Delayed Nosebleed After Hitting Your Head: What to Know

A blow can irritate or injure the delicate lining inside the nose, and bleeding may become noticeable later after activity, rubbing, or a change in pressure. A nosebleed can also occur with a separate cause such as a dry or inflamed nasal lining, a cold, sinusitis, allergic rhinitis, or uncontrolled high blood pressure.

Because the bleeding followed a head injury, do not use its delay to judge how serious the injury is. Blood from the nose after trauma can be difficult to distinguish from other fluid without an examination. Medicines that reduce clotting can also make bleeding harder to stop; tell the clinician if you take them.

Sit upright and lean slightly forward so blood can leave through the nose rather than run toward the throat. Pinch the soft part of the nose continuously with your fingers while breathing through your mouth. Spit out blood instead of swallowing it. Do not tilt your head back, blow your nose, pick inside it, or pack it with tissue.

Stop strenuous activity and arrange prompt medical advice, even if the bleeding settles. Keep track of when the head impact happened, when the bleeding began, whether it has returned, and any symptoms that appeared before or after it.

Seek emergency care immediately if the bleeding is severe or will not stop with firm pressure, or if you have worsening or severe headache, repeated vomiting, confusion, unusual sleepiness, fainting, a seizure, weakness, numbness, trouble speaking, vision changes, or difficulty walking. Clear watery drainage from the nose or ears, unequal pupils, or blood-thinning medicine after a head injury also requires urgent assessment.

Do not drive yourself if you feel confused, faint, unusually drowsy, or unsteady. Have someone stay with you and call local emergency services. A child, older adult, or person who cannot reliably describe symptoms should be assessed promptly after a head impact with later bleeding.

Ask: Could the nosebleed be related to the head impact? Does the nose need an internal examination? Which symptoms should prompt emergency care if they appear later? When can I safely return to exercise, work, or driving? Tell the clinician about the direction and force of the impact, loss of consciousness, vomiting, headache, nasal pain, and every medicine or supplement you use.