What causes bleeding when inserting a tissue into the nose, and what should be done?

Bleeding when inserting a tissue into the nose may be caused by nasal dryness, habitual nose picking, nasal trauma, allergic rhinitis, or vestibulitis. This can be improved through nasal moisturizing, correcting habits, local care, and medication. If bleeding occurs frequently or is heavy, prompt medical attention is necessary.

1. Nasal Dryness: Dry air or insufficient fluid intake can lead to dehydration of the nasal mucosa, making blood vessels fragile and prone to rupture upon contact with tissues, often accompanied by a dry sensation in the nose. It is recommended to use a saline nasal spray to keep the nasal passages moist, increase daily water intake, and use a humidifier indoors to maintain proper humidity levels.

2. Nose-Picking Habit: Frequent finger picking or aggressive wiping with tissues can damage the delicate blood vessels in the nasal mucosa, causing contact bleeding and minor mucosal injuries. It is advised to stop the habit of picking the nose, gently wipe with soft tissues, and avoid forceful contact with the inside of the nasal cavity.

3. Nasal Trauma: Physical impact or inserting tissues too deeply can injure blood vessels inside the nose, leading to bleeding, possibly accompanied by localized swelling or mild pain. Immediately apply pressure to both sides of the nostrils to stop bleeding. Apply cold compresses to the nose within 48 hours and avoid forceful nose-blowing.

4. Allergic Rhinitis: Exposure to allergens triggers nasal inflammation, causing mucosal congestion, swelling, and dilated blood vessels, which makes bleeding upon tissue contact more likely. Symptoms may include nasal itching and sneezing. Under medical guidance, patients may use medications such as mometasone furoate nasal spray, loratadine dispersible tablets, or montelukast sodium chewable tablets to relieve symptoms.

5. Nasal Vestibulitis: Bacterial infection causes inflammation of the skin in the nasal vestibule, leading to erosion and ulceration of the mucosa, resulting in bleeding upon tissue contact, along with pain and crusting at the front of the nose. Under medical supervision, topical treatments such as erythromycin ointment, mupirocin ointment, or physiological seawater nasal sprays can be used to alleviate discomfort.

Maintain clean and moist nasal passages, avoid aggressive nose picking or blowing, eat a light diet rich in fruits and vegetables, supplement with vitamins, and avoid dust and allergens to reduce irritation to the nasal mucosa.