Symptoms

The symptoms of haemophilia depend on how severe the condition is, but the main sign is prolonged bleeding.

The bleeding may occur spontaneously. For example, this could be:

• sudden nosebleeds
• bleeding gums
• joint bleeds (bleeding inside your joints, such as elbows)
• muscle bleeds

The bleeding may also occur after a medical procedure, such as having a tooth removed.

The severity of haemophilia is determined by the level of clotting factors in a person's blood:

• mild haemophilia – between 5 and 50% of the normal amount of clotting factors
• moderate haemophilia – between 1 and 5% 
• severe haemophilia – less than 1% 

Find out when to seek emergency medical help.

Mild haemophilia

Children born with mild haemophilia may not have any symptoms for many years.

The condition usually only becomes apparent after a significant wound or surgery, or a dental procedure such as having a tooth removed. These events could cause unusually prolonged bleeding.

Moderate haemophilia

Children with moderate haemophilia are affected in the same way as those with mild haemophilia, but also bruise easily.

They may also have symptoms of internal bleeding around their joints, particularly if they have a knock or a fall that affects their joints. This is known as a joint bleed.

The symptoms usually begin with a tingling feeling of irritation and mild pain in the affected joint – most commonly the ankles, knees, and elbows. Less commonly, the shoulder, wrist, and hip joints can also be affected.

If a joint bleed isn't treated, it can lead to:

• more severe joint pain
• stiffness
• the site of the bleed becoming hot, swollen, and tender

Severe haemophilia

The symptoms of severe haemophilia are similar to those of moderate haemophilia. However, joint bleeding is more frequent and severe.

Children with severe haemophilia have spontaneous bleeding. This means they start bleeding for no apparent reason.

For example, this could be:

• nosebleeds
• bleeding gums
• joint bleeds
• muscle bleeds

Without treatment, people with severe haemophilia can develop:

• joint deformity, which may require replacement surgery
• soft tissue bleeding
• serious internal bleeding

When to seek emergency medical help

There's a small risk of bleeding inside the skull, known as an intracranial haemorrhage. It's estimated 3% of people with moderate or severe haemophilia will have an intracranial haemorrhage. 

However, spontaneous bleeding inside the skull is uncommon and usually only caused by a head injury.

Bleeding in the skull should be treated as a medical emergency.

The symptoms of an intracranial haemorrhage include:

• a severe headache
• a stiff neck
• vomiting
• a change in mental state, such as confusion
• speaking difficulties, such as slurred speech
• changes in vision, such as double vision
• loss of co-ordination and balance
• paralysis of some or all of the facial muscles

Call 999 for an ambulance if you think someone is bleeding inside the skull.

Page last reviewed: Thu Apr 2020 Next review due: Wed Feb 2020