Most nosebleeds, also known as epistaxis, come from the small blood vessels in the mucous membrane that lines the inside of your nose.

Some common nosebleed causes are:

  • trauma
  • breathing very cold or dry air
  • picking your nose
  • blowing your nose hard

Blood clots are clumps of blood that form in response to an injured blood vessel. Blood clotting — also called coagulation — prevents excessive bleeding when a blood vessel is damaged.

To stop a bloody nose, most people:

  1. Slightly lean forward and tilt their head forward.
  2. Use their thumb and forefinger to pinch together the soft parts of their nose.
  3. Press the pinched parts of their nose firmly towards their face.
  4. Hold that position for 5 minutes.

When you pinch your nose to stop a nosebleed, the blood there will begin to clot and typically remain in your nostril until it’s removed or it comes out when you gently blow your nose.

Why is the clot so big?

There’s a fair amount of room in your nose for blood to collect. When that blood coagulates, it can form a clot that might be bigger than you expected.

There are a number of ways that a clot following a bloody nose will exit the nostril including:

  • If your nose starts to bleed again, sometimes the clot from the original nosebleed will come out with new blood. If it doesn’t come out on its own, consider gently blowing it out as it might prevent a better clot from forming.
  • If you’ve packed your nose with cotton or a tissue, the clot will often come out when that material is removed.
  • If you feel the need to blow your nose, sometimes the clot comes out of your nostril into the tissue. It’s not recommended that you blow your nose too soon after a nosebleed, but be sure to do it gently so you don’t start the bleeding again.

Once your nose has stopped bleeding, there are some steps you can take to prevent it from starting to bleed again, including:

  • resting with your head higher than your heart
  • talking to your doctor about skipping blood thinning medications, such as aspirin, warfarin (Coumadin) and clopidogrel (Plavix)
  • avoiding blowing your nose or putting anything in your nose
  • limiting bending
  • not lifting anything heavy
  • quitting smoking
  • avoiding hot liquids for a minimum of 24 hours
  • sneezing with your mouth open, trying to push air out of your mouth and not your nose

To stop a nosebleed, your body will form a blood clot. Since there’s room for blood to collect in your nose, the blood clot could be large. Sometimes the blood clot comes out if the nose begins to bleed again.

If your nose bleeds frequently, make an appointment to discuss the situation with your doctor. Seek immediate medical attention if:

  • Your nose bleed for longer than 20 minutes.
  • Your nosebleed was caused by head injury.
  • Your nose appears to have an odd shape following an injury and you think it could be broken.