter happen because the air dries out the thin lining at the front of the nose until it cracks. Central heating removes moisture from indoor air, cold outdoor air holds very little moisture to begin with, and you move between the two several times a day. The NHS lists "the inside of your nose being too dry (maybe because of a change in air temperature)" among the main causes of nosebleeds.
To stop a bleed, sit forward and pinch the soft part of the nose for 10 to 15 minutes without letting go. To prevent the next one, keep the lining moist with saline and a thin layer of nasal moisturiser. Keep bedroom humidity between 30% and 50%, and stop picking or blowing hard. Go to A&E if a bleed lasts longer than 10 to 15 minutes.
This guide explains what winter does to the nose and who is most affected. It then covers how to stop a nosebleed properly, and how to get through to spring without another one.
What winter does to the inside of your nose
The septum is the wall between the nostrils. Its front part is covered by a thin, moist lining with a dense web of small blood vessels close to the surface. It is the most common site of nosebleeds because it is exposed to every breath you take.
Dry indoor air
Heating air does not add moisture to it, so the relative humidity of a heated room falls. Indoor humidity in winter can drop below the 30% to 50% range that the Asthma and Allergy Foundation of America recommends for a home to control dust mites. Every breath of dry air pulls moisture out of the nasal lining. Over hours it dries, over days it crusts, and a crust that is picked or blown off takes the surface with it.
Cold outdoor air
Cold air carries little moisture even when it feels damp. Once your nose warms it to body temperature, that small amount of moisture is spread thin, so the air draws water from the lining. In cold weather the nose has to supply most of the moisture for every breath itself.
Moving between the two
The lining copes with steady conditions. What winter brings is repeated swings: a heated bedroom, a cold walk, a heated office, a cold walk home. Each swing is a small stress on a lining that is already drier than it should be.
Colds, allergies and blowing
Winter is also cold season. Blowing the nose repeatedly, often hard, over a week of congestion inflames and abrades the lining. Steroid and decongestant nasal sprays, used more in winter, can dry or irritate the septum if the nozzle is aimed at it. Dust mite allergy flares in heated bedrooms and brings rubbing and blowing with it. Our guide to winter allergies covers that side.
Who gets winter nosebleeds most
| Group | Why winter is worse for them | What matters most |
|---|---|---|
| Children | Thin lining, nose picking, frequent colds, heated bedrooms | Nails short, saline at bedtime, no picking |
| Older adults | Thinner, drier lining with age, more medicines that affect bleeding | Moisturise the lining, review medicines with a doctor. Bleeding that runs mainly down the throat rather than out of the nostril is more likely to come from deeper vessels and needs medical care |
| People on blood thinners or regular aspirin | Bleeds last longer and recur more easily | Tell your doctor about any nosebleeds; do not stop medicines yourself |
| Nasal spray users | Nozzle aimed at the septum dries and irritates the same spot nightly | Aim the nozzle outwards, towards the ear on the same side |
| People with allergies or a cold | Blowing, rubbing and inflammation | Blow gently, one nostril at a time, treat the cause |
| CPAP users | Hours of airflow can dry the lining overnight | Heated humidifier on the machine; see our CPAP dry nose guide |
Our guide to why your nose runs more as you age explains why the lining thins and dries with age.
The NHS also notes nosebleeds are more common in pregnancy and in people with high blood pressure. Neither causes winter bleeds on its own, but both make them harder to stop. Mention a nosebleed to your midwife or GP if either applies.
How to stop a nosebleed
The NHS nosebleed guidance is simple, and many people tip the head back, which is wrong. Do this instead:
- Sit down and lean forward, head tilted forward, mouth open. Leaning back sends blood down the throat.
- Pinch the soft part of the nose, just above the nostrils, firmly between finger and thumb.
- Hold for 10 to 15 minutes without letting go to check. Letting go early restarts the bleed. Time it.
- Breathe through your mouth and spit out any blood that reaches the throat rather than swallowing it.
- An ice pack on the top of the nose may help, though the NHS notes the evidence for it is not very strong.
For the 24 hours after it stops, the NHS advises against blowing or picking the nose, hot drinks, alcohol, heavy lifting, picking any scab, and lying flat. All of these can restart the bleed. Our nosebleed first aid guide goes through the steps in more detail.
How to prevent nosebleeds in winter
Prevention is about keeping the lining moist and leaving it alone. For many people the first three measures are enough.
Keep the lining moist
- Saline spray or gel as often as needed through the day, and always before bed. It replaces the moisture the air takes out.
- A thin layer of nasal moisturiser inside each nostril at bedtime, applied with a cotton bud to the front of the septum. Water-based gels and plain emollients are both used. Petroleum jelly is common, but some clinicians advise against regular use inside the nose, especially in children and older people, because tiny amounts can be inhaled. Ask a pharmacist which suits you.
- Drink enough water through the day. A dehydrated body has less to spare for the nasal lining.
Fix the air
- Measure bedroom humidity with a cheap hygrometer. If it is below 30%, a humidifier in the bedroom overnight helps. Keep it clean and keep humidity below 50%, because above that dust mites and mould thrive. Our guide to humidifiers for nosebleeds covers the choice.
- Turn the thermostat down a degree or two, especially in the bedroom. Cooler air holds its moisture better and dries the lining less.
- Breathe through a scarf outdoors in cold wind. It warms and humidifies the air before it reaches the nose.
Leave the nose alone
- Do not pick. In children, keep nails short and treat crusts with saline so there is nothing to pick.
- Blow gently, one nostril at a time, with the mouth open.
- If you use a nasal spray, aim the nozzle outwards and slightly away from the septum, towards the ear on the same side. A nozzle aimed straight in lands on the same spot every time.
- Heat widens blood vessels, so skip very hot showers and saunas on the day of a bleed.
Nosebleeds every day in winter
A bleed once or twice over a winter is common and rarely means anything. Nosebleeds every day, or several a week, need a different approach.
First check the obvious. Common culprits are a nasal spray aimed at the septum, picking (in children, almost always), or a new blood-thinning medicine. A crust that keeps being knocked off before it heals is another. Fix that and give the lining a week or two of saline and moisturiser to heal.
If bleeds continue, a doctor can look inside the nose. A single prominent vessel on the septum can be sealed with a chemical stick in a short clinic procedure. This often ends the cycle, though some people need it repeated. The NHS advises seeing a GP if you have regular nosebleeds or take blood-thinning medicines. See a GP too if you have symptoms of anaemia, such as a fast heartbeat, shortness of breath or pale skin.
Children and winter nosebleeds
Children get more nosebleeds than adults, and many parents see more of them in winter. The usual story is a dry heated bedroom, a cold, and a finger. The first aid is the same: sit forward, pinch for 10 to 15 minutes, reassure. Prevention is saline at bedtime, short nails, a cool bedroom and treating any cold or allergy that is causing rubbing. Our guide to common childhood nasal issues covers nosebleeds alongside congestion.
See a doctor for any nosebleed in a child under 2, and for a child whose nosebleeds are frequent, heavy, or come with bruising or bleeding gums.
When to see a doctor
See a GP if nosebleeds are regular, or if you have signs of anaemia. See a GP too if you take blood-thinning medicines such as warfarin, or have a clotting disorder such as haemophilia. Any nosebleed in a child under 2 needs a GP visit. Also see a GP if a bleed is always from the same side with a blocked nose, discharge or a change in smell. That needs a look inside the nose.
Go to A&E or call emergency services if a nosebleed lasts longer than 10 to 15 minutes of continuous pinching, or if the bleeding is heavy. Go too if you are swallowing a lot of blood and vomiting it, or if it started after a blow to the head. Feeling weak, dizzy or short of breath is also a reason to go. These are the NHS thresholds.
Frequently asked questions
Why do I get nosebleeds in winter?
Dry heated indoor air and cold, dry outdoor air pull moisture out of the thin lining at the front of the nose until it cracks and bleeds. Colds, blowing, picking and nasal sprays add to the damage. Keeping the lining moist with saline and a nasal moisturiser prevents most winter nosebleeds.
Why does dry air cause nosebleeds?
A nosebleed from dry air happens because the lining on the septum is thin, with blood vessels close to the surface. Dry air removes its moisture, it crusts and cracks, and the vessels underneath open. Below the 30% to 50% range the AAFA recommends for a home, drying speeds up.
Does cold weather cause nosebleeds?
Indirectly. Cold air holds very little moisture, so breathing it dries the nose. The bigger factor is usually the heated air indoors, and the swing between the two.
How do I stop a nosebleed fast?
Sit forward, pinch the soft part of the nose just above the nostrils, and hold for a full 10 to 15 minutes without checking. Spit out blood rather than swallowing it. Do not tip your head back.
When is a winter nosebleed serious?
When it lasts longer than 10 to 15 minutes of pinching, when it is heavy, when it follows a head injury, or when you feel faint. Regular nosebleeds, or any nosebleed in someone on blood thinners, need a GP visit even if each one stops quickly.
Does a humidifier stop nosebleeds?
It can help when bedroom humidity has dropped below the 30% to 50% range the AAFA recommends, which is common in heated homes in winter. Measure first, keep the humidifier clean, and keep humidity under 50%.
This article provides general information. A pharmacist or doctor should guide treatment, particularly for children, in pregnancy, or if you take blood-thinning medicines.
