Bloody Nose & Sore Throat: Causes, Treatment & When It’s Serious

Key takeaways:

• A bloody nose and sore throat may result from an infection, allergies, irritation, or trauma.
• Most bloody noses stop on their own or with direct pressure, head elevation, and ice.
• A persistent or severe bloody nose and sore throat may indicate a more serious medical condition. In such cases, always seek medical attention.

Nosebleeds are not uncommon and can range from mild to severe. They can occur spontaneously or after a minor or major injury. Common causes of nosebleeds include nose picking or rubbing. Most clear up on their own, so they aren’t usually reported to healthcare providers.

There are two categories of nosebleeds: anterior (bleeding from the nostrils) and posterior (bleeding that flows down the throat). If you experience a combination of nosebleed and sore throat, it could indicate irritation, inflammation, or infection.

This article explores the potential links between a nosebleed and a sore throat. It offers suggestions for relief from home treatment, and indicates when you should seek medical attention. It also explains how your doctor might evaluate your nosebleed and sore throat, what tests may be ordered, available treatments, and prevention tips.

Are a sore throat and a bloody nose related?

A sore throat and bloody nose often occur together. You might have irritation or inflammation in your nose for several reasons when you have a sore throat. Or, a bloody nose may occur spontaneously, with no clear cause.

Common causes of a sore throat and a bloody nose together

Experiencing a sore throat and a bloody nose together can result from infections, inflammation, trauma, dryness, medications, or underlying conditions like a deviated septum or high blood pressure.

Infection, inflammation, and allergies

The most common causes of a bloody nose and a sore throat are infections or inflammation inside the nose. A sore throat can be triggered by viral, bacterial, or, less commonly, fungal infections. Possible infections include:

• Strep tonsillitis
• Viral tonsillitis
• Common Cold
• COVID-19
• Bronchitis
• Pneumonia
• Laryngitis
• Sinusitis

When irritation and inflammation occur in the nasal passages, it can result in blood-streaked mucus. In more serious cases, the bleeding may be severe enough to require medical attention.

Trauma

Self-induced trauma, like rubbing or picking your nose, is common when you have an infection – and you may do it unintentionally. This can cause minor irritation and inflammation. If you notice blood in your nose, it is usually minor, such as streaks of blood. If you accidentally scratch the inside of your nose, however, the bleeding can become more serious.

Dryness

When you suffer from a sore throat, you may also have nasal dryness. This can be caused by inflammation or infection. You might notice symptoms such as nasal congestion, thick mucus, nasal crusting, or drainage, all of which could contribute to a bloody nose.

Medicines

Common medications for sore throat or allergies include antihistamines like loratadine (Claritin) and corticosteroid nasal sprays such as fluticasone (Flonase). However, many of these medications can worsen nasal dryness, especially when applied directly to the front part of the inside of your nose. Also, taking ibuprofen (Advil or Motrin), acetaminophen (Tylenol), or aspirin may increase the risk of having a bloody nose (with or without a sore throat).

Deviated septum

A deviated septum means the thin wall between the right and left sides of your nose (the septum) is off-center. This condition, which affects up to 80 percent of the population, increases the likelihood of nasal crusting and nosebleeds. This is especially true when you have a sore throat, nasal congestion, or drainage due to an infection or allergies. The risk is highest if you’ve broken your nose at some point in your life.

High blood pressure

If you have elevated blood pressure (hypertension), you have a higher risk of having a bloody nose and sore throat together. While high blood pressure rarely causes a bloody nose, it can be more common in those with hypertension. Anxiety related to being ill with a sore throat can further raise your blood pressure.

Other symptoms associated with a sore throat and a bloody nose

Your sore throat and bloody nose may be only part of the story; you may have several other symptoms at the same time. Many of these symptoms could be related to infection, inflammation, or allergies.

Headache

A sore throat caused by an infection or allergies often leads to headaches and a bloody nose. Inside the nose, an area of the septum known as the Kiesselbach plexus is especially prone to bleeding. Interestingly, irritation of the Kisselbach plexus may also be a potential trigger for migraines.

Cough

If your sore throat is from an infection or allergies, you might also be coughing, which can result in a bloody nose. A productive cough may produce thick phlegm. Frequent and forceful coughing can increase the chances of having a bloody nose when you have a sore throat. This risk is highest if your nasal passages are dry or if you’re taking medications that may lead to a higher likelihood of a bloody nose.

Nasal congestion, drainage, and crusting

Nasal congestion, drainage, and crusting are common symptoms of a sore throat caused by infection, inflammation, or irritation. Allergies can also lead to nasal symptoms, which may increase the risk of a bloody nose. If your nose feels irritated, you might be tempted to pick or rub it. This can aggravate already sensitive areas and promote bleeding.

Difficulty swallowing or breathing, and hoarseness

A sore throat can make it hard to swallow, breathe, and speak clearly. The scratchy, uncomfortable throat sensations may also make talking difficult, often giving your voice a hoarse or “hot-potato” (thick, muffled) quality. These symptoms are frequently accompanied by nasal congestion, drainage, and sometimes a bloody nose.

At-home remedies for relieving a sore throat and a bloody nose

At-home remedies should have two goals: provide relief for the sore throat and stop any nasal bleeding. Because a bloody nose can trigger anxiety, it should be addressed promptly.

Nasal pressure and ice

If you’re having a nosebleed, the first step is to apply direct pressure. Pinch your nostrils together for several minutes, or use a cloth or gauze to apply pressure. Keep your head elevated but avoid looking up, as this can cause blood to flow down your throat. That, in turn, can lead to coughing and swallowing, which may result in nausea or vomiting. Additionally, placing an ice pack on your forehead or the bridge of your nose (specifically on the side that’s bleeding) can help stop the bleeding.

Nasal packing, nasal sprays, and humidification

Do not stick dry tissues, gauze, or towels directly inside the nose, or you could cause further irritation. Instead, moisten gauze with saline solution or use over-the-counter medications like phenylephrine (Sudafed PE) or oxymetazoline (Afrin, Vicks Sinex) to help stop the bleeding.

Keeping nasal passages humid and moisturized can also be effective. Applying nasal saline, antibiotic ointment, or petroleum jelly may help reduce and prevent nosebleeds. However, use phenylephrine or oxymetazoline nasal sprays for no more than three to five days. They can be addictive and might lead to rhinitis medicamentosa, a condition that’s caused by overuse of nasal decongestants and that requires medical attention.

Diet, exercise, and throat lozenges or gargles

If you have a sore throat, be sure to stay hydrated and avoid hot, spicy foods and citrus juices. Effective remedies include warm saltwater gargles, rinses, and throat lozenges. If you have a combination sore throat with a bloody nose, it is crucial to refrain from strenuous activities and avoid picking your nose. Additionally, taking hot showers for humidity may make your nosebleeds, so keep those to a minimum.

When you should see a doctor for a sore throat and a bloody nose

A sore throat alone may not be serious enough to see a doctor. However, if you have a bloody nose and other symptoms, it may be wise to seek medical attention.

You should see a doctor if you have:

• Nasal bleeding that will not stop or keeps coming back
• Profuse nasal bleeding (even if it has stopped)
• Fever over 1010F
• Headache
• Yellow or green nasal drainage
• Neck stiffness or pain
• Neck mass, swelling, or drainage
• Difficulty breathing or swallowing, or making unusual noises when breathing
• Wheezing
• Nasal trauma
• Change in vision or double vision
• Swelling around the eye or bruising

You should go to the emergency room if you have/are:

• Profuse nasal bleeding
• High blood pressure, irregular heartbeat, or chest pain
• A bloody nose that persists and you take blood thinners
• Abdominal pain
• Coughing up blood
• Difficulty breathing, swallowing, or making unusual noises when breathing
• Bleeding or bruising in other parts of your body
• Nasal or facial trauma
• Migraine
• Swelling or bruising around the eye
• Loss of vision or double vision
• A history of bleeding problems such as hereditary hemorrhagic telangiectasia (also known as Osler Weber Rendu disease)

Questions to ask your doctor about a sore throat and a bloody nose

It is common when you have a bloody nose and sore throat to have many questions for your doctor. Here are some you might consider asking:

• How can I get my nose to stop bleeding?
• Is the bleeding from my nose serious?
• Does the bleeding from my nose mean I have cancer or some other disease?
• What tests or X-rays can tell why I have a sore throat and bloody nose?
• Am I contagious?
• Will I need a blood transfusion if I lose enough blood?
• What happens if you can’t get the bleeding to stop?

How a doctor can help treat a sore throat and bloody nose

Seek medical attention if your nosebleed continues, the bleeding is severe, or your sore throat won’t go away. Here are some ways your doctor may be able to help you find relief.

Nasal packing and cauterization

Your doctor may need to examine your nose closely to identify the exact source of the bleeding. Cauterization may be required, and/or nasal packing may be used to apply pressure to the area. Packing comes in various shapes and forms, many of which are absorbable, making them more comfortable and eliminating the need for removal.

Oral and topical antibiotics

You may need antibiotics for infections such as strep throat or other throat and sinus issues. If you have nasal packing, your doctor might recommend oral antibiotics to prevent toxic shock syndrome. Additionally, using topical antibiotic ointments or creams can help stop a bloody nose and soothe any irritation or inflammation in the nasal passages.

Medications to control an underlying problem

You may need medications to manage various medical conditions that are worsening your sore throat and bloody nose. These conditions may include:

• High blood pressure
• Diabetes mellitus
• Vitamin K deficiency
• Pneumonia
• Bronchitis
• COVID-19
• Bleeding or clotting disorders

Frequently asked questions: sore throat and bloody nose

Having a sore throat and bloody nose can be frightening. Following are some of the most common questions people may ask about this condition.

Can strep throat cause nosebleeds?

Strep throat does not directly cause a bloody nose, but the bacterial infection can affect the throat as well as the nose and sinuses. Symptoms may include headache, fever, nasal drainage or pus, as well as inflammation or irritation of the nasal passages. An infection of the lining inside the nose can lead to crusting and bleeding.

What if you wake up with a sore throat and a bloody nose?

Waking up with a bloody nose and a sore throat is quite common, especially if you’re having trouble swallowing or breathing through your nose. Irritation, thick mucus or crusting, and dryness in your nasal passages may occur when you need to breathe through your mouth. Furthermore, your nose might feel itchy and sore, leading you to rub or pick at it while you sleep. This can result in a bloody nose.

What if you’re experiencing a bloody nose, a sore throat, and a fever?

If you have a combination of bloody nose, sore throat, and fever, you may be suffering from a throat or sinus infection. Fever is a natural response from your immune system to fight off pathogens. It may be accompanied by sweating, chills, shivering, headaches, and dehydration, all of which can worsen nasal dryness and lead to a bloody nose. It is important to try to reduce your fever with ibuprofen (Advil or Motrin) or acetaminophen (Tylenol), but avoid using aspirin, as it could make your bloody nose worse. Be sure to contact your healthcare provider if you experience any of the following symptoms:

• Severe headache that doesn’t get better
• Rash
• Unusual sensitivity to light
• Stiff neck
• Mental confusion
• Altered speech
• Persistent nausea and vomiting
• Abdominal pain
• Difficulty breathing
• Chest pain
• Convulsions or seizures

Managing a bloody nose and sore throat

A combination of sore throat and bloody nose can be upsetting, as well as make you feel miserable. It may be due to an infection or inflammation, and isn’t necessarily serious – but any bleeding should raise concern, especially if it is severe or persists. While home remedies may help, it is important to seek medical attention if your sore throat doesn’t go away or you’re unable to stop a bloody nose.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Adam Carewe, MD.

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