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What Causes Nosebleeds With Large Blood Clots? Why Do They Happen And How To Stop Them?


Nosebleeds can be alarming, especially when substantial blood clots emerge. What leads to nosebleeds so severe that large clots form? Understanding the source allows proper treatment to prevent troublesome recurrences. Let’s examine the causes, treatments, and warning signs for clot-forming nosebleeds.

Common Causes Of Nosebleeds And The Presence Of Large Blood Clot

Nosebleeds, known medically as epistaxis, are common and usually harmless when mild. But frequent heavy nosebleeds with clot formation signal more serious underlying issues. 

Nosebleeds With Large Blood Clots
  • Formation of substantial blood clots results from profuse nosebleed bleeding exceeding the body’s normal clotting ability.
  • Common causes include nasal fractures, foreign objects, nasal polyps or tumors, hypertension, and blood clotting disorders.
  • Medications like anticoagulants, chemotherapy, and NSAIDs can increase clotting time and lead to heavy nosebleeds.

Large clots occur with injury, ruptured blood vessels, or bleeding disorders when copious amounts of blood accumulate faster than the body’s clotting mechanisms can keep up. Clots may extend from the nose into the throat. 

While distressing, determining the cause of clot-producing nosebleeds leads to solutions. Prompt evaluation and treatment prevent complications like anemia and hypovolemic shock from blood volume loss in severe cases.

Causes Of Nosebleeds with Clots

Here are possible causes of nosebleeds severe enough to generate substantial blood clotting:

Nasal Fractures:

Blunt facial trauma from injury falls, or blows can fracture the nasal bones. This damages the delicate nasal blood vessels and causes hemorrhage.

Foreign Objects:

Picking the nose can scratch the delicate nasal lining and small vessels, resulting in bleeding. Foreign bodies like button batteries stuck in the nose corrode tissue, eroding blood vessels.

Nasal Polyps or Tumors:

Noncancerous nasal polyps or rarely, cancerous tumors, irritate and wear down nasal blood vessel linings, leading to rupture. Bleeding from these growths is often profuse.


Untreated or unmanaged high blood pressure weakens arterial walls. The nasal blood vessels can rupture, causing heavy nosebleeds.

Blood Clotting Disorders

Deficiencies in platelets or clotting factors from diseases like hemophilia allow bleeding from even minor nasal vessel damage to become excessive. 

– Medications:

Anticoagulant drugs or medications that affect platelets increase the risk for prolonged, heavy nosebleeds. Chemotherapy also impairs clotting.

– Nose Picking:

Aggressively picking the nose can erode the delicate nasal membranes and blood vessels, leading to bleeding that doesn’t readily clot.

– Environmental Irritants:

Dry heated indoor air, cocaine use, and chemical irritants damage the nasal lining, making it more vulnerable to bleeding episodes.

Treatments For Nosebleeds With Blood Clots

– Apply Direct Pressure:

Pinch the nostrils shut firmly for 10 straight minutes to tamponade bleeding. Apply an ice pack over the nose to constrict blood vessels.

– Cauterization:

For chronic or refractory nosebleeds, surgical cauterization seals off bleeding blood vessels. Chemical cautery with silver nitrate can also be tried. 

– Nasal Packing:

Placing gauze strips inside the nasal cavity compresses blood vessels to stop heavy bleeding after injury or surgery. 

– Humidify

Using saline sprays and running a humidifier prevents nasal dryness and cracking that can trigger bleeding episodes.

– Elevate Head:

Keeping the head elevated above heart level lessens blood pressure in nasal blood vessels, slowing bleeding.

– Treat Underlying Conditions

Controlling high blood pressure, surgery for nasal obstructions, and coagulation medications for clotting disorders reduce recurrent massive nosebleeds.

Warning Signs To Seek Medical Care

Visit emergency care for nosebleeds with:

– Blood clots blocking the airway

– Profuse bleeding for over 20 minutes  

– Bleeding resuming after trying direct pressure 

– Weakness, lightheadedness, or fainting

– Recent trauma like a nasal fracture

Anticoagulant medication use or bleeding disorders

– Repeat severe, heavy nosebleeds

Urgent intervention may be needed to stop the bleeding and prevent dire complications like hypovolemic shock.

Prevention Of Nosebleeds With Clots

Here are some tips to help prevent problematic clot-forming nosebleeds:

➜ Use saline nasal spray and humidifiers to keep nasal passages moisturized

➜ Avoid nose picking and inserting objects into the nose

➜ Wear protective gear for sports to prevent nasal trauma

➜ Have regular doctor visits to control blood pressure if hypertensive

➜ Follow doctor’s orders for use of blood thinners 

➜ See an ENT to remove nasal obstructions like polyps

➜ Limit use of irritants like cocaine; seek addiction treatment if needed


While many nosebleeds are minor, recurrent episodes with sizeable clots warrant medical evaluation to determine the cause. Treatments range from simple measures like hydration to cauterization procedures for chronic bleeds.

Preventing future massive nosebleeds involves controlling causative factors like hypertension, nasal damage, coagulation disorders, or medication effects. Prompt intervention for nosebleeds producing substantial clotting can prevent major health consequences.


1. Why do I get big blood clots when I have a nosebleed?

Formation of large clots results from profuse nosebleed bleeding that exceeds the body’s normal clotting ability. The source is often injury, tumors, hypertension, or a bleeding disorder.

2. Do blood thinners cause bad nosebleeds with clots?

Yes, anticoagulant medications interfere with blood clotting and can increase risk for excessive, clot-forming nosebleeds. Proper medication dosing helps reduce bleeding.

3. Can frequent nose picking cause large nosebleed clots?

It can. Aggressively picking the nose damages the delicate nasal lining, causing bleeding that may become heavy with big clots due to disrupted local clotting.

4. Is a nosebleed with blood clots an emergency? 

Seek emergency care if bleeding is profuse after 20 minutes of direct pressure. Blood clots blocking the airway are an emergency requiring prompt medical attention.

5. How do you stop a nosebleed that keeps bleeding with clots?

Apply firm, constant pressure by pinching the nostrils for 10 full minutes. Use ice packs. Lie down with head elevated. Humidify airways. Seek medical help if bleeding persists despite pressure.

Dr. Harold Gojiberry is not just your ordinary General Practitioner; he is a compassionate healthcare provider with a deep commitment to patient well-being and a passion for literature. With extensive medical knowledge and experience, Dr. Gojiberry has made a significant impact in the field of healthcare, particularly in the area of liver diseases and viral hepatitis.

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