The Causes, Prevention, & Treatment of Nosebleeds

• Posted on: Nov 29 2022
• By: Sinus & Snoring Specialists

PREVENTING AND TREATING NOSEBLEEDS

As the weather shifts and the air becomes drier, nosebleeds tend to be a more common occurrence. Although nosebleeds can be alarming, most are minor and easy to control.

COMMON CAUSES OF NOSEBLEEDS

A nosebleed, medically referred to as epistaxis, is bleeding from the blood vessels that line the inside of the nasal cavity. When the mucous membrane of the nose becomes damaged, it can crack and expose the delicate blood vessels underneath resulting in bleeding.

Epistaxis can occur in different populations for different reasons.

Pediatric:

Common causes of nosebleeds in children include:

• Nasal Trauma: Many nosebleeds in children result from the trauma that occurs after picking the nose. Bleeding can also result from minor nasal injuries or forcefully blowing the nose.

• Change in Weather: Change in weather and humidity can cause the air to become dry which results in the cracking of the nasal lining. This is especially common in the winter months, as turning on the heater reduces the moisture in the air.

• Foreign Bodies: Younger children are especially prone to putting small objects or toys in the nose. Foreign bodies in the nose can cause damage to the nasal lining which results in bleeding. Foreign bodies that have been lodged deep inside the nasal cavity often require removal by an ENT specialist.

• Allergies or Infection: Allergies or infections of the nasal or sinus cavities can inflame the nasal mucosa and make it more susceptible to nosebleeds.

• Bleeding Disorders: Children with blood clotting disorders such as hemophilia may have frequent spontaneous nosebleeds.

Adult:

Common causes of nosebleeds in adults include:

• Nasal Sprays: Frequent use of nasal sprays (especially allergy medications) can dry out the nasal lining, causing it to crack and bleed.

• Change in Weather: Just like in children, change in weather and humidity causes the air to become dry which results in cracking of the nasal lining. Dry air occurs more commonly in the winter when heaters in the home are turned on.

• Structural Issues: Structural issues in the nose such as a deviated septum can expose the nasal mucosa and make the nose more susceptible to bleeding.

• Allergies or Infection: Allergies or infection of the nasal lining or sinus cavities results in inflammation of the nasal mucosa and can increase susceptibility to nosebleeds.

• High Blood Pressure: High blood pressure that is unmanaged can result in nosebleeds and make them more difficult to stop.

• Blood Thinners: Medications that thin the blood such as Aspirin can cause or worsen nosebleeds. Blood thinning medications make clotting more difficult, therefore it may be more difficult to stop nosebleeds in those taking blood thinners.

• Recent Nasal Surgery: While it is normal to have some bloody discharge for the first 3-5 days after sinus or nasal surgery, rarely bleeding can last longer or be heavier than expected. If you are concerned with the level of bleeding after surgery, contact your ENT office right away and attempt to stop the bleeding.

HOW TO STOP A NOSEBLEED

1. Remain Calm: Although nosebleeds can be frightening, most are not dangerous and are easy to stop. If you are having a nosebleed, it is important to remain calm. Panicking will raise your blood pressure which will only make the bleeding worse.
2. Use a Decongestant Nasal Spray: Apply 5 large sprays of a decongestant nasal spray to both sides of the nose. A common decongestant nasal spray is Afrin, but any spray with the ingredient Oxymetazoline will work.
3. Apply Pressure: Pinch the soft part of the nose right above the nostrils and apply firm pressure for at least 15 minutes. Do not let go of the nose to check for bleeding before the 15 minutes is up.
4. Do Not Lie Down: Sit upright when trying to stop a nosebleed. This will reduce pressure inside the head and make it easier to stop the bleeding. Lying down can also cause blood to flow down the back of the throat which can result in vomiting.
5. Check Blood Pressure: High blood pressure can cause nosebleeds and make them more difficult to stop.
6. Avoid Manipulation: Avoid putting tissues, cotton, or any form of nasal packing in the nose. This can further irritate blood vessels and prolong bleeding.
7. Relax: Avoid exertion for a full week following a nosebleed. Avoid exercise and picking up heavy items as this can induce bleeding again.

Rarely nosebleeds cannot be stopped at home and require the help of a medical professional.

SEEK MEDICAL ATTENTION IF:

• You have tried the above steps and the bleeding does not stop for more than 30 minutes.
• If you have had recent nasal surgery.
• You have heavy bleeding that is running down the back of your throat or causing vomiting.
• If bleeding is associated with other symptoms such as lightheadedness, chest pain, difficulty breathing, rapid heart rate, or very high blood pressure.
• If you have nosebleeds that come and go regularly.
• A nosebleed follows a serious injury such as a car accident.

NOSEBLEED PREVENTION

• Keep the Lining of the Nose Moist: Try using a daily saline-based gel such as AYR gel or use a saline mist.
• Use a Humidifier: Use a humidifier, especially in the winter months when the air tends to be drier. Humidifiers add moisture to the air and help keep the nasal lining healthy.
• Avoid Manipulation: Keep children’s fingernails short and avoid putting anything inside the nose. Minimize nose blowing as much as possible.
• Avoid Nasal Sprays: Most nasal sprays are drying to the lining of the nose. If you have frequent nosebleeds avoiding nasal sprays altogether is sometimes necessary. Pointing the tip of the spray bottle toward the ear and away from the septum can help reduce irritation from nasal sprays.

WHEN TO SEE AN EAR, NOSE & THROAT SPECIALIST:

If nosebleeds are still occurring despite trying the tips listed above, an ear, nose, and throat (ENT) doctor may be required to identify the source of bleeding and to provide treatment.

The following are common techniques used by the ENT to resolve nosebleeds:

• Silver Nitrate: Silver nitrate is a form of chemical cautery. This is a simple procedure that can be done in the office to seal off blood vessels that are prone to bleeding.
• Electric Cautery: Sometimes nosebleeds are more severe and chemical cautery with silver nitrate is not enough. This form of cautery uses an electric current to cauterize bleeding vessels and often has to be performed under anesthesia.
• Correction of Structural Issues: Structural issues such as a deviated septum can make the nose more prone to bleeding. Surgical correction of these structural issues is sometimes required to resolve the cause of nosebleeds.
• Nasal Packing: Packing the nose can be necessary for nosebleeds that are actively occurring and are not stopping with decongestant sprays and pressure. Those with nasal packing in often require treatment with antibiotics.

SCHEDULE A CONSULTATION

If you are having frequent nosebleeds, call to schedule an appointment at Sinus and Snoring Specialists for a thorough evaluation. Contact us today by calling or securely texting 512-601-0303 to schedule an appointment.

Tagged with: epistaxis, nosebleed, nosebleeds

Posted in: Nosebleed, Pediatric ENT