What causes nosebleeds with thick blood clots?

Generally, nosebleeds accompanied by thick blood clots may be caused by dry nasal passages, forceful nose-blowing, allergic rhinitis, sinusitis, or deviated septum. If discomfort occurs, it is recommended to seek timely medical evaluation and treatment at a reputable hospital. Specific causes are analyzed as follows:

1. Dry Nasal Passages

Dry climates or low indoor humidity can cause the nasal mucosa to lose moisture, becoming fragile and prone to blood vessel rupture and bleeding. Blood remaining in the nasal cavity may then coagulate into thick clots. Use a humidifier indoors to maintain humidity levels between 50% and 60%, drink plenty of warm water, and avoid prolonged exposure to air-conditioned environments.

2. Forceful Nose-Blowing

Blowing the nose too hard during nasal congestion creates airflow that damages the nasal mucosa, leading to vessel rupture. If the resulting blood is not expelled promptly, it may form thick clots. Avoid blowing your nose forcefully. For congestion, use saline solution to rinse the nasal cavity. When bleeding occurs, lean forward with your head slightly lowered and pinch the soft part of the nose to stop the bleeding.

3. Allergic Rhinitis

Exposure to allergens such as pollen or dust mites causes nasal mucosal congestion and swelling. Frequent sneezing or rubbing the nose can damage the mucosa and lead to bleeding, which may mix with secretions and coagulate into clumps. Follow your doctor’s instructions to use medications such as mometasone furoate nasal spray, loratadine tablets, or montelukast sodium tablets, and avoid known allergens.

4. Sinusitis

Bacterial or viral infections causing sinus inflammation produce purulent secretions that irritate the nasal mucosa, leading to erosion and bleeding. The blood may mix with pus to form thick clots. Under medical guidance, treatments may include cefixime dispersible tablets, physiological seawater nasal spray, and eucalyptus citronellal enteric soft capsules, along with regular nasal irrigation.

5. Deviated Septum

An abnormally shaped nasal septum that leans to one side results in thin mucosa at the deviated area, making it susceptible to injury from airflow and prone to recurrent bleeding. Blood accumulates and coagulates in the nasal cavity, often leading to repeated episodes. Mild bleeding can be managed with cold compresses; however, frequent bleeding may require septoplasty (nasal septum correction surgery). After surgery, avoid trauma to the nasal area.

In daily life, maintain appropriate indoor humidity and keep the nasal passages well-moisturized. Develop gentle nasal care habits to prevent physical injury, avoid allergens, prevent respiratory infections, perform regular nasal check-ups, and seek medical attention promptly if recurrent nosebleeds occur.