The nose is an area of the body that contains many tiny blood vessels (#arterioles) that can easily break. In the United States, one of every seven people will develop a nosebleed some time in their lifetime. Nosebleeds occur at any age but are most common in children aged two to ten years and adults aged 50-80 years. Nosebleeds are divided into two types depending on whether the bleeding is coming from the front or back of the nose.

Most nosebleeds (#epistaxes) begin in the lower part of the septum, the semi-rigid wall that separates the two nostrils of the nose. The septum contains blood vessels that can be broken by a blow to the nose or the edge of a sharp fingernail. Nosebleeds coming from the front of the nose (#AnteriorNosebleeds) often begin with a flow of blood out one nostril when the patient is sitting or standing.

Anterior Nosebleeds

Anterior nosebleeds are common in dry climates or during the winter months when dry, heated indoor air dehydrates the nasal membranes. Dryness may result in crusting, cracking, and bleeding. This can be prevented by placing 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 called the septum.

For a child with a nosebleed, it is important to stay calm, which will help the child to stay calm. A person who is agitated may bleed more profusely than someone who is been reassured and supported. Keep the head higher than the level of the heart. Sit up and Lean slightly forward so the blood won’t drain in the back of the throat. Hold the position for five minutes, if it is still bleeding, hold it again for an additional ten minutes. Gently blow any clotted blood out of the nose, then spray a nasal decongestant in the nose. Using the thumb and index finger, pinch all the soft parts of the nose and DO NOT pack the inside of the nose with gauze or cotton.

Posterior Nosebleeds

It is rare that a nosebleed begins high and deep within the nose and flows down the back of the mouth and throat, even if the patient is sitting or standing.

Obviously, when lying down, even anterior (front of the nasal cavity) nosebleeds may seem to flow toward the back of the throat, especially if coughing or blowing the nose. It is important to try to make the distinction between the anterior and posterior nosebleed since posterior nosebleeds are often more severe and almost always require a physician’s care. Posterior nosebleeds are more likely to occur in older people, persons with high blood pressure and in cases of injury to the nose or face.

Other causes of nosebleeds are: 

If you suffer from allergies, infections, or dryness that cause itching and lead to picking of the nose
Vigorous nose-blowing that ruptures superficial blood vessels
Clotting disorders that run in families or are due to medications
Drugs (such as anticoagulants or anti-inflammatories)
Fractures of the nose or the base of the skull
Head injuries that cause nosebleeds should be regarded seriously
Hereditary hemorrhagic telangiectasia, a disorder involving a blood vessel growth similar to a birthmark in the back of the nose
Tumors, both malignant and nonmalignant, particularly in older patients or smokers

Seeking Treatment

If frequent nosebleeds are a problem, it is important to make an appointment with one of the physicians at Oklahoma Otolaryngology Associates, as an ear, nose, and throat specialist, we will carefully examine the nose using an endoscope, a tube with a light for seeing inside the nose, prior to making any treatment recommendation. Two of the most common treatments are cautery and packing the nose. Cautery is a technique in which the blood vessel is burned with an electric current, silver nitrate or a laser. Sometimes, the doctor may just pack the nose with a special gauze or an inflatable latex balloon to put pressure on the blood vessel.

Things you can do to help stabilize your nose: Keep the lining of the nose moist by gently applying a light coating of petroleum jelly or an antibiotic ointment with a cotton swab three times daily, including at bedtime. Commonly used products include Bacitracin, A and D Ointment, Eucerin, Polysporin, and Vaseline; keep children’s fingernails short and discourage nose-picking; counteract the effects of dry air by using a humidifier in your bedroom at night; use a saline nasal spray to moisten dry nasal membranes; quit smoking. smoking dries out the nose and irritates it; do not pick or blow nose vigorously; do not strain or bend down to lift anything heavy; keep your head higher than the heart; attempt to clear nose of all blood clots; spray nose four times in the bleeding nostril(s) with a decongestant spray.



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