The nose contains many small blood vessels that are close to the surface, making it easy for them to get irritated. Nosebleeds (also called epistaxis) are very common and usually occur because of minor irritations or colds. Children aged 2-10 years and adults aged 50-80 years are most affected.
WHAT CAUSES NOSEBLEEDS?
Dry or cold air is the most common trigger for nosebleeds, which is why they are more frequent during the fall and winter seasons. They can also be caused by a deviated nasal septum, nose-picking, or the use of nasal sprays such as fluticasone (Flonase).
Although rare, nosebleeds can also be caused by a more serious issue such as a high blood pressure or a bleeding disorder. Blood thinners, such as Coumadin, Plavix, Eliquis, or aspirin, may cause or worsen nosebleeds.
There are two types of nosebleeds. Anterior bleeds occur towards the front of the nose, causing blood to flow out of the nostril. These are the most common and usually easy to control.
Posterior nosebleeds occur deeper in the nose towards the back of the nasal passage and are often more difficult to stop without seeking the help of a medical professional. However, nosebleeds are rarely life threatening.
HOW CAN I PREVENT A NOSEBLEED?
- Use a humidifier in your bedroom when you sleep.
- Use an over-the-counter saline nasal spray to keep the nose moist or a nasal oil emollient.
- Apply a light coating of petroleum jelly or an antibiotic ointment on the end of a fingertip and then rubbing it inside the nose, especially on the middle portion of the nose (the septum).
- Avoid nose picking or activities that could lead to a nasal injury or fracture.
Quit smoking. Smoking dries out the nose and irritates it.
HOW CAN I STOP A NOSEBLEED?
Here’s what you should do if you get one:
- Stay calm! A rise in blood pressure can make the bleeding worse.
- Pinch the soft part of both nostrils at the bottom of your nose. Pinching the bridge of the nose or one nostril will not help stop the bleeding.
- Squeeze your nose closed for at least 15 minutes. Do not release the pressure every so often to check whether the bleeding has stopped. You can hurt your chances of stopping the bleeding by releasing the pressure too soon.
- Use Afrin nasal decongestant spray. Carefully moisten a cotton ball with the solution and place it in the nostril that is bleeding for 15-30 minutes. Repeat this as necessary until the bleeding stops. A cold compress or ice pack over the nose may also help slow the bleeding.
If you followed the steps outlined above, and your nose continues to bleed, seek care at an emergency room. The ER physician may place nasal packing inside the nose that will require removal after 5-7 days. This time period allows the area to heal and to prevent bleeding again by removing the nasal packing too soon
TREATMENT FOR RECURRENT NOSEBLEEDS
If frequent nosebleeds are a problem, Dr. Sikand can examine the nose using a nasal endoscope, a “tube” with a light for seeing inside the nose, prior to making a treatment recommendation. The most common treatment performed in the office is cautery with silver nitrate.
Silver nitrate sticks look like long matchsticks and chemically cauterize the blood vessels inside the nose. This is a simple procedure that takes only a few minutes and requires no “down time”.
Other surgical procedures may be recommended if simple cautery is not enough to help control the nosebleeds.