Approximately 60% of people experience nosebleeds or epistaxes at some point in their life. They are most common among children under ten years old and adults age 50 to 80. Though a bleeding nose can be frightening, only about six to 10% of cases require medical treatment. The cause, severity, and exactly location of the bleed determine the best course of treatment. Often, home remedies will suffice, though sometimes a nosebleed signals an emergency.
Nosebleeds Can Happen to Anyone
Nosebleeds can occur at any age and happen to six out of every 10 people at some point. There are many reasons one might occur. People with medical conditions such as a deviated septum or leukemia are more likely to experience nosebleeds, and sinusitis — inflammation of the sinus tissues — can prompt them as well. Minor trauma, irritation, and medications can affect the complex vascular structure of the nose as well, causing bleeding.
Treating Nosebleeds at Home
Scratching and picking the nose, or a minor injury such as walking into a door, can cause the blood vessels in the nose to break. Some nosebleeds stop on their own, but a person can facilitate this by sitting upright and apply constant pressure with the index finger and thumb against the soft part of the nose.
Moisture Can Prevent Nosebleeds
Environmental irritants can cause dryness and lead to nosebleeds. Applying a water-based lubricant or antibiotic ointment to the inside of the nose can treat this. Sleeping with a humidifier may help reduce frequency for someone prone to nosebleeds, and such individuals should treat their noses with care — frequently blowing or wiping the nose can further irritate the sensitive skin.
Doctor’s Care for Nosebleeds
If you experience frequent, unresolved nosebleeds, make an appointment with your primary care physician. People taking blood thinners or other medications may need an adjustment to their dosage. The doctor may also order some imaging tests if they are not sure what is causing the nosebleeds. Referral to an ear, nose, and throat specialist is possible if basic tests do not explain the cause.
Diagnosis from a Specialist
The otorhinolaryngologist or ENT doctor first conducts a visual exam. Then, they may use a nasal speculum and headlamp for an anterior rhinoscopy — examination of the inside of the nose. This can help the doctor identify the source of the nosebleed. Endoscopy is often used to diagnose nosebleeds flowing from the posterior nasal cavity. This variety can be more serious and require more advanced treatment.
Two In-Office Treatments for Nosebleeds
One common treatment a doctor may perform is cauterization of the problematic blood vessel. They will use a silver nitrate stick, electric currents, or a laser. Another treatment possibility is nasal packing, which entails packing the nose with gauze, cotton, or foam treated with an antibiotic solution. Nasal packing applies additional pressure to stop the bleeding.
Surgical Solutions for Nosebleeds
In serious cases, surgery can correct issues that cause nosebleeds. If the doctor cannot stop bleeding through cauterization or nasal packing, surgical procedure may be the final option. A hard impact from a sports injury or accident can fracture the nose, and a deviated septum from trauma or genetics can also cause chronic nosebleeds. An operation can correct both these issues. In some cases, the surgeon needs to clip closed the problematic artery.
When Surgery Is Not An Option
There are a variety of reasons a person may be unable to undergo surgery, including various health conditions and an allergy to anesthesia. The physician will consider the patient’s total health when recommending treatments for nosebleeds. Embolization is a non-surgical option that requires the use of a catheter: a balloon is inserted into the nose, which helps reduce blood flow and stop the bleeding.
Emergency Treatment for Nosebleeds
A nosebleed that lasts longer than 30 minutes needs treatment, and emergency services should be called if the cause is a serious injury or the person feels nauseated or dizzy. Emergencies like nasal fractures can cause the loss of a lot of blood very quickly. Emergency medical staff help clear blood clots and assist in treating significant nosebleeds when at-home remedies are insufficient.
Limiting Recurring Nosebleeds
Following these tips after a nosebleed helps to prevent further bleeding:
- Do not blow or pick your nose.
- Avoid sports or rough playing.
- Do not bend or carry anything heavy.
- Avoid hot drinks and hot showers.
- Remain sitting upright with your head above your heart.
- Use soft cloths or tissues on the outside of the nose only.