Why Do You Get More Nosebleeds in Winter? Doctors Explain

Winter brings cozy blankets and warm evenings indoors, but for many people, it also brings an unwelcome surprise. ENT experts are weighing in on why the colder months can take such a toll on our noses.

Nosebleeds can occur for a number of reasons, particularly during the hotter months. Surprisingly, though, some people tend to experience them more often in winter. The culprit behind them, in both cold and warm weather, may surprise you.

As temperatures continue to drop, people are spending more time indoors to enjoy the toasty warmth of their heating. What many might not realize is that those very heating systems can create the perfect environment for nosebleeds.

Still, the answer isn't entirely straightforward, as heated air isn't the direct cause. Nosebleeds are triggered not by heat but by extremely dry air, which can crack the delicate skin inside your nose and make you more prone to bleeding.

Dr. Erich Voigt, director of general otolaryngology and sleep surgery at NYU Langone, agrees that dry air and home heating are two major factors.

Dr. Voigt noted that the network of blood vessels in the nasal septum works to warm and humidify the air we breathe in, but when one of those vessels lies close to the surface and ruptures or gets scratched, the bleeding can be heavy.

Moreover, Dr. Voigt noted that people are more likely to catch colds and other respiratory illnesses during the winter months.

That "can make their nasal tissues irritated, and they tend to blow their nose more, and they're rubbing their nose more and their nose is irritated. So when you put those three factors together, nosebleeds exponentially go up in the winter," he said.

Dr. Kanwar Kelley, an ENT otolaryngologist in Orinda, California, echoed this, adding that the dryness also causes the nasal lining to thin: "As your nasal mucosal linings dry out, the blood vessels that live underneath the mucosal linings become more susceptible to bursting and bleeding."

Age plays a role, too. People in their 50s, 60s, and beyond are more likely to experience nosebleeds because their nasal linings naturally become thinner over time, leaving them more susceptible to irritation, dryness, and bleeding in winter.

According to Dr. Kelley, the timeline differs from person to person, though most people start to notice the changes speeding up in midlife. Hormonal shifts can also impact the mucosal lining, he added, which means women in menopause and postmenopause may have thinner nasal linings.

So, where does home heating fit into all of this? As it turns out, the answer largely depends on the age of your furnace.

Older models are more likely to dry out the air inside the home than newer ones because they draw indoor air into their combustion chambers, which means the house is then filled with dry air from outside.

Modern furnaces, on the other hand, draw air only from outdoors, leaving the indoor air untouched. As a result, switching on the heat won't necessarily make the air any drier. Newer furnaces also come with humidification systems, which further help keep the air moist.

Even so, dry air remains a problem no matter what the temperature is. Thankfully, a humidifier can help solve the problem. On top of keeping your nasal passages hydrated, it may also soothe any cold or flu symptoms you're dealing with.

That said, mold and dust allergies tend to flare up in winter, and because mold flourishes in damp conditions, you might not want leave a humidifier on for too long. Keeping your nose moisturized is another way to keep bleeds at bay.

"You can help your nose by applying bacitracin ointment with a Q-tip inside your nose at night," CEENTA ENT doctor Gregory Parsons, MD, said. "However, if your nosebleeds don't resolve in two weeks, you need to see your primary care physician or your ENT doctor."

If you do find yourself dealing with a nosebleed, here are the steps experts recommend you follow:

1. Sit upright and lean slightly forward. Avoid tilting your head back, as this sends blood down your throat. Ensure you breathe through your mouth instead.
2. Pinch the soft part of your nose. Firmly squeeze the soft cartilage (not the bony bridge) for at least 5 to 10 minutes, resisting the urge to check whether the bleeding has stopped.
3. If the bleeding persists, try a nasal decongestant spray — but use it sparingly.
4. Use the right packing material. If pressure alone doesn't do the trick, Dr. Voigt suggests adding compression inside the nose with "packing material," such as a large cotton ball, which is soft and won't get lost in the nose or inhaled.

Dr. Voigt notes that frequent nosebleeds could signal an underlying medical issue that needs evaluation. He advises calling emergency services if the bleeding lasts more than 20 to 30 minutes.

His advice also applies if you're on blood thinners and experiencing recurrent bleeds, if you bleed from both nostrils at once, if there's concern that a growth or mass may be involved, or if you have a progressive nasal breathing obstruction.