What is the cause of intermittent left nasal bleeding for 6 to 7 days?

Intermittent Left-Sided Nasal Bleeding for 6-7 Days

Your intermittent left-sided nosebleeds over 6-7 days are most likely caused by local trauma (such as nose picking), mucosal dryness, or localized inflammation, and you should start with firm nasal compression for 5-10 minutes, apply nasal moisturizers twice daily, and seek medical evaluation if bleeding persists beyond 20 minutes or recurs more than once weekly. 1

Most Common Causes of Unilateral Epistaxis

The fact that your bleeding is only on the left side points toward specific local causes rather than systemic problems:

• Digital manipulation (nose picking) is the leading cause of unilateral epistaxis, directly damaging fragile vessels in the anterior nasal septum on one side 1
• Mucosal dryness and inflammation from dry environments, indoor heating, or nasal oxygen use commonly affects one nostril more than the other 1
• Localized infection such as rhinosinusitis can affect only one side of the nasal cavity 1
• Intranasal drug use, including overuse of topical nasal medications or illicit drug snorting, typically affects one nostril 1
• Previous nasal or sinus surgery on that side can create vulnerable areas prone to bleeding 1

Immediate Home Management

Apply firm, sustained compression to the soft lower third of your nose for a full 5-10 minutes without checking if bleeding has stopped, sitting upright with your head tilted slightly forward 2, 1

If bleeding continues after 10 minutes:

• Apply over-the-counter oxymetazoline (Afrin) or phenylephrine nasal spray directly to the left nostril, which stops bleeding in 65-75% of cases through local vasoconstriction 1
• Resume firm compression for another 5 minutes 1

Essential Prevention Measures

Start these immediately to prevent recurrence:

• Apply petroleum jelly or saline nasal gel to the inside of your left nostril twice daily to maintain mucosal moisture 1
• Use a humidifier in your bedroom, especially during winter months or in dry climates 1
• Apply regular saline nasal spray to the affected nostril several times daily 1
• Keep fingernails trimmed and avoid nose picking 1

When to Seek Medical Evaluation

You need to see a healthcare provider if:

• Bleeding lasts longer than 20 minutes despite proper compression 2
• Bleeding recurs more than once weekly despite preventive measures 1
• You develop associated symptoms such as nasal obstruction, facial pain, or visual changes, which may suggest a mass lesion 1
• You notice foul-smelling discharge from the left nostril, which could indicate a foreign body or infection 1

What Your Doctor Will Do

If you require medical evaluation, expect:

• Anterior rhinoscopy after removing any blood clots to identify the specific bleeding site in your left nostril 2, 1
• Nasal cautery restricted only to the active bleeding site if one is identified, after anesthetizing the area 2, 1
• Nasal endoscopy if bleeding is difficult to control or if there's concern for unrecognized pathology like a tumor or vascular malformation 2, 1

Red Flags Requiring Urgent Evaluation

While your intermittent bleeding over 6-7 days suggests a benign local cause, seek emergency care if you develop:

• Bleeding lasting more than 30 minutes, which meets the threshold for severe epistaxis 2
• Signs of significant blood loss including dizziness, rapid heartbeat, or feeling faint 2
• Bleeding from both nostrils or blood coming from your mouth 2

Systemic Factors to Consider

Even though unilateral bleeding suggests a local cause, certain systemic factors can make bleeding worse on one side:

• Anticoagulant or antiplatelet medications (aspirin, warfarin, clopidogrel) may cause bleeding that manifests in one nostril first where there's already a vulnerable vessel 1
• Hypertension can exacerbate bleeding from a pre-existing weak vessel on one side 1
• Coagulation disorders may initially present with unilateral epistaxis 1

Common Pitfalls to Avoid

• Do not place tissues or cotton inside your nose, as they can be aspirated and may restart bleeding when removed 1
• Do not tilt your head backward, as this causes blood to flow down your throat and prevents accurate assessment of bleeding severity 1
• Do not check if bleeding has stopped before the full 5-10 minutes of compression, as premature release prevents clot formation 1
• Do not ignore recurrent bleeding, as persistent unilateral epistaxis requires examination to rule out structural abnormalities or tumors 1