What should you know about nose bleeding during cold and cough?

A cold can inflame the nasal lining and increase discharge. Repeated wiping, rubbing and hard nose blowing can then open a small surface vessel. Dry indoor air, smoke and some nasal products may add irritation. Coughing can increase pressure briefly, but the cough and the nosebleed may still have separate causes. Allergic rhinitis can cause sneezing and an itchy, runny nose, while acute bronchitis or asthma may cause a cough without being the source of nasal blood. Blood from the nose is usually bright red and starts at a nostril; blood coughed up from the chest may look different and should be assessed if its origin is unclear.

Sit upright, lean forward and pinch the soft part of the nose without checking repeatedly. Keep pressure for ten minutes, breathing through the mouth. Spit out blood that reaches the throat. Afterward, avoid forceful blowing, nose picking and strenuous activity for the rest of the day. Saline spray can help moisturise irritated tissue. Use cough or cold medicines only as directed; a pharmacist can check whether a product is suitable for you, especially if you have asthma, high blood pressure or take medicines that affect clotting.

Get urgent help if bleeding is heavy, follows an injury, causes faintness or breathing difficulty, or does not settle after sustained pressure. Arrange a medical review if nosebleeds keep returning, the cough lasts beyond the expected illness, you cough up blood from the chest, or you develop chest pain, worsening breathlessness, high fever or unusual weakness. Children, older adults and people taking blood-thinning medicines may need a lower threshold for assessment.

Is the blood most consistent with a nosebleed or a chest cough? Could allergies, a medicine or dry nasal tissue be contributing? How should I manage the cough while the nose heals?