Nosebleeds: Causes and Remedies for Cold Weather

Nosebleed

Hello, doctor.
I'm not sure if it's due to the recent cold weather, but I've noticed that I wake up with nasal congestion (which happens when it's cold).
However, when I blow my nose, there is often blood mixed with the mucus! This has happened before as well.
I'm wondering if my nasal passages are too dry, which could be causing this.
Recently, during these cold days, I've even found that putting tissue in my nose still results in bleeding! It seems like it doesn't stop.
Could it be that the cold weather and my dry nasal passages are causing this?

Zhu, 20~29 year old female. Ask Date: 2005/03/06

Dr. Ye Dawei reply Otolaryngology

Ms.
Zhu, your speculation is likely the reason.
Attached is an article for your reference.

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This article will be organized in the future on the 【 Yeh Da-Wei ENT Clinic website/Health Education】.
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【The 'Cure-All Nasal Disease Surgery' That Makes One's Nose Sour】
In the outpatient clinic of ENT specialists, symptoms such as cough, headache, dizziness, and nasal congestion are quite common.
However, due to their complex causes, treatment can be challenging, leading patients to flock to exaggerated advertisements claiming "cure" and "guaranteed treatment." In the past two years, many patients treated after undergoing the so-called "five-minute nasal disease cure" have experienced issues such as nasal mucosal adhesion, nasal vestibule inflammation, nasal cavity narrowing, and nasal septum perforation, which are truly numerous and disheartening.

The causes of nasal congestion generally include "infection," "structural abnormalities of the nose," "allergic rhinitis," and "vasomotor rhinitis," each with its own pathogenic mechanisms and treatment options.
Of course, each condition has its limits in efficacy, which has allowed these alternative practitioners to find a niche for their unconventional therapies.
Below is a brief introduction to each condition based on this classification.
◎ Infection: The most common cause of nasal congestion is the common cold.
Once the cold resolves, the nasal congestion typically improves.
Bacterial infections leading to sinusitis are more severe and can include symptoms such as post-nasal drip, headache, difficulty concentrating, and chronic nighttime coughing.
In children, this can significantly affect sleep quality and academic performance.
If conservative treatments such as medication and nasal irrigation are ineffective, surgery may be recommended.
The traditional Luc's surgery, which involved incising the lip to remove the entire sinus mucosa, has now been completely replaced by endoscopic sinus surgery.
This technique allows for selective removal of obstructive mucosal tissue under good visualization, restoring normal sinus function.
◎ Structural Abnormalities of the Nose: Deviated septum and chronic hypertrophic rhinitis.
A deviated septum can occur due to natural compression at birth or as a result of trauma causing cartilage distortion.
The degree of deviation does not always correlate with nasal congestion severity, and the decision to surgically correct it can depend on the patient's subjective experience.
Chronic hypertrophic rhinitis refers to the thickening of normal turbinate tissue, which can lead to nasal congestion symptoms.
The turbinates, also known as nasal conchae, are normal physiological structures located on the lateral walls of the nasal cavity, and patients can often see them when examining their own nasal cavities.
Sometimes, patients are misinformed that these are nasal polyps and undergo inappropriate cauterization procedures.
◎ Allergic Rhinitis: Currently, there is no definitive cure for allergic rhinitis, which is a disease caused by a specific predisposition.
It leads to nasal mucosal edema, resulting in nasal congestion.
Treatment can be tailored based on the severity of symptoms, utilizing oral medications, nasal sprays, immunotherapy, or surgery to alleviate nasal congestion.
◎ Vasomotor Rhinitis: Various factors can cause vasomotor rhinitis, including work stress, hormonal changes during pregnancy, certain antihypertensive medications, and even irritants such as perfumes, temperature and humidity changes, or cooking fumes.
These factors can cause vasodilation and congestion of the nasal mucosa, leading to symptoms of nasal congestion.
Treatment options for chronic hypertrophic rhinitis, allergic rhinitis, or vasomotor rhinitis include conservative oral medications, nasal sprays, traditional inferior turbinate resection, and advanced laser surgery.
There are also newer techniques using thermal probes placed submucosally in the turbinates, where radiofrequency generates low heat to cause protein coagulation in the submucosal tissue, leading to fibrosis and reduction of the enlarged turbinate tissue.
Nasal congestion is not classified as a disease, but it is a highly bothersome symptom.
It can cause difficulty breathing and may easily lead to dizziness, headaches, difficulty concentrating, snoring, insomnia, or sleep apnea.
Consulting a professional ENT physician to identify the true cause of nasal congestion and selecting appropriate symptomatic treatment is the right approach.
I sincerely hope to no longer see so-called "cure-all nasal disease surgeries" in the outpatient clinic.

Reply Date: 2005/03/06

More Info

Nosebleeds, or epistaxis, can indeed be more common in cold weather, and your observations about experiencing nasal congestion and bleeding during colder days are not unusual. The primary reasons for this phenomenon are related to the effects of cold air on the nasal passages and the overall humidity levels during winter months.

Causes of Nosebleeds in Cold Weather
1. Dry Air: Cold weather often coincides with lower humidity levels, both outdoors and indoors (especially when heating systems are in use). Dry air can lead to the drying out of the mucous membranes in the nasal passages. When these membranes become dry, they can crack and bleed easily, resulting in nosebleeds.

2. Nasal Congestion: Cold weather can also lead to increased nasal congestion due to colds or allergies. When you blow your nose frequently to relieve congestion, this can further irritate the nasal lining and contribute to bleeding.

3. Vasodilation and Blood Vessel Fragility: In response to cold, blood vessels in the nasal passages may constrict and then dilate when exposed to warmth (like when you come indoors). This fluctuation can make the blood vessels more susceptible to rupture, especially if they are already weakened by dryness.

4. Increased Nose Picking or Rubbing: During colder months, people may unconsciously rub or pick their noses more often to relieve discomfort from dryness or congestion, which can lead to further irritation and bleeding.

Remedies for Nosebleeds
1. Humidification: One of the most effective ways to prevent nosebleeds in cold weather is to maintain humidity levels in your home. Using a humidifier can help keep the air moist, which in turn helps keep your nasal passages hydrated.

2. Nasal Saline Sprays: Regular use of saline nasal sprays can help keep the nasal mucosa moist. These sprays are safe and can be used multiple times a day to prevent dryness.

3. Stay Hydrated: Drinking plenty of fluids can help keep your mucous membranes hydrated from the inside out. This is particularly important in winter when people tend to drink less water.

4. Avoid Irritants: Try to avoid exposure to irritants such as smoke, strong odors, or allergens that can exacerbate nasal irritation and lead to bleeding.

5. Gentle Nose Blowing: If you have nasal congestion, blow your nose gently to avoid trauma to the nasal lining. If you feel the need to clear your nose, do it softly.

6. Moisturizing Ointments: Applying a thin layer of petroleum jelly or a specialized nasal ointment to the inside of your nostrils can help keep the area moist and reduce the likelihood of bleeding.

7. Seek Medical Attention: If nosebleeds are frequent, severe, or accompanied by other symptoms (such as significant pain or swelling), it’s important to consult a healthcare provider. They can evaluate for underlying conditions such as clotting disorders or structural issues in the nasal passages.

Conclusion
In summary, the cold weather can indeed contribute to the occurrence of nosebleeds, primarily due to dry air and nasal irritation. By taking preventive measures such as using humidifiers, saline sprays, and staying hydrated, you can significantly reduce the frequency of nosebleeds during the winter months. If the problem persists or worsens, it is advisable to seek medical advice to rule out any underlying health issues.

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