Nosebleeds

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at November 20, 2015
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Nosebleeds are something that can be scary and quite alarming. The good news is, they are usually not serious and most often can be taken care of without medical attention. Knowing more about a nosebleed helps ease the fear and anxiety that can come with them.

Contents

Definition & Facts

There are two different types of nosebleeds a person can have. The type of nosebleed is determined by where the bleeding is coming from. The most common type of nosebleed, making up more than 90%, comes from a blood vessel being opened in the front, or anterior, of the nose. These are typically easy to control without medical attention.

The second type of nosebleed comes from an artery in the back, or posterior, of the nose. These often require help from a medical specialist. Nosebleeds can happen to any person of any age, but more commonly occur in dry conditions, such as during the winter months or in dry climates.

It is also most common for children that are between the ages of 2 and 10 along with adults between the ages of 50 and 80 to get nosebleeds.

Causes

There are a variety of things that can cause a nosebleed, but some are more common than others. Trauma to the nose is the most common cause. The trauma can be either inside or outside of the nose. Outside trauma is typically from a hit to the nose. Inside trauma is often caused by an irritation that is occurring repeatedly for a period of time, such as with a cold or can be from nose picking.

Some of the other causes include being in a climate that is cold and dry for a long period of time, sinus infections, a foreign object stuck in the nose, blowing the nose vigorously for a period time, nasal surgery, or cocaine use.

A much less common cause of nosebleeds is another medical issue that prohibits a person's blood from clotting as it should. In the most rare cases, cancer or abnormal blood vessels can be the cause as well.

When to see a doctor

A person does not need to contact their doctor the minute a nosebleed occurs, but there are times that a person should contact their doctor. If nosebleeds are occurring on a consistent basis, the person bruises easily, or if there is blood in a person's urine or stool along with the nosebleeds a doctor needs to be contacted.

Additional reasons to contact a doctor is if a blood-thinning medication is being taken by the person having the nosebleeds, if a person has any issues with their blood clotting while having nosebleeds, and if the person with the bloody nose has recently had chemotherapy. There are also times that a person with a nosebleed should go directly to the hospital, such as the person feeling dizzy, lightheaded or feeling like they could pass out.

Other reasons include a person having a bloody nose and vomiting blood, rapid heartbeat, having issues breathing, a rash, or a temperature that is 101.5 F (38,6 °C) or higher. If pinching the nose of a person with a nosebleed does not stop the bleeding or a large amount of blood is lost the person should go to the hospital.

Treatment & Therapy

There are a number of treatments that someone with a nosebleed can use. If the nose is bleeding just a small amount, there really isn't much that needs to be done with it. Just try not to blow the nose with too much force, avoid picking it, and try not to sneeze.

This will often keep the bleeding from getting any worse and the body will then take over and clot its blood in order to stop the bleeding. If there is more than just a small amount of blood on a tissue, there are steps that can be taken to stop the bleeding. First, the head should be tilted forward slightly. This will help to ensure that the blood is not swallowed. Pressure should be applied on the outside of the nostrils using the index finger and thumb for ten minutes.

These steps will stop the bleeding with the majority of nosebleeds a person will have. After a nosebleed has been stopped, it is important to take care of it to ensure the bleeding does not begin again. This can be done by not forcefully blowing the nose, keeping the air as moist as possible, and using a lubricating ointment or saline spray to keep the nose moist. If medical treatment is needed, there are a variety of things the doctor can do as well.

For nosebleeds that are in the front of the nose, the doctor will likely cauterize a blood vessel that is visible in order to get the vessel to seal. In cases where the bleeding is more difficult to stop, the doctor may use anterior nasal packing in order to get the bleeding to stop. This is done by putting a sponge or other material that will expand as it fills in order to get the area to stop bleeding and then allow it to clot.

If the nosebleed is in the back of the nose, hospitalization will be required. Although the bleed will be treated with posterior nasal packing, it is important for the person to be monitored to avoid any complications such as infection, difficulty breathing, and to monitor pain.

Prevention & Prophylaxis

Dealing with nosebleeds can be frustrating, but there are ways to try and prevent them before they even begin. Because many nosebleeds occur during the winter months and in dry climates, a humidifier can be used in order to add moisture to the air. This will help to keep the inside of the nose lubricated reducing the risk of a nosebleed.

A petroleum jelly or saline mist can also be used in order to keep the inside of the nose moist. Try not to blow the nose too forcefully or to pick it. This will help reduce the irritation on the inside that can also cause a nosebleed. If there are any health conditions that are causing the nosebleeds, it is important to follow the doctor's orders to try and reduce the risk of a nosebleed.

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