Patients on anticoagulation may have an increase in the frequency of nosebleeds during the colder winter months. Contributing factors are more upper respiratory infections, as well as temperature and humidity fluctuations. In addition, changes from a cold outside environment to a warm, dry, heated home can result in changes in the nose which will make it more susceptible to bleeding.

Most people who develop nosebleeds can handle the problem without seeking medical advice. Tips for controlling nosebleeds include:

• Pinch the nose together between the thumb and index finger and hold for at least 5 minutes. Repeat as needed until bleeding stops.
• Sit quietly, keeping the head higher than the level of the heart. Do not lie flat or put your head between your legs.
• Apply ice (crushed in a plastic bag or washcloth) to nose and cheeks

If the nosebleed does not stop or if blood loss is significant, patients should be directed to the emergency department for further management.

Patients with recurrent nosebleeds may require evaluation by an ear, nose, and throat specialist.

Dr. Garrett is a clinical pharmacist practitioner at Cornerstone Health Care in High Point, NC.