Nosebleeds: What You Need to Know

Epistaxis (nosebleed) is the loss of blood from the tissues and vessels inside the nose. Nosebleeds are very common among all ages, genders, and ethnicities.

There are actually two different kinds of nosebleeds:

  1. Anterior – begins in the front of the nose where there are hundreds of tiny capillaries. This is the most common type of bleed, and most of the time – not serious.
  2. Posterior – begins deeper inside the nose, usually affecting the larger blood vessels. This type of bleed causes heavy bleeding and often needs medical attention.

The causes of nosebleeds can vary among age groups and different circumstances. Children can get nosebleeds due to allergies, objects in the nose, or physical trauma due to accidents. Adults may have nosebleeds due to certain medications (aspirin, warfarin) or medical conditions (high blood pressure, hemophilia). Pregnancy can also affect the size of blood vessels, putting pressure on the lining of the nose. Blood clotting disorders can also cause nosebleeds.

Common causes of nosebleeds:

  • Dry air (drier, low-humidity climates or heated indoor air)
  • Colds or upper respiratory infections (sinusitis)
  • Allergies (inflammation of the nose)
  • Blowing the nose forcefully
  • Frequent nasal spray usage
  • Objects in the nose
  • Chemical irritants
  • Deviated septum
  • Illegal drug-use
  • Injury

Less common causes of nosebleeds:

  • Illegal drug-use or alcohol use or tobacco use (smoking)
  • Bleeding disorders (hemophilia, leukemia, von Willebrand disease)
  • High blood pressure (Atherosclerosis)
  • Facial and Nasal surgeries due to tumors or polyps
  • Pregnancy

When you have a nosebleed, the best thing you can do is remain calm and sit upright with your head slightly leaned forward. Leaning slightly forward will keep blood from being swallowed, causing choking, nausea, vomiting or diarrhea. Pinch the soft parts of your nose together for at least 5 minutes. You can apply ice to the bridge of your nose, or you can use a decongestant spray on the bleeding side of the nose to help with the bleeding if necessary. Depending on the seriousness of the nosebleed and conditions, there are several treatment options. Please see an ENT specialist if you have concerns of recurring or frequent bleeds.

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