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Nosebleeds (Epistaxis)

The nose is an area of the body that contains many tiny blood vessels or arterioles that can break easily. In the United States, one of every seven people will develop a nosebleed some time in their lifetime. Nosebleeds (also known as epistaxis: ep-ih-STAK-sis) can occur at any age but are most common in children aged 2-10 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.

Anterior Nosebleeds
Most nosebleeds 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 or anterior nosebleeds often begin with a flow of blood out one nostril when the patient is sitting or standing. 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 rub it inside the nose, especially on the middle portion of the nose (the septum).

Posterior Nosebleeds
More rarely, a nosebleed can begin high and deep within the nose and flow down the back of the mouth and throat even if the patient is sitting or standing.
Obviously, when lying down, even anterior (front of 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.

 


 

 

 

 

 

 

 

 

Causes of recurring nosebleeds:

  • 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 the older patient or in smokers.

BleedArrest Nasal Strips are produced from a flexible foam and are designed to accelerate blood clotting—especially in the nose. Click here for more information.

 

Information on nosebleeds (epistaxis) taken from American Academy of Otolaryngology–Head and Neck Surgery.

Bleeding 101