Are Hemophilia Nosebleeds “Normal”?how to prevent them


Learn what causes nosebleeds and how to prevent them.

Hemophilia Nosebleed in a little boy

Parents whose children are diagnosed with hemophilia, von Willebrand disease or another bleeding disorder generally learn about the causes and symptoms of their child’s condition as soon as possible. They recognize risks and protect their kids from trauma, including “hemophilia-proofing” the house for young children, creating a hemophilia care plan for school and helping them safely enjoy sports.

One bleeding disorder symptom that may arise regularly is the nosebleed (also known as epistaxis). Nosebleeds, which originate in the mucus membranes lining the nose, are caused by irritation to the small blood vessels inside the nostrils. These vessels can be broken by a host of irritants, both environmental and physical, including dry air; nose-picking; physical trauma, such as a hit or fall; sneezing; or even blowing your nose powerfully.


Children with hemophilia may be distressed or frightened when a nosebleed occurs. Luckily, the National Hemophilia Foundation suggests addressing the bleed can be as simple as pinching the nose near the bridge, tilting the head down or forward and applying an ice pack. Pressure on the bridge of the nose can slow the flow or halt the bleed altogether, allowing a clot to form.

While it may be tempting to allow the first clots, which can be stringy or jellylike, to build up,Hemophilia of Georgia notes that this type of clot is not strong enough to block continued bleeding and recommends that patients gently blow the first few clots out of your nose.

If a nosebleed lasts longer than usual, or the bleeder has severe hemophilia, it may be necessary to infuse with factor. Give your doctor a call if the nosebleed is bad enough to need factor, if you get nosebleeds often or if there is green or yellow mucus that may indicate an infection.

Once the blood flow has stopped, it’s important not to disturb the clot forming inside the nose.Hemophilia of Georgia notes that drinking hot beverages or liquids (like tea or soup) can cause the bleed to start again, so you may want to avoid these for a few hours after a nosebleed.

Those who experience frequent or severe nosebleeds should talk to their doctor about clot-supporting medications, including hemostatic agents, which can be injected or taken orally. An entire range of prescription medications— available in powder, gel, cream, spray and pill form—exists to help bleeding disorder patients manage their conditions.


Though nosebleeds are not life-threatening for the majority of people with bleeding disorders, it’s certainly simpler to prevent them than it is to treat them. Because bleeds are often caused by dryness or irritation in the nose, keep the inside of the nose moist. You can do this by using a humidifier, especially during dry winter months—just remember to change the water in the humidifier daily to prevent germs from collecting in it.

Certain topical ointments and nasal sprays can also be effective at keeping the inside of the nose moist. These include saline spray (misted inside the nose as needed on a daily basis), saline nasal gel or triple antibiotic ointment (applied gently to the insides of the nostrils with a clean Q-tip).

While chronic or recurrent nosebleeds sometimes can be treated by cauterizing (burning) the vessels in the nose, cauterization should be approached carefully in people with bleeding disorders. Ear, nose and throat physicians can cauterize vessels using chemical, electric or laser methods; however, it’s important for your ENT to work hand-in-hand with your hematologist in order to prevent causing worse or more frequently occurring nosebleeds later on.

Talk with your hematologist or local Hemophilia Treatment Center if you experience regular or severe nosebleeds. They may be able to create a specialized treatment plan for you.


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