Have you been getting nosebleeds during chemotherapy (chemo) and wonder if the two are related? You’re not alone. Many MyBCTeam members have experience with nosebleeds and chemo, more commonly with regimens involving gemcitabine, platinum, or anthracycline but also with taxane-based treatments, available as Abraxane and previously sold in the U.S. as Taxol.

“Since I started receiving Taxol, my nose is bleeding slightly and has started running,” one MyBCTeam member shared.

“I had nosebleeds like crazy!” another member wrote. “I spent so much time at the ENT [ear, nose, and throat] doctor, and he just shrugged it off as ‘chemo-related.’”

Chemotherapy drugs like Taxol and nosebleeds can sometimes go hand in hand. Chemo can destroy platelets — cells that form blood clots to help stop bleeding — which can lead to thrombocytopenia (a low platelet count) and make you more susceptible to bleeding, especially nosebleeds.

The possibility of hair loss during chemotherapy can affect not only your head but also your nasal passages, leading to nosebleeds. Similar to how the hair on your head helps protect your scalp, your nasal hair protects the mucous membranes in your nose. Without nasal hair, your nose can dry out quicker. Simply blowing your nose or accidentally bumping it can trigger a nosebleed.

Here are three ways to stop nosebleeds that might come with chemo.

1. Pinch Your Nose

When you have a nosebleed, one way to stop it is to pinch together your nostrils (the soft part of your nose) and lean your head slightly forward. Hold your nostrils closed for 10 minutes, breathing through your mouth while you wait. Use a timer or watch the clock to make sure you keep your nose closed and apply pressure for the entire 10 minutes. Avoid checking before that to see if the bleeding has stopped — this can cause the bleeding to go on longer.

2. Use an Ice Pack

If pinching your nose doesn’t stop the bleeding after 10 minutes, you can also try applying an ice pack or cold compress to the bridge (bony part) of your nose. The coolness can help slow and stop bleeding by causing the blood vessels in the nose to narrow. The chill might also feel good as you wait for the bleeding to stop.

3. Try a Decongestant Spray

Another way to stop a bloody nose is to use a decongestant spray in the side of your nose that’s bleeding. You can usually buy decongestant sprays such as oxymetazoline (sold as brands such as Afrin and Vicks Sinex) over the counter. After you spray the decongestant, apply pressure to your nose by pinching your nostrils together (as in step No. 1).

If you decide to try a decongestant spray to help stop nosebleeds, ask your doctor how long the product can be used. If used too often, decongestant sprays can increase the risk of nosebleeds.

Do’s and Don’ts of Stopping a Nosebleed

When trying to stop a nosebleed, keep in mind a few important do’s and don’ts:

• Do spit out any blood in your mouth. Swallowing blood may make you feel nauseated or vomit.
• Do sit or stand. If you lie down, blood could run down your throat and cause you to cough or choke.
• Don’t tilt your head back. Otherwise, you might swallow blood as it drains from your nose into the back of your throat, causing stomach upset.
• Don’t put tissues (or anything else) up your nose to catch the blood. Removing them can irritate the inside of your nose and cause more bleeding.

Tips for Preventing Nosebleeds

Many chemo side effects can be managed at home, and so can a dry or bloody nose. “I can’t remember if this was AC [doxorubicin and cyclophosphamide] or Taxol, but the random nosebleeds were annoying,” one member wrote.

Nosebleeds can be a nuisance, but they can sometimes be prevented. Although a low platelet count from chemo is outside your control, you may be able to lower the chances of getting a nosebleed by reducing dryness. Consider these tips for preventing nosebleeds:

• Use saline spray or nose drops to moisten and protect mucous membranes.
• Run a humidifier or vaporizer to address dry air at home. Be sure the device is sanitized, and use clean distilled water each time.
• Gently apply a small amount of gel or ointment, such as petroleum jelly, just inside your nostrils.
• Limit or avoid use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (sold as Advil, Motrin, and others) or aspirin, which can increase the risk of bleeding.
• Don’t blow your nose too hard, and try to avoid blowing or scratching it for 24 hours after a nosebleed.

Many MyBCTeam members have reported success using some of these strategies. “Mostly I had dried blood constantly in my nose (I know, gross!). I used saline nose drops, which really helped,” one member shared.

Another member noted that applying Vicks VapoRub just under the nose helped: “I too have been having nosebleeds. The Vicks really does work for me. Put a little under my nose at bedtime. Haven’t had a nosebleed since I started doing this.”

“Try a humidifier and see if that helps keep your nasal passages from drying out,” another member suggested. “Nosebleeds will pass …. just scary right now. It’s going to be OK.”

Talk to your health care team about prevention tips for nosebleeds from chemo and any over-the-counter treatments they may recommend for keeping your nose from becoming too dry. Be sure to follow your doctor’s instructions for using nasal sprays or ointments to avoid overuse.

When To Talk to Your Doctor About Nosebleeds

Even though nosebleeds after chemo may be expected, it’s still best to tell your health care provider about them, especially if you have frequent nosebleeds or one that doesn’t stop. In addition, tell your doctor if you notice more bruising or bleeding than usual, including nosebleeds, blood in your stool or urine, or bleeding gums. These may be signs of a low platelet count from chemo, like Taxol. Your doctor may recommend getting a platelet transfusion to help boost the number of platelets in your body.

Breast cancer treatments like chemo can also cause anemia (a low red blood cell count) from severe nosebleeds. You might have symptoms of anemia if you’re feeling:

• More tired than usual
• Weak
• Unexpectedly cold
• Cranky
• Dizzy, faint, or light-headed

Be sure to talk to your doctor if you think you may have symptoms of low platelets or anemia. They can recommend ways to help manage the condition, such as with medication or dietary changes.

Talk With Others Who Understand

MyBCTeam is the social network for people with breast cancer and their loved ones. On MyBCTeam, more than 64,000 members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.

Have you had nosebleeds while undergoing chemo? What has worked best to stop them? Share your experience in the comments below, or start a conversation by posting on your Activities page.