Have you been getting nosebleeds during chemotherapy (chemo) and wondering if the two are related? You’re not alone.

Nosebleeds can be a side effect of certain breast cancer treatments because some can cause your platelet count to drop too low. Some chemo regimens are more likely than others to cause low platelets. These include regimens with gemcitabine, platinum, or anthracycline drugs.

Taxane-based treatments, such as paclitaxel, docetaxel, or nab-paclitaxel (Abraxane), can also affect blood counts.

“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.’”

How Can Chemotherapy Cause Nosebleeds?

Chemotherapy can affect bone marrow cells, which help make platelets. Platelets help your blood clot. When platelet levels are low, you have a condition called thrombocytopenia. This can make bleeding harder to stop, including bleeding from the nose.

Not every chemo regimen causes nosebleeds or low platelets, and the risk can vary by cancer type, treatment, and personal health factors.

Some medicines can raise the risk of bleeding. These include blood thinners, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen. Talk with your oncology team before changing how you take any of these medicines.

Hair loss during chemotherapy can affect more than the hair on your head. You may also lose nose hairs. Nose hairs help protect the lining of your nose, and dry air can make the nasal lining more likely to crack or bleed. Blowing your nose, rubbing it, or accidentally bumping it may trigger a nosebleed.

How To Stop Nosebleeds From Chemo

Here are three ways to help stop nosebleeds during chemo:

Tips for Preventing Nosebleeds

Some chemo side effects can be managed at home, and you may be able to lower your chances of getting a dry or bloody nose by keeping your nasal passages moist.

“I can’t remember if this was AC [doxorubicin and cyclophosphamide] or Taxol, but the random nosebleeds were annoying,” one member wrote.

You may not be able to prevent low platelets from chemo, but you can help keep your nose from getting too dry.

Here are some tips:

• Use saline spray or nose drops to moisten nasal passages.
• Run a humidifier or vaporizer to add moisture to dry air at home.
• Gently apply a small amount of nasal gel or ointment, such as petroleum jelly, just inside your nostrils.
• Ask your oncology team before cutting back on aspirin, ibuprofen, naproxen, or other medicines that may increase bleeding risk.
• Don’t blow your nose too hard, and try not to rub, pick, or scratch it 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 said 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.”

Ask your oncology team before using medicated ointments or vapor rubs near your nose, and don’t put these products inside your nostrils unless your doctor says it’s OK.

“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 healthcare team about ways to prevent nosebleeds from chemo and which over-the-counter products they recommend for keeping your nose from getting too dry. Be sure to follow your doctor’s instructions for using nasal sprays or ointments to avoid using them too often.

When To Talk to Your Doctor About Nosebleeds

Even if nosebleeds after chemo are expected, it’s still best to tell your healthcare provider about them. Contact your oncology team right away if you have:

• Frequent nosebleeds
• A nosebleed that’s hard to stop despite proper first aid
• Easy bruising
• Bleeding gums
• Blood in your urine or stool
• Small red or purple spots on your skin

These symptoms may be signs of a low platelet count from cancer treatment. If platelets become too low or if you’re bleeding, your doctor may recommend a platelet transfusion or another treatment approach.

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

• More tired than usual
• Weak
• Unexpectedly cold
• Irritable
• Dizzy, faint, or lightheaded

Talk to your doctor if you think you may have symptoms of low platelets or anemia. They can check your blood counts and recommend the right next steps.

Join the Conversation

On MyBCTeam, people share their experiences with breast cancer, get advice, and find support from others who understand.

Have you had nosebleeds while undergoing chemo? Let others know in the comments below.