As far as I can tell it's 100% cotton and I know the fabric. They wrinkle if that's a problem for you. My husband enjoys ironing, and now that he's retired, he irons himself. If your nose is bleeding, hydrogen peroxide or an Oxyclean spray can help prevent permanent blood stains, which sometimes happens. I recommend them to people who don't mind wrinkled handkerchiefs or tight handkerchiefs. If you want tissues that won't wrinkle, choose a blend of polyester and cotton, and they're not as absorbent as pure cotton. I've been married to a handkerchief for 42 years, so I've probably washed 1000 handkerchiefs over the years. (I don't let the husband in the wash, he will shrink/bleach/break something!)