Why blowing your nose causes blood
The inside of the nose is lined with thin mucous membrane that has many small blood vessels close to the surface, particularly on the nasal septum near the front. When the lining is dry, inflamed or injured, the pressure of blowing, sneezing or rubbing can break a vessel, producing blood-streaked mucus or tissue stained pink or red. In most cases the amount is small and stops on its own. See nosebleed causes and how to stop a nosebleed.
Common causes
- Dry air from heating, air conditioning, winter or altitude.
- Colds, allergies and sinus infections, which inflame the lining and make you blow often. See sinus infection symptoms.
- Forceful or repeated nose blowing and sneezing.
- Nose picking or rubbing.
- Nasal sprays (steroid, decongestant, antihistamine) and drying medicines.
- Nasal irrigation done too forcefully.
- Minor trauma to the nose.
- Deviated septum or nasal polyps. See nasal polyps.
- Blood thinners and aspirin, which increase bleeding.
- Recreational drugs snorted into the nose.
What the blood looks like
- Pink or red streaks in clear mucus: fresh minor bleeding from the lining.
- Brown or dark flecks and clots or scabs, particularly in the morning: old, dried blood from irritation.
- Blood in mucus with a cold or sinus infection: due to inflamed lining.
- Frequent, one-sided bleeding: consider a local cause such as a septal vessel, a polyp or, rarely, a tumour.
- Heavy red blood that drips: a nosebleed.
- Blood from the nose can also be swallowed and reappear as dark stools or coffee-ground vomit, so tell your doctor about these.
What to do and home care
- Blow gently, one nostril at a time, with your mouth open; avoid forceful blowing.
- Use saline nasal spray or gel several times a day to moisturise.
- Apply a small amount of petroleum jelly or an antibiotic-free nasal ointment inside the nostril at night.
- Use a humidifier in the bedroom, cleaning it regularly.
- Do not pick or scratch; keep nails short.
- Treat allergies and congestion with saline rinses and steroid sprays aimed away from the septum.
- Stay hydrated.
- If bleeding occurs, pinch the soft part of the nose for 10–15 minutes while leaning forward.
Medicines and sprays
Intranasal steroid sprays can dry the lining and cause streaks of blood, especially if aimed at the septum; point the nozzle outward toward the ear on the same side and ask your doctor or pharmacist about technique. Decongestant sprays used for more than 3 days can cause rebound congestion and damage the lining. Blood thinners and aspirin increase bleeding but must not be stopped without medical advice. Supplements such as fish oil, ginkgo and vitamin E can also increase bleeding.
Children and babies
Blood-streaked mucus in children is usually from colds, dry air or picking. Use saline spray, keep nails short and use a humidifier. See a doctor if a child has frequent nosebleeds, bleeding from one nostril with a foul-smelling discharge (possible foreign body), easy bruising, or if a baby under 2 has bleeding.
Red flags
- Bleeding on one side only that keeps recurring, with a blocked nose, facial pain, numbness or swelling.
- A lump in the neck, change in vision or reduced smell.
- Frequent or heavy nosebleeds, or bleeding with easy bruising, bleeding gums or blood in urine or stools.
- Unexplained weight loss, fever or night sweats.
- Persistent crusting with foul smell.
- Blood in mucus after a head injury (possible fracture or CSF leak, clear fluid): urgent.
- Nasal bleeding in people with high blood pressure that is poorly controlled.
What the doctor may do
A doctor will ask about frequency, side, triggers, medicines, drugs and bleeding history, and examine the nose with a light and speculum. An ENT specialist may use a small camera to inspect the nasal passages and sinuses. Treatments include antiseptic ointments, silver nitrate cautery for a visible bleeding vessel, treating infection or allergy, adjusting medicines and, rarely, biopsy or imaging for suspicious lesions. Blood tests are done if a bleeding disorder is suspected.
When to see a doctor
- Blood in mucus more than a few times a week or lasting over 2 weeks.
- Bleeding from only one nostril, repeatedly.
- Heavy bleeding, or bleeding that is hard to stop.
- Taking blood thinners with recurrent bleeding.
- Any of the red flags above.
- Nasal blockage on one side that does not improve.
- Smokers or people who snort drugs with persistent bleeding.
Three common situations
Pink streaks after blowing during a cold in winter: gentle blowing, saline and a humidifier usually settle it.
Morning brown clots in a person using a steroid spray: adjust the aim and moisturise; ask a pharmacist.
Repeated blood from the left nostril with a persistent blockage on that side: needs an ENT examination.
Key points to remember
Blood when blowing the nose is usually from dry, irritated lining and settles with moisturising, gentle blowing and avoiding picking. See a doctor if bleeding is frequent, one-sided, heavy or comes with other symptoms. Our ENT team can examine your nose.
This guide is for general information and does not replace an examination by your own doctor or ENT specialist.
Questions about blood when blowing your nose
These answers are general information and do not replace an examination or individual medical advice.
Why is there blood when I blow my nose?
Usually because the nasal lining is dry or irritated from colds, allergies, dry air or forceful blowing.
Is blood in mucus serious?
Rarely; it is usually minor, but frequent, one-sided or heavy bleeding should be checked.
Why is my snot brown or dark?
Old dried blood from small irritations, often overnight.
How can I stop it from happening?
Keep the nose moist, humidify the air, blow gently and avoid picking.
Can nasal sprays cause it?
Yes, particularly if aimed at the septum or overused.
When should I see a doctor?
If it is recurrent, one-sided, heavy or accompanied by other symptoms.
Sources
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.