Causes of nosebleeds
- A dry nose
- Thin mucous membranes
- Vigorous blowing of the nose
- Clotting disorders
- Fractures of the nose or of the base of skull
Types of nosebleeds
Most nosebleeds (epistaxis) are mere nuisances. But some are quite frightening, and a few are even life threatening. Physicians classify nosebleeds into two different categories.
Anterior nosebleeds originate from the front of the nose. They often occur when an individual is standing or sitting upright. Usually, blood will start to flow out of one nostril first.
Most nosebleeds start in the lower region of the septum, the structural wall that separates the two nostrils of the nose. The blood vessels found inside the septum can burst easily due to trauma.
Anterior nosebleeds often occur in dry climates or during winter months since the nasal membranes become dried out. Dryness may result in crusting, cracking, and bleeding.
To prevent the nose from becoming too dry, apply Vaseline or antibiotic ointment to the nasal mucosa and along the nasal septum. Up to three applications a day may be needed, but usually every night at bedtime is enough. A saline nasal spray will also help to moisten dry nasal membranes.
An anterior nosebleed might be managed at home by following the recommended guidance listed below:
- Stay calm. A person who is agitated may bleed more profusely than one who has been reassured and supported
- Either pinch the soft part of the nose between the thumb and side of the index finger – or – Soak a cotton ball in Afrin or Neo-Synephrine then place the material inside the nostril
- Press firmly with your thumb and index finger, compressing the pinched parts of the nose against the facial bones
- Hold that position for a full 5 minutes
- Keep head higher than the level of the heart — sit or lay back a little with head elevated
- Apply ice, crushed in a plastic bag or washcloth, to the nose and cheeks
- If the nosebleeds persist, you should see your doctor. Using an endoscope, a tube with a light for seeing inside the nose, your physician may find a problem within the nose that can be fixed. A procedure that is usually performed to prevent re-occurring nosebleeds is known as cauterization, which is the (sealing) of whichever blood vessels are causing the bleeding.
Posterior nosebleeds are rarer and usually originate high and deep within the nose then flow down the back of the throat.
Posterior nosebleeds are more likely to occur in older people, those with high blood pressure, and in cases of injury to the nose or face.
Posterior nosebleeds cannot be controlled at home with pressure on the nose. Posterior nosebleeds can be life-threatening and generally require placement of a balloon or other packing deep in the nose. If you are not able to see a specialist immediately, go to the nearest emergency room or call 911.
To prevent rebleeding:
- Do not pick or blow nose
- Do not strain or bend down to lift anything heavy
- Keep head higher than the heart
- Use a humidifier during dry winter months
If rebleeding occurs:
- Attempt to clear nose of all blood clots
- Spray decongestant spray (such as Afrin) into whichever nostril is bleeding
- Call a doctor if bleeding persists after 30 minutes or if nosebleed occurs after an injury to the head