Nosebleeds might happen when dry air causes the lining in the nose to crack and bleed, or when the use of certain medications affects the blood’s ability to clot. People with MS may take these drugs to address symptoms of MS or other coexisting conditions. Therefore, people with MS could experience nosebleeds from medications, but not directly from MS.
Another way that people with MS could experience nosebleeds is through trauma or injury to the nose. Sometimes, MS produces issues with balance and trouble walking. Falling and hitting your nose could result in a nosebleed.
Although nosebleeds can be scary, they are usually not serious. Nosebleeds can be treated at home, but there are several situations when a nosebleed may require medical attention.
Nosebleeds (also called epistaxis) occur when there is damage to the blood vessels in the nose that results in bleeding. This type of bleeding is rarely serious, but if you experience nosebleeds frequently or for longer than 30 minutes, you may need to seek professional medical advice.
There are several different reasons someone may experience a nosebleed. More common reasons include:
Less common causes of nosebleeds include:
MS is not considered a cause of nosebleeds.
MS can produce a range of symptoms. It is a disorder in which the immune system mistakenly attacks the protective sheath (myelin) that covers nerve cells in the central nervous system (the brain and spinal cord). Symptoms of MS affect different parts of the body, and they may change or worsen as the disease progresses. Some common symptoms of MS include:
Although nosebleeds are not a symptom of MS, medications used to treat the symptoms of MS and the chance of injury due to MS symptoms could influence the risk of nosebleeds in people with the condition.
NSAIDs, which include ibuprofen (Motrin or Advil), are a type of medication that is sometimes used to address symptoms of neuromuscular pain in people with MS. NSAIDs affect the ability of blood to clot and are indicated as a cause of nosebleeds. People who take NSAIDs regularly may be at an increased risk of nosebleeds.
Aspirin is another medication used to address specific MS symptoms. Fatigue is a common symptom in people with MS, and some doctors may recommend medical treatment for fatigue. A research study found that taking regular aspirin twice daily helped reduce MS-related fatigue.
Aspirin also affects blood clotting and is listed as a cause of nosebleeds. Taking aspirin regularly, whether for fatigue or other reasons, could affect your risk of nosebleeds.
Some symptoms of MS, like spasticity, dizziness, reduced coordination and balance, and difficulty walking increase the risk of falling and injury in people with MS. According to the Cleveland Clinic, 40 percent to 50 percent of people with MS experience falls that result in injury. One member of MyMSTeam wrote, “Fell on my face — severe nosebleed.”
Treatment options for MS comorbidities may also affect the risk of nosebleeds. Comorbidities are other diseases or conditions that exist in people with a given disease. Comorbidities are not caused by the other disease.
Common comorbidities in people with MS include:
Cardiovascular disease, or heart disease, includes issues such as high blood pressure (hypertension), high cholesterol (hyperlipidemia), heart attack, stroke, and heart failure. Often, medications like aspirin or anticoagulants are used for the treatment of heart disease and the prevention of blood clots that may cause heart attacks or strokes. Aspirin and anticoagulants can cause nosebleeds, however.
“Had an issue this week with nosebleeds due to all of the heart medications I am on,” wrote a MyMSTeam member.
Most nosebleeds can be managed at home and do not require medical attention. If you have a nosebleed, follow these steps:
You may require immediate medical attention if you:
In these situations, you should call your doctor, call 911, or have someone drive you to an emergency room or urgent care center. Do not drive — attempting to drive with a nosebleed can cause distractions and be dangerous.
Sometimes, nosebleeds do not require immediate medical attention, but you should talk to a health care professional about them soon if:
MyMSTeam is the social network for people with multiple sclerosis. On MyMSTeam, more than 182,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.
Do you have MS and experience nosebleeds? Share your experience in the comments below, or start a conversation by posting on your Activities page.