Does Alcohol Cause Nosebleeds?

You wake up after a rowdy roommates’ night out and rub your eyes. Thinking of the shots you did (whose idea was well tequila?), you groan, steeling yourself against the inevitable hangover.

As you shake the sleep off (and maybe do a quick morning scroll on your phone), you start to think that so far you seem relatively unscathed …

Until you sit up and feel a warm sensation spreading over your mouth and chin.

“Seriously?! Again? Why does my nose bleed when I drink alcohol?”

Can Drinking Cause Nosebleeds?

If you’ve seen your nose bleed after drinking, you’re not alone. Many of us experience next-day nosebleeds after a night on the town.

Our nasal passages are lined with mucosa: a delicate, vessel-covered tissue. Everything from a slight scratch to a dry room can damage the mucosa, spurring sudden bleeding. The scientific name for that hemorrhage is epistaxis.

We can separate nosebleeds into two distinct categories.

• Anterior nosebleeds occur near the opening of our nasal cavity, where five different blood vessels crisscross the skin’s thin surface. This area is regularly exposed to harsh temperatures and arid conditions, both of which can cause bleeding. Anterior nosebleeds are more common.
• Posterior nosebleeds are both rarer and more serious. They originate in larger vessels deep within the nasal cavity and may be associated with underlying issues like high blood pressure, medication side effects, and blood disorders. When experiencing this type of epistaxis, we might feel blood running down the back of our throat instead of out our nose.

We think of alcohol as an everyday substance and nosebleeds as a normal occurrence, but both can raise red flags. Let’s examine how drinking can impact our risk of bloody noses and what this symptom may mean for our health.

Alcohol and Nosebleeds Explained

Back in the ‘90s, researchers from the Glasgow Royal Infirmary decided to investigate potential root causes of epistaxis. They interviewed a total of 253 people — 140 patients with bloody noses and 113 age- and gender-matched controls — and titled their study “Relation Between Alcohol and Nose Bleeds.”

So, what’s the verdict? Can drinking cause nosebleeds? Yes!

The Scottish medical team made three key discoveries:

1. On average, nosebleed patients drank more alcohol than those in the control group (33 units per week vs. 7).
2. There were many more regular drinkers in the epistaxis group than in the control group (45% of the nosebleed patients drank regularly vs. 30% of the control patients).
3. Nosebleed patients were significantly more likely to have consumed alcohol within 24 hours of admission.

When summarizing their findings, the authors wrote that the study “confirm[ed] an association in adults between regular, high alcohol consumption and nose bleeds.” They also explained the potential method of action behind drinking-induced epistaxis.

Causes of Nosebleeds From Drinking

According to the researchers at the Glasgow Royal Infirmary, frequent drinking reduces the aggregation of platelets, prolonging the time our body spends bleeding. When combined with other alcohol effects, our risk of nosebleeds increases. 

• Dehydration. Dryness is the leading cause of bloody noses. When the delicate mucosa tissue within our nasal passages dries out, it becomes especially vulnerable to irritation, infection, and bleeding. Living in a high-altitude, low-humidity environment can predispose us to bloody noses — especially when we consume alcohol, which dehydrates our bodies further.
• Vasodilation. Alcohol adversely affects blood platelets: the cells responsible for clotting. In addition, drinking dilates our blood vessels. This is the phenomenon behind “drinker’s nose.” The combination of blood thinning and vasodilation can create an increased risk of nosebleeds.
• Irritation. Drinking might cause irritation, especially if we’re allergic to alcohol. Consuming intoxicating beverages may lead to inflammation, which can kick-start a bloody nose.

In other cases, a bloody nose may be symptomatic of a serious condition such as alcoholic liver disease.

Alcoholic Liver Disease

Recurring nosebleeds may be a sign of alcoholic liver disease (ALD), a difficult-to-detect condition with subtle early symptoms. In the beginning stages of ALD (also called fatty liver disease), we may notice vague problems like fatigue, loss of appetite, and stomach pain. While this condition is reversible, it can progress into more severe disorders if left untreated.

Only when the liver sustains serious damage will we experience more overt symptoms such as jaundice, hair loss, and a tendency to bleed easily. Much of that bleeding takes place within the nose. For many people with ALD, frequent nosebleeds are the first sign that something is seriously wrong.

An estimated 90% of heavy drinkers will eventually develop this condition, which is just one possible consequence of heavy alcohol consumption.

Heavy Drinking: Potential Health Risks

Eventually, alcoholic liver disease may progress into cirrhosis and liver failure.

• Cirrhosis is the medical term for liver scarring. Over time, heavy drinking damages our internal organs, replacing functional, healthy material with fibroids (scar tissue). Many cirrhosis patients present with recurring nosebleeds, which may trigger life-threatening complications like encephalopathy (a broad term for changes to our brain’s functioning) or gastrointestinal bleeding.  
• Liver failure occurs when cirrhosis has progressed, seriously impacting the organ’s functionality. As our liver shuts down, it stops producing bile and filtering waste. We may begin to experience more bloody noses during this time. Occasionally, epistaxis is mistaken for severe gastrointestinal bleeding in liver failure patients, confusing medical teams and complicating care plans. Recurring nosebleeds are associated with a high mortality rate in patients who do not receive liver transplants.

We know cirrhosis and liver failure can be disturbing to consider, but awareness is crucial, especially if we drink a lot. Remember, the earlier we address warning signs like frequent nosebleeds, the better our outcomes will be.

Stop an Alcohol-Related Nosebleed

If you found this page after a panicked Google search, we’ve got you covered! Whenever you experience a nosebleed after drinking, just follow these three steps.

1. Tilt your face forward and carefully clear your airways. Stay upright and lean forward to prevent the blood from running down your throat, which can cause stomach upset. Gently blow your nose to remove any blood clots stuck in your nasal passages.
2. Apply pressure. Pinch both sides of your nose for 10 to 15 minutes to stop the bleeding. Switch to breathing through your mouth. If blood keeps coming, seek medical attention.
3. Moisturize your nostrils. Daub Vaseline or Neosporin on the inside of your nose. Focus your application on the septum: the thin, rigid line dividing your nostrils. If necessary, consider using ice packs or steam to calm any remaining nasal irritation.

Common environmental triggers of nosebleeds include nose picking, dry air, sinus infections, allergies, blunt trauma, drug use, blood thinners, and alcohol use. If we know our triggers, it’s possible to avoid nosebleeds by limiting contributing factors.

How To Prevent Nosebleeds After Drinking

Do you regularly get a bloody nose after drinking? You’re not the only one! If you’re sick of ruined sheets and stained T-shirts, it may be time to look into these preventative measures.

• Don’t mess with your nose. Blowing, tissue-stuffing, and picking can all irritate the sensitive tissue lining our nasal cavity. When in doubt, stay out.
• Humidify your home. Nosebleeds often occur in dry or high-altitude settings. If you find yourself beset with blood, consider using a humidifier to add some much-needed moisture to the air.
• Moisturize that mucosa. Nasal gels and saline sprays can protect soft tissue from superficial damage. Talk to your doctor before applying any topicals to your nose.
• Avoid alcohol. If heavy alcohol use is behind your bloody nose, consider quitting or cutting back. In addition to professional help, apps like Reframe can offer the support you need to rethink drinking.

Don’t Ignore a Bloody Nose After Drinking

Let’s roll it back: you’re sitting in bed with that bloody nose, hand clapped to your face, panicking in disbelief. If these nosebleeds become more common, talk to your healthcare provider about potential causes. Be honest with them about your alcohol intake, which could be the reason behind your symptoms.

If you’re ready to rethink your drinking habits, download Reframe, the #1 iOS app for alcohol reduction and cessation. Our science-backed readings and courses offer realistic, effective tactics for reevaluating your relationship with alcohol — and with yourself. Through our strategic partnerships with hundreds of industry experts, we’ve crafted an evidence-based program that really works. Visit the App Store or Google Play to start your journey to sobriety.