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Why are there blood spots on my pillow?

Waking up to find blood spots on your pillow can be alarming. However, there are a few potential reasons why this may occur that are usually harmless. In this article, we’ll explore the most common causes and when you may need to see a doctor.

Nosebleeds

One of the most common reasons for blood spots on your pillow is a nosebleed that happens while you’re asleep. Nosebleeds can occur spontaneously when the nasal membranes dry out and crack. Other causes include:

  • Allergies
  • Upper respiratory infections
  • Dry air
  • Vigorous nose blowing
  • Trauma to the nose
  • Medications like blood thinners
  • Drug use, such as cocaine

When you have a nosebleed during sleep, blood drips down the back of your nose and throat, resulting in spots on your pillow. Try using a humidifier at night and lubricating nasal gels to prevent bleeds from dry nasal passages.

Acne

For those who struggle with facial acne, blood spots can appear after pimples pop overnight. Acne forms when pores become clogged with oil and dead skin cells, creating pimples. Cystic acne goes deeper under the skin, forming painful bumps. These can burst while you sleep, leaving behind blood and fluid on your pillowcase.

To prevent acne-related blood spots:

  • Wash your face daily
  • Use acne-fighting ingredients like salicylic acid and benzoyl peroxide
  • Avoid popping pimples
  • Change your pillowcase frequently to avoid reinfection

See a dermatologist if you have severe, cystic acne that isn’t getting better with over-the-counter methods.

cuts or scrapes

If you have any open cuts or scrapes on your face, they can leak small amounts of blood during the night. This may happen if you have:

  • Cuts from shaving
  • Scrapes or scratches from a fall or sports
  • Skin tears from injury
  • Sores from picking at acne

Keep any facial wounds clean and covered with a bandage at night to avoid getting blood on your pillow. Change the bandage daily.

Mouth sores

Certain mouth conditions can cause sores that may bleed at night, like:

  • Canker sores – Small, painful ulcers caused by injury or irritation
  • Cold sores – Fluid-filled blisters around the lips from herpes simplex virus
  • Oral lichen planus – An inflammatory condition affecting the mouth lining
  • Gingivitis – Bleeding, inflamed gums from poor oral hygiene

Practice good oral care by brushing twice a day, flossing daily, and using antiseptic mouthwash to keep the mouth bacteria-free. See your dentist if mouth pain or bleeding persists.

Sleep apnea

Sleep apnea, which causes disrupted breathing during sleep, can also cause morning blood spots. The lack of oxygen causes blood vessels in the mouth to burst and leak.

Other signs of sleep apnea include:

  • Loud snoring
  • Gasping or choking at night
  • Excessive daytime sleepiness
  • Morning headaches
  • Difficulty concentrating

See a sleep doctor if you think you may suffer from sleep apnea. Treatments like CPAP machines can restore normal breathing.

More serious causes

While usually harmless, blood spots can occasionally signal a more serious health issue. See your doctor if bleeding is excessive or accompanied by:

  • Fever
  • Unintentional weight loss
  • Swelling or enlarged lymph nodes in your neck
  • Persistent headaches
  • Numbness or tingling
  • Unexplained bruising

These may be signs of autoimmune disorders, nasal tumors, blood cancers like leukemia, or von Willebrand disease, a bleeding disorder.

When to see a doctor

You should make an appointment with your doctor if:

  • Blood spots keep appearing and you don’t know the cause
  • Bleeding is frequent or excessive
  • Bleeding is accompanied by other symptoms like headaches, weight loss, or fever
  • You have blood clots or clumps, not just spots
  • Bleeding lasts more than 20 minutes at a time

Seek emergency care if you’re coughing up blood clots, experience heavy bleeding from the nose or mouth, or feel weak/dizzy from blood loss.

Diagnosing the cause

To determine the cause of blood spots, your doctor may:

  • Ask about your symptoms and medical history
  • Conduct a physical exam to look for signs of infection or injury
  • Examine your nose, mouth, ears, and skin for sources of bleeding
  • Order blood tests to check for anemia and bleeding disorders
  • Arrange for imaging tests like an MRI to look for nasal obstructions or systemic issues
  • Refer you to a specialist like an ENT doctor, dermatologist, or hematologist for further assessment

Treatment

Treatment will depend on the underlying cause found but may include:

  • Using nasal decongestants and saline sprays for nosebleeds
  • Oral and topical antibiotics for bacterial infections
  • Steroid creams and antihistamines for allergic rashes
  • Cauterization to seal off bleeding blood vessels
  • Surgery to remove nasal obstructions or lesions
  • Medications like antifibrinolytics to improve blood clotting
  • Treating underlying conditions like sleep apnea

Lifestyle remedies include using a humidifier, rinsing with salt water, stopping smoking, and practicing good hygiene. Maintain follow-ups as directed to monitor bleeding.

Prevention

You can reduce occurrences of blood spots on your pillow by:

  • Treating the condition causing bleeding, like acne or mouth sores
  • Using a nasal lubricant before bed if prone to nosebleeds
  • Running a humidifier in your room at night
  • Cleaning any cuts thoroughly and covering with bandages
  • Changing pillowcases frequently to avoid recontamination
  • Avoiding irritants like smoking, alcohol, spicy foods
  • Practicing good oral hygiene and seeing your dentist regularly

When to change your pillow

It’s generally recommended you replace pillows every 1-2 years, or sooner if:

  • You see blood spots frequently
  • Your pillow has visible stains
  • It’s misshapen or flattened
  • Your neck feels sore in the morning

Be sure to launder pillow protectors and pillowcases regularly as well.

Conclusion

Discovering blood on your pillow can look alarming, but is rarely a cause for concern. Frequent nosebleeds, acne, mouth sores, and facial injuries are among the most common culprits. In most cases, blood spots can be prevented with simple home remedies and lifestyle changes.

See your doctor if bleeding seems abnormal or excessive. With the right diagnosis, underlying health issues leading to blood spots can be successfully managed or treated.

Cause Symptoms Treatment
Nosebleeds Blood from nostrils, congestion Nasal sprays, humidifier, avoid irritants
Acne Pimples, cysts on face Improved hygiene, OTC creams, prescription antibiotics
Cuts/scrapes Visible wounds on face Keep clean and covered
Mouth sores Oral ulcers, swollen gums Oral hygiene, antiseptic rinses, dental exam
Sleep apnea Snoring, fatigue, morning headaches CPAP machine, sleep study