Who among us has never had a nosebleed? Whether a dab of blood on a tissue or a terrifying flood, a nosebleed can arise from many causes: dry winter air, colds, injuries, or the common if unsavory habit of picking one's nose. In many cases, no cause can be identified with certainty.
Sometimes nosebleeds arise more frequently because of faulty or weak collagen, a strengthening protein present in blood vessel walls and the surrounding connective tissue. Collagen problems may lead to nosebleeds in people who take corticosteroids and those with a condition called "fragile capillaries." Corticosteroids, including nasal steroids used for allergies, can thin the collagen in the mucous membranes lining the nose. In fragile capillaries, weak or defective collagen in blood vessel walls may contribute to bleeding. People with such collagen problems may have problems with bleeding gums, heavy menstrual periods, and bruising in addition to nosebleeds.
Rarely, the cause of nosebleeds and other bleeding lies in the blood itself. Anything that reduces blood clotting may lead to nosebleeds. Drugs such as warfarin (Coumadin) or heparin, or regular use of aspirin, decrease the blood's tendency to clot. Caution: if you are taking such medications and begin to experience nosebleeds, talk to your doctor. Even natural substances such as ginkgo, policosanol, high-dose vitamin E, and garlic may increase the tendency to bleed.
Conventional treatments for nosebleeds include various maneuvers for stopping acute bleeding, followed by the diagnosis and treatment of any underlying problems. Sometimes a physician can prevent future nosebleeds by cauterizing the blood vessel responsible.
One supplement that may help prevent nosebleeds is citrus bioflavonoids. Bioflavonoids (or flavonoids) are plant substances that bring color to many fruits and vegetables. Citrus fruits are a rich source of bioflavonoids, including disomin, hesperidin, rutin, and naringen.
A double-blind, placebo controlled study of 96 people with fragile capillaries found that a combination of the bioflavonoids diosmin and hesperidin decreased symptoms of capillary fragility, such as nosebleeds and bruising.1 In this 6-week trial, participants—41% of whom had problems with nosebleeds—took 2 tablets daily of the bioflavonoid combination or placebo. Those who received bioflavonoids had significantly greater improvements in both their symptoms and their capillary strength compared to those taking placebo. Unfortunately, the researchers did not state how much the nosebleeds improved.
For more information, including dosage and safety issues, see the full citrus bioflavonoids article.
OPCs are bioflavonoid-like compounds found in large amounts in grape seed and grape extract products. Test tube studies have found that OPCs protect collagen, partly by inhibiting an enzyme that breaks it down.3 One rather poorly designed double-blind study of 37 people—most of whom had fragile capillaries—found that OPCs were more effective than placebo in decreasing capillary fragility 4 ; however, the study authors left many questions unanswered in their report, making it hard to determine how seriously to take their results, and they did not address nosebleeds specifically.
Related chemicals called anthocyanosides are present in high concentrations in the herb bilberry. Like OPCs, anthocyanosides may strengthen capillaries through their effects on collagen. Proteolytic enzymes (such as bromelain) are also thought to possibly help stabilize capillaries. However, no studies have directly addressed the potential value of either of these treatments for nosebleeds.
Vitamin C is vital for the development of normal collagen. People with scurvy (severe vitamin C deficiency) may bleed easily from the nose, as well as developing spontaneous bruises and other bleeding symptoms. However, there is no evidence as yet that vitamin C supplementation helps to decrease nosebleeds in the absence of true scurvy, a condition that is rare today.
The herb shepherd's purse ( Capsella bursae pastoris) has been traditionally used as a topical application to control nosebleeds, although scientific evidence of its effectiveness is lacking. The herb should not be used during pregnancy because it is thought to stimulate uterine contractions.
1. Galley P and Thiollet M. A double-blind, placebo-controlled trial of a new veno-active flavonoid fraction (S 5682) in the treatment of symptomatic capillary fragility. Int Angiol. 1993;12:69–72.
3. Maffei Facino R, Carini M, Aldini G, et al. Free radicals scavenging action and anti-enzyme activities of procyanidines from Vitis vinifera: a mechanism for their capillary protective action. Arzneimittelforschung. 1994;44:592–601.
4. Dartenuc J-Y, Marache P, Choussat H. Capillary resistance in geriatry: a study of a microangioprotector = Endotelon [translated from French]. Bord Med. 1980;13:903–907.
Last reviewed December 2015 by EBSCO CAM Review Board
Last Updated: 12/15/2015