Cold Weather Can Mean an Increase in Nosebleeds

For patients with bleeding disorders, the winter can be miserable with nosebleeds (also called epistaxis). Since cold air does not hold as much moisture as warm air, this can cause sinuses and mucous membranes to dry out, resulting in damage to the nose lining. This damage can cause normally moist membranes to crack. Heated indoor air may dry out your nasal passages and make the tiny blood vessels inside them more fragile.

Preventing nosebleeds needs to be a priority. Here are ways to help:

• Do not smoke.
• Keep your blood pressure under control.
• Drink 48-64 ounces of water daily.
• Humidify air with a cool mist humidifier.
• Avoid picking your nose or blowing it very hard.
• Treat any seasonal allergies.
• Keep the inside of your nose moist so that it doesn't crust over, crack, and bleed. Put a little Vaseline® or olive oil in each nostril to hold in the moisture during cold weather. Ayr® Gel, available at most drugstores, can also help keep your nose moist.

Most nosebleeds will respond to pressure that is maintained for 20 minutes. It is essential to maintain constant pressure on the front of the nose. Tilt your head forward and pinch the nostrils together just below the bony center part of your nose. Nose clips, instant ice packs and NoseBudd® ice packs can help you keep pressure. Products other than these should be used only after 20-30 minutes of pressure to the bridge of the nose. Treatments such as factor products can also be used if prescribed by your hematologist. Additionally, Stimate nasal spray (currently unavailable until 2024) or a generic compounded Desmopressin Acetate nasal spray is available from our pharmacies. Amicar® and Lysteda® are other options that may also be considered.
Please consult your HTC before trying these:

• Afrin® – shrinks swollen membranes in the nose (only use if over 6 years old; may apply to cotton ball and pack cotton ball in nose)
• Salt pork – may work by promoting clotting. Salt pork can be found in the meat department of grocery stores. Roll the salt pork into a plug that matches the size of your nostril and that will hang at least ¼ inch to ½ inch outside for easier removal. Freeze the prepared plugs until ready to use. Leave the plug in the nostril for an hour.
• WoundSeal® Powder for Nosebleeds – works independently of blood clotting. An occlusive seal is formed which stops further bleeding or oozing. Blood solids continue to stack beneath the seal to strengthen it.
• NasalCEASE® – contains calcium alginate; when calcium contacts the blood, it can promote clotting.

You can learn more about preventing and treating nosebleeds through our online Handbook. Please contact your HTC or Hemophilia of Georgia Outreach Nurse if you have any questions or concerns.