By themselves, both nosebleeds and headaches are common in children over the age of two and are usually not caused by a serious problem. Together, however, these two symptoms might indicate certain medical issues. Common causes include an upper respiratory infection, sinus condition, or a foreign body in the nose, and serious conditions range from head trauma to tumors. Sometimes, nosebleeds are part of childhood migraines.
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Symptoms
Both nosebleeds (epistaxis) and headaches can be caused by a wide variety of issues in children.
Nosebleeds (Epistaxis)
Nosebleeds (epistaxis) are common in mid-childhood, with the incidence highest in children between the ages of three and eight. Roughly 56% of children between the ages of six and 10 will have at least one nosebleed each year.
Nosebleeds are uncommon before the age of two. A very young child who has a nosebleed should get medical attention.
Nosebleeds occur when small blood vessels in the nose break. Common reasons for nosebleeds include dry air (especially cold air), upper respiratory infections, a foreign body in the nose, picking at the nose, and overuse of nasal decongestants.
Less common, but serious causes may include tumors in the nose and sinus passages or a low platelet count due to conditions including liver disease, kidney disease, bleeding disorders, or blood-related cancers.
Headaches
Headaches in children are also common but rarely affect those under the age of six. Headaches may be classified as primary or secondary. Primary headaches aren't caused by an underlying medical illness, and secondary headaches occur due to another condition, such as an infection or head trauma.
Subtypes of primary headaches include tension headaches, migraine headaches, and cluster headaches. Headaches can cause pain in different areas of the head and they may be sharp, dull, throbbing, or constant, and can range in severity.
Parents often wonder when they should worry about childhood headaches.
Headaches are usually of greater concern if:
- The child is younger than six.
- The child has had a previous head injury.
- The headache awakens the child from sleep
- The child has more than one headache per month.
- There are additional symptoms such as fever, neck stiffness, lethargy, lightheadedness, confusion, tremors, vision changes, numbness, muscle weakness, or fainting.
Headaches and Nosebleeds Together
When a child experiences headaches and nosebleeds together, it sometimes narrows down the list of possible causes but also increases the chance that there's an underlying medical condition.
Causes
Looking at some of the potential causes of headaches with nosebleeds in children can be frightening, especially if your child has these symptoms. Keep in mind that common things are common and uncommon conditions are uncommon.
Nevertheless, it is important for parents to have an awareness of some of the more serious causes of headaches and nosebleeds, but keep in mind that allergies are much more common than brain tumors.
Sometimes the headaches and nosebleeds can occur at the same time, or they may occur within a few days of each other.
Allergies (Allergic Rhinitis)
Allergic rhinitis or hayfever is a common cause of both headaches and nosebleeds. With allergies, nosebleeds can be recurrent, and headaches are usually relatively mild.
Children who have allergies may also have other atopic diseases, such as eczema or asthma, and may have a family history of these as well.
Infections
Infections may also cause headaches with nosebleeds, and sometimes fever is present as well. The common cold or sinus infections are most common, especially in children predisposed (such as those who have a deviated septum).
Headaches due to sinus infections may be described as "heavy" and the child may feel pressure behind their eyes and nose.
Although uncommon, headaches with nosebleeds are classic signs of animal-transmitted infections like brucellosis and psittacosis.
- Brucellosis, which can be transmitted through unpasteurized milk, is often associated with joint aches and fatigue, and it can also cause systemic symptoms.
- Psittacosis is transmitted from birds, including pet birds, and it can cause flu-like symptoms.
Foreign Objects
A foreign body that is lodged in the nasal passages can cause headaches with nosebleeds and it isn't uncommon in young children. For example, a Lego accidentally placed in the nose can lead to nosebleeds and uncomfortable headaches.
When the foreign body has been in place for some time, children often develop a thick, foul-smelling nasal discharge.
Migraine Headaches
Just as with adults, migraines in children may have symptoms other than headaches. Childhood migraine can involve stomachaches, nausea, dizziness, and fatigue along with head pain.
According to a 2015 study in the European Journal of Paediatric Neurology, 1.1% of children with migraines have nosebleeds during an attack, although some scientists believe that the incidence is higher.
It was found that nosebleeds often preceded the headaches by around three years.
Overall, children who have recurrent nosebleeds are four times more likely to develop migraine headaches.
High Blood Pressure (Hypertension)
Headaches and nosebleeds have been considered a symptom of hypertension, but the link is complex.
According to the American Heart Association, high blood pressure doesn't cause headaches and nosebleeds unless the blood pressure is over 180/120. This severe elevation of blood pressure is referred to as malignant hypertension or a hypertensive crisis.
Unlike mild or moderate hypertension, blood pressure this high is not caused by being overweight or poor dietary choices. In children, underlying causes of severe hypertension may include some poisonings (including those related to medications), kidney disease, adrenal tumors, brain tumors, or head trauma.
Trauma
Trauma to the head, face, or nose may lead to headaches and nosebleeds. Children who have either or both of these symptoms after a head injury should be evaluated immediately by a physician.
Tumors
Tumors in the nasal cavity or paranasal sinuses are very uncommon and can lead to both headaches and nosebleeds. These tumors can be benign or malignant and include many types of tumors such as angiofibromas, sarcomas, neuroblastomas, and much more.
Brain tumors, such as olfactory groove meningiomas, may also give rise to these symptoms. While brain tumors are a common concern when a child has headaches, symptoms of brain tumors usually include other neurological signs and not just headaches and nosebleeds alone.
Poisoning
Accidental ingestion of medications (especially blood thinners or anti-inflammatory drugs), household cleaners, and more may result in headaches and nosebleeds.
Vascular Disorders
Conditions marked by abnormalities in blood vessels can give rise to both headaches and nosebleeds. One such example is the genetic disorder hereditary hemorrhagic telangiectasia which can lead to arteriovenous malformations (abnormal connections between arteries and veins in the head and neck).
Vasculitis, a type of inflammation of the blood vessels that's common in connective tissue diseases such as lupus, may also cause nosebleeds and headaches.
Blood Disorders
Blood disorders ranging from hemophilia to aplastic anemia are very uncommon, but possible causes of these symptoms. They can cause bleeding, which may lead to nosebleeds. If bleeding occurs in the brain, it can cause headaches.
Leukemia
Leukemia, especially acute lymphocytic leukemia, the most common childhood cancer, may lead to headaches.
These cancers may involve the central nervous system, causing headaches. And they can cause nosebleeds due to the effect of cancer on the bone marrow, resulting in a low platelet count.
Coincidence
Just because your child has headaches and nosebleeds at the same time doesn't mean they will always be related. In fact, it could simply be a coincidence that your child has both symptoms, and they can be unrelated.
For example, your child could have a headache from sleeping in an uncomfortable position and a nosebleed from picking their nose.
When to See the Doctor
Call your pediatrician if your child's nosebleed is heavy, won't stop bleeding after 20 minutes, or is causing lightheadedness or fainting. Lethargy, confusion, or the sudden onset of a severe headache may be signs of a serious condition. If your child has a history of head trauma, seek immediate care.
It is important to contact your child's pediatrician about any symptom that concerns you, even if that symptom is only your "gut feeling." Trust your instincts as a parent and call.
Diagnosis
If your child has nosebleeds and headaches, your pediatrician will likely first ask about a history of head injuries. This can sometimes mean urgent care is needed.
The doctor will also ask for more detail about your child's headaches and nosebleeds, including when they began, whether they are worsening or improving, and what additional symptoms you may have noticed.
Some symptoms that can help narrow the possible causes are:
- Fatigue
- Fever
- Bruising and/or pallor
- Pain
- Lightheadedness or dizziness
- Weight loss
- Nausea and/or vomiting
- Neurological symptoms
- Confusion
Your pediatrician will then perform a physical exam. Depending on the findings, they may recommend further evaluation. For example, they may refer your child to an ear, nose, and throat (ENT) specialist if there's a concern about serious sinus problems.
Lab Tests
A number of different lab tests may be recommended:
- Complete blood count (CBC): A CBC can determine if your child has anemia (low red blood cells) or thrombocytopenia (low platelets).
- Chemistry panel: The comprehensive blood and urine evaluation will include kidney and liver function tests
- Coagulation tests: Bleeding tests can determine if your child's blood is clotting normally.
Other Tests
Imaging tests may include computed tomography (CT) or magnetic resonance imaging (MRI) to evaluate the nasal cavities and sinuses or the head.
If your child's CBC is abnormal and your pediatrician is suspicious about leukemia, aplastic anemia, or other serious conditions, a bone marrow biopsy may be ordered. Bone marrow studies are typically performed if signs of anemia, thrombocytopenia, fever, lymphadenopathy (swollen lymph nodes), and hepatosplenomegaly (swollen liver and spleen) cannot be explained.
The treatment of nosebleeds and headaches will depend on the underlying cause.
A Word From Verywell
While both headaches and nosebleeds are common in children over age two, when they occur together it's important to look a bit deeper. The cause could be minor, such as the common cold, but could potentially be something much more serious, especially if the nosebleeds are recurrent and the headache is persistent or worsening. Of course, it could simply be a coincidence that your child has both symptoms at the same time.
In being an advocate for your child it's helpful to learn about potential causes. Doing so can sometimes alert parents to report a symptom they might otherwise dismiss as unrelated or unimportant. Most importantly, your intuition as a parent can be priceless, so make sure you listen to it.
FAQs
Headaches and Nosebleeds Are Sometimes Serious in Kids? ›
Research also shows that children with migraines are more likely to have nosebleeds. Excessive bleeding can sometimes cause headaches. When these symptoms happen frequently and closely together, it might indicate a more serious condition, such as high blood pressure, leukemia, or anemia.
Why does my child have a headache and nose bleeds? ›Together, however, these two symptoms might indicate certain medical issues. Common causes include an upper respiratory infection, sinus condition, or a foreign body in the nose, and serious conditions range from head trauma to tumors. Sometimes, nosebleeds are part of childhood migraines.
When should I worry about nosebleeds and headaches? ›However, their cause is generally minor health issues like allergies, colds, and irritation. If the nosebleed or headache is severe or does not go away, it's time to contact your healthcare provider. They can help you find out what is causing them, form a treatment plan, and work to prevent them from happening again.
Can a brain tumor cause headaches and nosebleeds? ›Nosebleeds can occur particularly from brain tumors in the sinus area (which is uncommon), or from tumors that start at the base of the skull, such as meningioma which is usually benign.
What causes bad headaches and nosebleeds? ›In many cases, having a headache and a nosebleed at the same time is a coincidence. In other cases, everyday factors such as the common cold or seasonal allergies can cause both symptoms. Both headaches and nosebleeds are very common, and they are usually not a cause for concern.
When should I be concerned about my childs nosebleed? ›If your child gets nosebleeds more than once a week, call your doctor. Usually, frequent nosebleeds are easily treated. Sometimes tiny blood vessels inside the nose are irritated and don't heal, which happens more often in kids with ongoing allergies or who get a lot of colds.
What diseases cause nosebleeds in children? ›Blood diseases, such as hemophilia, also can provoke and worsen nosebleeds. Chronic illness: Any child with a long-term illness, or who may require extra oxygen or other medication that can dry out or affect the lining of the nose, is likely to have nosebleeds.
Can nosebleeds mean something serious? ›Sometimes, the cause of nosebleeds can't be determined. Frequent nosebleeds may mean you have a more serious problem. For example, nosebleeds and bruising can be early signs of leukemia. Nosebleeds can also be a sign of a blood clotting or blood vessel disorder, or a nasal tumor (both non-cancerous and cancerous).
Can low iron cause nosebleeds? ›Other types of anemia, including iron deficiency anemia, may also contribute to uncontrolled bleeding. If you have had anemia for a long time, your body can experience visible physical changes that leave you susceptible to frequent nosebleeds. Cuts and other types of injuries may take longer to stop bleeding.
Are nosebleeds a symptom of anything? ›Occasionally, nosebleeds may indicate other disorders such as bleeding disorders, high blood pressure, or hardening of the arteries. A nosebleed may be caused by trauma, irritation or dryness of the lining of the nose, allergic rhinitis, colds, or sinusitis.
How I found out my child had a brain tumor? ›
Several tests can help the doctor determine whether a brain tumor is present. These can include: A neurological exam — Tests your child's reflexes, muscle strength, sensation, eye and mouth movement, coordination and alertness. Imaging tests — Detailed pictures of the brain's structures and possible signs of a tumor.
What are the first warning signs of a brain tumor? ›- Headache or pressure in the head that is worse in the morning.
- Headaches that happen more often and seem more severe.
- Headaches that are sometimes described as tension headaches or migraines.
- Nausea or vomiting.
- Eye problems, such as blurry vision, seeing double or losing sight on the sides of your vision.
- Headaches.
- Mental status changes, including brain fog.
- Cranial nerve abnormalities, which could cause vision problems.
- Weakness.
Nosebleeds are very common in children and often caused by harmless activities. Most nosebleeds cause only minor discomfort to your child. First aid is used to treat nosebleeds. For severe nosebleeds, a doctor may use an ointment, cauterisation or nasal packing to stop the bleeding.
Why does my son keep having a nose bleed? ›Key points about a nosebleed in children
They happen more often in dry climates. They also happen more during the winter. That's when dry heat in homes and buildings can cause drying, cracking, and crusting inside the nose. Nosebleeds can be caused by many things, such as dry air, nose picking, and allergies.
Low iron can cause the brain to receive less oxygen than needed for optimal functioning, leading to headaches. Iron deficiency anemia can also cause migraines, mostly in menstruating women. If you have frequent or recurrent headaches, it can be a symptom of iron deficiency anemia.
What vitamin is lacking in a child with a bleeding nose? ›Vitamin K deficiency bleeding or VKDB, occurs when babies cannot stop bleeding because their blood does not have enough Vitamin K to form a clot. The bleeding can occur anywhere on the inside or outside of the body. When the bleeding occurs inside the body, it can be difficult to notice.
Are nosebleeds high blood pressure headaches? ›The best evidence indicates that high blood pressure does not cause headaches or nosebleeds. If your blood pressure is unusually high AND you have headache or nosebleed and are feeling unwell, wait five minutes and retest. If your reading remains at 180/120 mm Hg or higher, call 911.