What illnesses are bloody noses a symptom of?

September 25, 2025 •

4 min read

Approximately 60% of people will experience at least one bloody nose in their lifetime, with most being minor and harmless. However, persistent or severe nosebleeds, known as epistaxis, can sometimes signal an underlying medical condition. This guide will explore what illnesses are bloody noses a symptom of and differentiate between minor irritations and more serious concerns.

Quick Summary

Bloody noses, especially if recurrent or severe, can be a symptom of various health problems including blood clotting disorders like hemophilia and von Willebrand disease, hypertension, certain cancers such as leukemia, nasal tumors, and liver or kidney diseases.

Key Points

Blood Clotting Disorders: Conditions like hemophilia, von Willebrand disease, and immune thrombocytopenia can lead to frequent, hard-to-stop nosebleeds.
High Blood Pressure: Severe, uncontrolled hypertension can cause blood vessels in the nose to rupture, resulting in epistaxis that may require immediate medical attention.
Cancers and Systemic Diseases: Leukemia, nasal tumors, liver disease, and kidney disease can all affect blood clotting and cause recurrent bloody noses.
Localized Nasal Issues: Nasal polyps, chronic sinus infections, and a deviated septum can irritate the nasal lining and lead to bleeding.
When to See a Doctor: Seek medical evaluation for frequent, heavy, or posterior nosebleeds, especially if accompanied by other symptoms like easy bruising or fatigue.
Hereditary Conditions: Genetic disorders such as Hereditary Hemorrhagic Telangiectasia (HHT) are characterized by fragile blood vessels that cause recurrent and severe nosebleeds.

A Common Symptom with Diverse Causes

Nosebleeds, medically termed epistaxis, occur due to the rich network of blood vessels in the nasal lining. These vessels lie close to the surface and are easily damaged. While most cases are caused by minor trauma, dry air, or common colds, recurrent or heavy bleeding can indicate a more systemic issue. Understanding the difference is crucial for proper care.

Blood Disorders and Coagulopathies

One of the most concerning causes of frequent bloody noses is an underlying blood disorder that affects clotting. When blood does not clot properly, bleeding is more likely and harder to stop. Several conditions fall into this category:

Hemophilia: An inherited disorder where the blood lacks specific clotting factors. Hemophilia A and B can cause prolonged and heavy bleeding, including recurrent epistaxis, often beginning in childhood.
Von Willebrand Disease (vWD): The most common inherited bleeding disorder, caused by a deficiency or defect in von Willebrand factor, a protein vital for platelet adhesion. Symptoms often include frequent nosebleeds, easy bruising, and heavy menstrual bleeding.
Immune Thrombocytopenia (ITP): An autoimmune disorder resulting in a low platelet count. Symptoms can include petechiae (small red spots), easy bruising, and recurrent nosebleeds.
Leukemia: This cancer of the blood and bone marrow can cause low platelet counts and impair normal clotting, leading to frequent and severe nosebleeds. Other symptoms often include fatigue, fever, and easy bruising.

Cardiovascular and Organ-Related Conditions

Beyond blood composition, problems with the circulatory system or vital organs can also trigger bloody noses.

Hypertension (High Blood Pressure): Severe, uncontrolled high blood pressure can cause epistaxis. The elevated pressure can damage and weaken the delicate blood vessels in the nose, causing them to rupture. A bloody nose, especially a posterior (deep) one, can be a sign of a hypertensive crisis, which requires immediate medical attention.
Atherosclerosis: The hardening and narrowing of arteries, commonly seen in older adults, can be associated with posterior nosebleeds. The changes in blood vessel walls can make them more prone to rupture.
Liver Disease: The liver produces many of the body's clotting factors. Severe liver disease, such as cirrhosis, impairs this function, leading to decreased clotting ability and an increased risk of bleeding, including frequent bloody noses.
Kidney Disease: Chronic kidney disease can affect blood clotting and raise blood pressure, contributing to recurrent epistaxis.

Local Nasal and Sinus Issues

Sometimes, the cause is localized within the nasal passages but requires medical intervention.

Nasal Polyps and Tumors: Both benign nasal polyps and, rarely, malignant tumors in the nasal cavity or sinuses can cause bleeding. A mass obstructing the nasal passages or irritating the lining can lead to recurring nosebleeds, often accompanied by other symptoms like congestion or facial pain.
Chronic Sinusitis: Persistent inflammation of the sinus and nasal passages can irritate blood vessels, making them susceptible to bleeding.
Hereditary Hemorrhagic Telangiectasia (HHT): Also known as Osler-Weber-Rendu disease, this genetic disorder causes the development of abnormal, fragile blood vessels (telangiectasias) in the nasal lining and other organs. Epistaxis is often the most common symptom, and can become progressively more severe.

A Comparison of Common and Serious Causes

To help you better assess your situation, here is a comparison of typical symptoms and potential causes of nosebleeds.


Feature	Common/Minor Causes	Serious/Underlying Illnesses
Bleeding Frequency	Infrequent, isolated incidents	Frequent, recurrent episodes
Bleeding Severity	Mild, easily controlled with pressure	Heavy, prolonged, difficult to stop
Associated Symptoms	Often none, or simple congestion/dryness	Easy bruising, fatigue, fever, dizziness, unexplained weight loss
Bleeding Location	Usually anterior (front of the nose)	Can be posterior (back of the nose), with blood flowing down the throat
Risk Factors	Dry climate, allergies, nose-picking, medication use (aspirin)	Family history of bleeding disorders, high blood pressure, liver/kidney disease

The Diagnostic Process

If you or a loved one experiences frequent, heavy, or recurrent nosebleeds, it is essential to see a healthcare provider. The diagnostic process may include:

Medical History and Physical Exam: The doctor will ask about the frequency, duration, and severity of the nosebleeds, along with any other symptoms. A physical exam of the nose can identify a common anterior bleed or a more complex issue.
Blood Tests: A complete blood count (CBC) and coagulation studies (like prothrombin time/partial thromboplastin time) can check for bleeding disorders or other hematologic conditions like leukemia.
Endoscopy and Imaging: For posterior nosebleeds or suspected masses, an ENT specialist may use a nasal endoscope to examine the nasal passages. Imaging tests like a CT scan might also be ordered.
Specialist Referral: Depending on the findings, a referral may be made to a hematologist (for blood disorders) or an ENT surgeon.

When to Seek Immediate Medical Help

While most nosebleeds resolve on their own, some situations warrant immediate medical attention. Seek emergency care if:

The bleeding does not stop after 20 minutes of continuous pressure.
The blood loss is excessive (more than a cup).
The nosebleed is accompanied by dizziness, weakness, or fainting.
It follows a head injury.
You are taking blood-thinning medication, and the bleeding is difficult to control.

Prevention and Management

For most individuals, simple measures can help prevent and manage bloody noses. For chronic or serious conditions, ongoing medical treatment is necessary. For deeper insights into epistaxis, the National Institutes of Health offers a comprehensive overview on the topic.

Conclusion

Bloody noses, though a common ailment, should not be ignored when they become frequent or severe. From simple environmental factors like dry air to complex systemic diseases like leukemia or high blood pressure, the causes are varied. Understanding what illnesses are bloody noses a symptom of empowers you to know when to manage them at home and, more importantly, when to seek professional medical evaluation for a proper diagnosis and treatment plan.

Frequently Asked Questions

While extremely rare, tumors affecting the nasal cavity or sinuses can cause bloody noses. However, a brain tumor does not typically cause nosebleeds directly. If a nosebleed is accompanied by neurological symptoms, a medical evaluation is necessary.

Yes, a bloody nose can be a symptom of severe, uncontrolled high blood pressure. In a hypertensive crisis, the forceful pressure can cause the delicate nasal blood vessels to burst. If you experience a heavy nosebleed along with a severe headache or other symptoms, seek immediate medical care.

An anterior nosebleed originates from the front of the nose and is usually less severe, while a posterior nosebleed comes from a larger blood vessel deeper in the nose near the throat. Posterior bleeds are less common but often more serious and may require professional medical attention.

Yes, certain cancers, particularly leukemia, can cause frequent bloody noses due to a low platelet count. In rare cases, a tumor in the nasal cavity can also cause bleeding.

A nosebleed is considered serious if it is prolonged (over 20 minutes), heavy (more than a cup of blood), or if you experience dizziness or shortness of breath. Recurrent, unexplained nosebleeds also warrant a doctor's visit.

Yes, significant liver disease can impair the production of proteins needed for blood clotting. This can lead to an increased tendency to bleed, with frequent or prolonged nosebleeds being a potential symptom.

If you experience frequent bloody noses, it's best to consult a healthcare provider. They can help determine the underlying cause and recommend appropriate treatment, which may range from simple nasal moisturizers to managing a more serious condition.