Chances are, you’ve been surprised at some point by a sudden trickle of blood from your nostril. And if you have lupus, you might have wondered if your condition is behind your nosebleeds.

In this article, we’ll explore whether nosebleeds can be a symptom of lupus, discuss other possible causes, and provide practical tips for managing them.

Nosebleeds Aren’t a Common Lupus Symptom

Nosebleeds are generally not considered a common lupus symptom. Rather, nosebleeds are often caused by triggers unrelated to lupus, such as:

• Nasal dryness
• Allergies
• Sinus infections
• Certain medicines
• Minor injuries

That said, some MyLupusTeam members have reported experiencing nosebleeds.

“A few months ago, I started having nosebleeds, especially during lupus flares. I noticed they were worse when my sinuses became dry and inflamed,” one member shared. “To address this, I placed a humidifier on my nightstand while I slept, and it has significantly helped.”

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Another member reported, “I have only had one nosebleed in my 20 years of lupus. About 17 years ago, I experienced it for the first time while taking prednisone due to a flare.

“I stopped the bleed and attributed it to the medication. Since then, I haven’t had any nosebleeds.”

Although this member attributed the nosebleed to prednisone, the cause wasn’t confirmed. Research has found that steroid nasal sprays can increase the risk of nosebleeds.

Those experiences illustrate how nosebleeds can vary among people with lupus. Some may attribute occasional nosebleeds to lupus treatments or flare-ups, whereas others may not experience nosebleeds at all.

Can Lupus Cause Nosebleeds?

Factors related to lupus could lead to nosebleeds in some people who have the condition. Inflammation-related sores, certain lupus treatments, or a low platelet count could all play a role.

Lupus Nasal Sores and Ulcers

As an autoimmune disease, lupus can cause inflammation in various parts of your body. Lupus may affect the skin and mucous membranes, and nose and mouth sores can occur.

These nasal ulcers may make you more susceptible to nosebleeds. Sores may occur more often during lupus flares, when symptoms worsen for a period of time.

If you develop sores in your nose, ask your doctor how to manage them. The right treatment depends on what’s causing the sores.

Medications and Treatments

Certain medications used to prevent or treat blood clots, such as anticoagulants and antiplatelet drugs, can increase bleeding risk. This may lead to or worsen nosebleeds.

If a medication may be contributing to your nosebleeds, talk with the healthcare provider who manages it. They can decide whether your treatment needs to be changed. Don’t reduce your dose or stop taking a blood thinner without medical guidance.

Low Platelet Count

Platelets are blood cells that help blood clot and stop bleeding. Too few platelets can increase bleeding risk. In lupus, your immune system can attack and destroy platelets, leading to thrombocytopenia (low platelet count).

According to the Hospital for Special Surgery, up to 25 percent of people with systemic lupus erythematosus (SLE), the most common type of lupus, may develop thrombocytopenia.

Some medications can also cause thrombocytopenia. For example, statins, which are used to lower cholesterol, and some nonsteroidal anti-inflammatory drugs (NSAIDs) can lower platelet counts.

NSAIDs such as naproxen and ibuprofen may be used to manage pain and inflammation in people with lupus.

A low platelet count can cause easy bruising and bleeding, including nosebleeds.

Treatment for lupus-related thrombocytopenia depends on how low your platelet count is, whether you have bleeding, and how severe your symptoms are. Treatment may include corticosteroids along with other medicines.

Nosebleeds Happen for Various Reasons

Many factors can set off a nosebleed. Knowing about these triggers can help you determine whether your nosebleeds are related to lupus. Common causes of nosebleeds in people with and without lupus include:

• Dry air — Dry air is a common culprit for nosebleeds, especially during cold weather or in places with low humidity. When the air lacks moisture, it can dry out the inside of your nose, making the blood vessels more fragile and prone to bleeding.
• Allergies and sinus infections — If you have allergies or a sinus infection, your nasal passages can become inflamed and congested. The swelling and irritation can make the blood vessels in your nose more likely to break and bleed.
• Physical trauma — Any injury to your nose, such as getting hit in the face or picking your nose too much, can lead to nosebleeds. The impact or pressure can cause blood vessels inside your nose to break, resulting in bleeding.
• Medications — Certain medications, such as blood thinners, can interfere with your blood’s ability to clot, making nosebleeds more likely. If you’re taking any medications, it’s important to discuss potential side effects with your healthcare provider.

You Can Take Steps To Manage Nosebleeds

You can take several steps to stop an active nosebleed. In addition, several strategies can help reduce your risk of getting nosebleeds.

Treating a Nosebleed

Dealing with a nosebleed can be a bit scary, but a simple plan can help you manage it effectively. Follow these steps to treat a nosebleed:

1. Stay calm — Take a deep breath and focus on the steps below.
2. Sit up and lean forward — Don’t tilt your head back during a nosebleed because blood may flow down your throat. Instead, sit up straight and lean forward slightly.
3. Pinch your nose — Using your thumb and index finger, pinch both nostrils together for 15 to 20 minutes without releasing pressure. The constant pressure helps the blood clot and stops the bleeding.
4. Breathe through your mouth — Make sure you’re getting enough air so you aren’t tempted to stop pinching your nose before time is up.
5. Get medical help if needed — Seek medical care if the bleeding is severe, you feel dizzy, or the bleeding doesn’t stop despite firm, continuous pressure. If the bleeding continues for 30 minutes, seek emergency medical care.

After your nose stops bleeding, proceed with caution. To prevent the nosebleed from coming back, don’t bend down or blow or pick your nose for several hours.

Preventing Nosebleeds

Whether or not your nosebleeds are related to lupus, you can take several measures to help prevent them:

• Keep your nose moisturized — Using a saline nasal spray or dabbing a bit of petroleum jelly inside your nose can help prevent dryness and minimize the risk of nosebleeds.
• Run a humidifier — Adding moisture to the air can help prevent dryness in your nasal passages, especially during dry seasons or in environments with low humidity.
• Stay away from irritants — Cigarette smoke, strong chemical smells, allergy triggers, and dry air can dry out your nose even more and increase the risk of nosebleeds.
• Avoid injuring your nose — Picking your nose and inserting objects into your nostrils can damage the delicate blood vessels and trigger nosebleeds.

Some Nosebleeds Warrant Medical Attention

Although most nosebleeds can be managed at home, some require emergency care. Seek emergency medical care if:

• The nosebleed follows a serious injury, such as a car accident or hitting your head.
• Bleeding is heavy, makes it hard to breathe, or lasts longer than 30 minutes.
• You feel faint or dizzy during the bleeding.
• You also have chest pain or a severe headache.

Contact your healthcare provider if:

• You have nosebleeds more than once a week or they don’t improve with home care.
• You have unexplained bruising, a bleeding disorder, or take blood-thinning medication.

Remember, it’s always better to seek medical advice if you’re unsure or concerned about your symptoms.