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Nosebleeds
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NOSEBLEEDS | CAUSES AND TREATMENTS | ENT IN STAMFORD CT

Epistaxis, commonly known as a nosebleed, refers to bleeding from tissues inside the nose caused by broken blood vessels.  Bloody noses can happen to anyone but occur most frequently in children. While scary, the occasional nosebleed is no cause for concern. However, frequent nose bleeds may require intervention from a medical professional, such as an Ear, Nose, and Throat (ENT) doctor.

Read on to learn the common causes of bloody noses, how to stop a nosebleed, when you should contact your doctor and available treatments for improving frequent nosebleeds.

THE ANATOMY OF A BLOODY NOSE

The nose contains numerous blood vessels located in the front (anterior) and back (posterior) of the nose. These small blood vessels are known as capillaries. They are fragile and break easily. When a capillary breaks, blood may drip or flow out of one or both nostrils.

There are two main types of nose bleeds:

Anterior nose bleeds are the most common. They occur when blood vessels at the front of the nose, near the nostril, break. Most anterior nosebleeds are not serious.

Posterior nose bleeds are less common. They occur when blood vessels at the back of the nose break and bleed. Posterior nose bleeds are more serious and require medical intervention.

CAUSES OF NOSE BLEEDING

Most anterior nosebleeds are caused by dryness. Low humidity environments caused by arid temperatures or dry air from central heating during the wintertime often cause membranes inside the nose to dry out and crack.

Besides dry air, common causes of nose bleeding include: 

  • Nose picking
  • Blowing your nose too forcefully
  • Side effects of certain medications (allergy medication, blood thinners, etc.)
  • Minor injury
  • Thin air at high elevations
  • Irritation caused by colds and allergies

NOSEBLEEDS IN KIDS

Nosebleeds in kids are common, particularly between the ages of 2 and 10. A bloody nose looks scary, especially to a child. Fortunately, they are rarely a serious problem.

Most nosebleeds in kids are anterior nosebleeds. As mentioned, anterior nosebleeds originate from the front of the nose. The more serious type of a bloody nose, posterior nosebleeds, rarely occur in children. They are more common in older adults with high blood pressure or following a severe facial or head trauma.

Random or infrequent nosebleeds are rarely dangerous. However, you may want to visit a kid’s ENT if nose bleeds occur more than once a week.

HOW TO HELP PREVENT A BLOODY NOSE

Epistaxis mostly commonly occurs when the membranes inside the nose dry out and become irritated. This can be caused by dry air (especially in winter), colds, and allergy medications. Nose bleeds are often started when a person scratches or picks inside his or her nose due to itching caused by dryness. The following suggestions may help prevent a bloody nose:

  • Humidify the air
  • Do not pick or scratch inside the nose
  • Apply Vaseline to the inside of the nose
  • Contact a medical professional if you take an allergy medication
  • Protect the face from injury with proper equipment when playing sports  

HOW TO STOP A NOSEBLEED?

If you or your child has a bloody nose, don’t panic. Follow these steps:

  1. Sit up and lean your head forward. Do not lay down or tilt your head back. By sitting up, you keep your nose above your heart. This decreases blood pressure, which helps stop the bleeding. Leaning forward helps to avoid swallowing blood.
  2. Pinch your nose. Apply pressure by pinching the soft part of your nose (just above your nostrils.) Breathe through your mouth while doing this.
  3. You can apply ice. Some people apply an icepack to the bridge of their nose to help constrict the blood vessels and ease discomfort. This step is not necessary to stop a bloody nose but may be performed if you like.
  4. Perform these steps for 10 to 15 minutes. After this, check to see if the nose is still bleeding. If so, repeat the steps for another 10 to 15 minutes. If the nose is still bleeding after the second round, seek emergency care.

WHEN TO SEEK MEDICAL ATTENTION?

The occasional bloody nose, is rarely a cause for concern. However, you should seek emergency care if:

  • You cannot stop the bleeding after attempting home care (as listed in the steps above)
  • There is so much blood it is hard to breath
  • The bleeding is rapid or heavy (more than a cup of blood loss)
  • There is vomiting from swallowing too much blood
  • The person with the bloody nose is on blood-thinning medications (warfarin, aspirin, etc.) or has a blood disorder
  • The bloody nose results from severe trauma to the head or face (fall, punched in the face, car accident, etc.)

FREQUENT NOSEBLEEDS

Frequent epistaxis is most often caused by capillaries inside the nose that are irritated and won’t heal properly. Consider visiting a medical professional if you or your child experiences more than one nosebleed a week.

EPISTAXIS TREATMENTS

Frequent epistaxis may require intervention from an otolaryngologist, a medical professional commonly known as an Ear, Nose, and Throat (ENT) doctor.

At the doctor’s office, your ENT may inquire about:

  • How much blood is lost during the nosebleed(s)
  • How long the nosebleed(s) last
  • How often the nosebleeds occur
  • Does the nosebleed(s) involve one or both nostrils
  • Medical history (including a family history of blood disorders or drug use involving snorting the drug)
  • Medications (such as blood thinners or medicine for allergies or colds)

Your ENT physician may use a thin, long camera called a nasal endoscope to examine the inside of your nose to determine the source and severity of the bleeding.

Once your ENT identifies the source and cause of the bloody nose, he or she will present the patient with treatment options. Treatment may include:

  • the adjustment of medications
  • retrieval of foreign bodies that may have been stuck up the nose
  • surgery (when dealing with a deviated septum or broken nose)
  • treatment to stem the bleeding, such as nasal packing or cauterizing the nose.

Cauterizing the nose

If your ENT determines that frequent anterior nosebleeds are caused by an irritated blood vessel, he or she may suggest cauterizing the nose. Cauterization burns the irritated blood vessel to seal it close. For this procedure, the ENT typically applies chemical cauterization using silver nitrate. Silver nitrate cauterization can be done safely in the clinic while you are awake. After numbing the area with topical lidocaine, the physician touches the affected blood vessel with a silver nitrate stick for several seconds until it seals closed. 

Nasal Packing

Some nosebleeds require nasal packing to be placed for several days to control the bleeding. The packing may be absorbable, which dissolves over time and does not need to be removed. Sometimes a permanent pack needs to be used to control the bleeding. If this occurs, your doctor may put you on antibiotics while the packing is in place to prevent infection.

ENT NEAR ME

If you or a loved one suffers from frequent nosebleeds, schedule an appointment with one of our ENT physicians to determine whether intervention could benefit your situation. Contact the Ear, Nose & Throat Center in Stamford CT, to schedule a consultation. Reach out online by completing the form below or call 203-353-0000 to schedule your appointment.

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