It is common to experience a bloody nose when you are sick, and in most cases associated with minor illness, this symptom is considered normal. The delicate lining of the nasal passages is easily irritated by the body’s response to infection, making minor bleeding a frequent occurrence. This bleeding typically results from minor ruptures in the small blood vessels near the surface of the nose. Understanding the physical changes that happen inside your nose during an illness helps explain why this bleeding occurs.
Why Illness Makes the Nose Vulnerable
The body’s immune system responds to viral or bacterial infections by initiating inflammation, known as rhinitis, within the nasal passages. This inflammation causes the tissue lining the nose to swell and become engorged with blood. This response increases the delivery of immune cells to the site of the infection to fight off invading pathogens.
This influx of blood causes vasodilation, where tiny capillaries expand and move closer to the surface of the mucous membrane. The capillaries in the front part of the nasal septum (Little’s area) are already fragile. Swelling and increased pressure transform these delicate vessels into easily ruptured targets, even without direct trauma.
Sickness also contributes to vulnerability through increased dryness. Fevers can lead to dehydration, and constant airflow from congestion-related mouth breathing dries out the nasal lining. When the mucous membrane dries out, it loses protective moisture and flexibility. This leads to cracking and crusting that exposes the underlying fragile capillaries, creating an environment for minor bleeding.
Actions That Trigger Bleeding While Sick
The increased fragility of the nasal vessels means that routine actions taken while sick can easily trigger a nosebleed. The most common trigger is forceful nose blowing, which is necessary when dealing with congestion. Blowing the nose too hard creates a sudden, high-pressure change within the nasal cavity. This pressure is often enough to rupture the already weakened and engorged capillaries.
Physical irritation from trying to clear the nose is another factor. Frequent touching, rubbing, or nose picking, often due to discomfort from crusting or itching, can directly damage the inflamed mucous membranes. The combination of a dry, cracked lining and minor mechanical trauma is a direct route to epistaxis.
Certain cold and flu medications can also contribute to the risk of bleeding. Over-the-counter decongestant nasal sprays, if used too frequently, can cause excessive dryness and irritation. Additionally, many people take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to manage fever and pain. These medications can have a mild blood-thinning effect, increasing the likelihood of a vessel continuing to bleed once it has ruptured.
Knowing When a Bloody Nose Requires a Doctor
While most nosebleeds while sick are harmless, certain signs indicate the need for medical attention. Seek emergency medical care if the bleeding is severe or if it lasts longer than 20 minutes, even after applying continuous, firm pressure to the soft part of the nose. Bleeding that is very heavy, or a flow running down the back of the throat, may indicate a more serious posterior nosebleed.
Consult a healthcare provider if you experience frequent nosebleeds, such as multiple times a week, as this may signal an underlying issue. Immediate medical attention is necessary if the nosebleed is accompanied by symptoms like dizziness, feeling faint, or difficulty breathing, which could indicate significant blood loss.
If you are taking blood-thinning medication and experience a nosebleed that is difficult to stop, seek medical advice promptly.