Anterior epistaxis: a nosebleed from the front of the nose

The blood commonly comes through one nostril, although it can spread to both sides. Dryness, rubbing or picking, forceful nose blowing, minor injury, and irritation during a cold or allergic rhinitis can disturb fragile vessels near the nasal entrance.

Anterior describes the likely location of bleeding rather than its cause. These bleeds begin toward the front of the nasal partition, where small blood vessels lie close to the surface. Blood flowing mainly down the throat, especially without much visible at the nostrils, needs medical assessment because the source may be farther back.

Medicines that affect clotting, a bleeding disorder, nasal sprays used incorrectly, recent nasal procedures, and repeated irritation can change how readily bleeding starts or stops. High blood pressure may complicate management, but a nosebleed alone cannot diagnose hypertension.

Sit upright and lean forward so blood does not run into the throat. Spit out blood that reaches the mouth. Using thumb and finger, pinch the soft part of the nose just below the bony bridge, closing both nostrils, and maintain continuous pressure for ten to fifteen minutes while breathing through the mouth.

Do not tilt the head back, lie flat, or repeatedly release the pressure to check. After bleeding stops, avoid picking, forceful blowing, heavy exertion, and very hot showers or drinks for the rest of the day. Saline gel or other moisturising care suggested by a clinician may help when dryness is a recurring trigger.

Seek urgent care if firm pressure does not stop the bleeding, the flow is heavy, blood is causing choking or breathing difficulty, you feel faint or weak, or the bleed followed a significant head or facial injury. Emergency help is appropriate for severe breathing difficulty, collapse, or uncontrolled blood loss.

Arrange a medical review for frequent recurrences, easy bruising or bleeding elsewhere, or nosebleeds while taking anticoagulant or antiplatelet medicine. Do not stop prescribed clot-preventing medicine yourself; the treating clinician should weigh the bleeding concern against the reason it was prescribed.

Ask whether dryness, inflammation, spray technique, medicines, or a visible vessel may be contributing; which moisturising product is suitable; and whether cautery or referral is warranted. Bring a current medication list and describe which nostril bleeds, how the episodes start, and what stops them.