Dry, thin nasal mucous membranes and a bloody nose

The nose is the olfactory organ, but has a respiratory function as well.
When you inhale through the nose, it heats up and humidifies the air you just breathed in. The nasal mucosa is normally well vascularised and rather humid as the tiny capillaries are close to the surface and provide heat.

The internal core body temperature is tightly regulated and the tiny air sacs in the lungs, known as alveoli, that are responsible for exchanging oxygen and carbon dioxide amongst other gasses are very sensitive to changes in their environment. If we were to breathe in -20°C air without warming it, this cold inhale would reach the lungs and potentially damage tissue. By warming it to body temperature prior to reaching the lungs, we maintain optimal respiratory function.

The nose also filters the inhaled air. To perform those functions, the nose consists of a humid nasal mucous membrane and fine cilia. These cilia clean over 10,000 litres of breathing air per day and ensures that as few dust particles, bacteria and viruses as possible enter the body. The nasal secretions slow and trap pathogens, like a human wading through a pool, while the cilia sweep the mucous up and out of the body.
To benefit from these nasal functions, we should inhale through our "humid" nose.

The symptoms of a dry nasal mucous membrane are:

• A thin and dry feeling.
• Crusts and wounds.
• Pain.
• Small amounts of blood.

The nasal mucous membrane should be humid to defend itself against infections. Think of growing a plant. With well-tended soil kept moist (depending on the species), the plant thrives and is able to defend itself against fungi or disease.

When the soil dries out, the plant has to rely on the moisture in its leaves, quickly wilting and becoming more susceptible to infection. You begin to see the soil clump and crack, like the surface of Death Valley or other areas that were once covered by water.

These cracks occur in the nasal mucosa as the cells begin to shrivel, providing easy access for potential viruses or bacteria trying to set up camp.

Dry crusts in your nose can also tempt you to pick at them, bringing bacteria and who knows what else into your nose via your fingers. As there is so little moisture or nasal secretions, the capillaries are more prone to injury and when you do pick at the dry crusts, your nail may damage the mucosal lining and cause a nosebleed - more on that below.

Cold and dry air are common causes of nasal dryness. The cold winter air is very dry as it lacks the humidity of the summer months when the heat evaporates water from lakes and rivers, allowing it to enter the air as water vapour. This means our body has to produce more moisture to compensate for the dry winter air you're inhaling.

Indoor heating systems also dry the air so in the winter, there is no avoiding dry air inside or out. That is why nasal dryness is so frequent, resulting in crusts and wounds.
Other factors that cause dryness of the nasal mucous membrane:

• Allergies, such as hay fever
• Runny nose
• Hormonal changes (women during menopause for instance).
• The use of certain medications
• Staying indoors with low humidity due to air-conditioning or central heating (at home, office, hospital, airplane)
• Low humidity outside (e.g. during winter)
• Disease, such as Sjögren syndrome

There are a few things you can do to alleviate or prevent complaints of nasal dryness:

• Try to avoid the triggers that cause the complaints as much as possible, including allergens.
• Hang containers of water over radiators or over your fireplace as this will help keep the ambient air humid. Ensure you change the water regularly, so that it doesn't become a breeding ground for bacteria.
• Use a humidifier
• Do not put the heat higher than 20 to 21°C
• Besides that, there are nasal sprays which keep the nasal mucous membrane humid. A natural nasal spray that humidifies and alleviates the nasal cavities for a long period of time, is Dry Nose Relief. A combination of moisturizing and anti-microbial hyaluronic acid, saline, and chamomile to soothe those irritated tissues.

When your nasal mucous membrane is too dry, it can easily crack as we mentioned above. If your nose gets bloody when the air is dry, you probably suffer from dry nasal mucous membrane.

The body knows how to handle wounds and will quickly activate coagulation pathways to halt the bleeding. The platelets will come together to bind the flow of blood out of the nose, which is why a clot begins to form. We want to encourage this process instead of impeding it, so you can handle it as follows:

• Avoid blowing your nose.
• Squeeze the bridge of your nose (the bone at the top of your nose).
• Keep your head a bit forward, in a reading position
• Stay seated that way for ten minutes.
• The nosebleed should be over after this. If it is not the case, repeat for another ten minutes.
• If the bleeding continues relentlessly, it is important get in touch with your primary care provider.