Nose bleeding – Causes, Treatment & Prevention

Overview

Nosebleeds, or Epistaxis, are common among adults and rarely indicate a severe medical problem. Nosebleeds can occur especially in children between 3 and 10, as the small blood vessels in the nose can break easily.
The nose contains a thin membrane that holds several blood vessels close to the surface in the front and back of the nose. When the blood vessels break, it causes bleeding because of fragility and may be scary.
Nosebleeds are of two types:

• Anterior Nosebleed – Blood vessels in the front of the nose break and bleed.

• Posterior Nosebleed – Blood flows in the back of the throat and occurs in the deepest part of the nose. You have to be careful with posterior nosebleeds as they can be dangerous.

This article delves into the causes of nosebleeds, diagnosis and treatment, and preventive techniques.

What causes nosebleeds?

Dry air is the most common cause of a nosebleed, either being in a hot, low-humidity climate or from having the heat on in winter. A central heating system or living in a dry environment can dry the nasal membranes (tissues inside the nose).
Another cause of nosebleeds is frequent nose blowing. Taking decongestants and antihistamines for colds, sinus problems, and allergies can dry the membranes and cause nosebleeds.
Other common causes include:

• Nose picking
• Rubbing or scratching the nose often
• Blowing too hard
• Abnormal tissue growth, such as polyps
• Chemical irritants
• Repeated sneezing
• Colds or allergies
• Changes in temperature or humidity
• Injuries caused by a fall

Injuries that cause nosebleeds include car accidents, recent nasal surgery, head blows, atherosclerosis (hardened arteries), or getting hit. The after-effects of an injury will indicate a broken nose, internal bleeding, or a skull fracture.
Most nosebleeds will not require medical attention. However, you should go for a consultation if it lasts more than 20 minutes. It can signify posterior nosebleeds that tend to be more serious.
Bruising and nosebleeds can be early signs of leukaemia. It can also result in blood vessel disorder, blood clotting, or a nasal tumour (both cancerous and non-cancerous).

Diagnosis of a nosebleed

There is no particular test to determine the cause of a nosebleed. Your healthcare provider might use specific diagnostic tests to find the root cause. 
Before this, your doctor will conduct a physical examination and check your nose for signs of foreign objects. You must be informed about your medical history and current medications for the doctor to understand your condition.
Also, tell your doctor about your recent injuries and other symptoms. The diagnostic tests include:

• Partial thromboplastin time (PTT) – blood test taken to check how long it takes for blood to clot
• Nasal endoscopy
• Nose CT scan
• X-ray of face and nose
• Complete blood count (CBC) – a blood test to check blood disorders

How to stop a nosebleed?

Usually, nosebleeds are not severe. Depending on the type and cause, you can treat nosebleeds with the following at-home remedies:

Treating anterior nosebleeds

Anterior nosebleeds occur when bleeding originates from the front of the nose, typically from one nostril. To address an anterior nosebleed at home, sit upright and gently pinch the soft part of your nose. Ensure that both nostrils are closed and maintain this position for 10 minutes. Lean forward slightly and breathe through your mouth.
It is important not to lie down while attempting to stop a nosebleed, as this can lead to swallowing blood and stomach irritation. After 10 minutes, release your nostrils and check if the bleeding has ceased. If the bleeding continues, repeat these steps.
In addition, you can apply a cold compress to the bridge of your nose or use a nasal spray decongestant to constrict the small blood vessels.
If you cannot stop a nosebleed on your own, you must seek immediate medical attention from your doctor. You may be experiencing a posterior nosebleed, which requires more extensive treatment.

Treating posterior nosebleeds

In the case of a posterior nosebleed, bleeding occurs from the back of the nose and often flows down the throat. Posterior nosebleeds are less common but more serious than anterior nosebleeds. It is not recommended to treat posterior nosebleeds at home. Talk to your doctor immediately or visit the emergency room if you suspect a posterior nosebleed.

Nosebleeds caused by foreign objects

If a foreign object is causing the nosebleed, your doctor can remove it. 

Cauterization

In persistent nosebleeds, a medical technique called cauterization may be employed. This involves your doctor using a silver nitrate (a compound used to remove tissue) or a heating device to burn the blood vessels in your nose. 
Your doctor may also pack your nose with cotton, gauze, or foam or use a balloon catheter to apply pressure to the blood vessels and stop the bleeding.

When to seek medical advice?

Contact your doctor if:

• You have nosebleeds regularly
• You have symptoms of breath shortness, heart palpitations, and pale complexions
• The bleeding continues for over 20 minutes
• A child under the age of 2 has a nosebleed
• The bleeding is because of an injury or fall
• You are taking a blood-thinning medicine
• You feel lightheaded or faint

Preventing nosebleeds

You cannot prevent nosebleeds, but there are a few things to help lower the chances of getting them:

• Use a saline nasal product – Keep the nasal passages moist by spraying the saline drops in your nostrils.
• Use a cotton swab – Dryness can cause nosebleeds. Gently smear a thin layer of petroleum jelly in your nostrils three times daily or use an antibiotic ointment such as Polysporin or Bacitracin.
• Discourage nose picking – Keep your children’s fingernails short to limit nose injury and prevent scratching.
• Use a humidifier – The air in your house may be dry. It results in the dryness of your nostrils; hence, be sure to use a cool vaporizer or a mist humidifier to keep the air moist.
• Limit the usage of allergy decongestants – Intake of aspirin can thin your blood and contribute to a nosebleed. Discuss with your doctor before taking these medications.

Takeaway

Anterior nosebleeds are a common occurrence and can be easily treated at home. They usually happen suddenly and don’t last long. However, they can be caused by various factors, such as dry air and frequent nose-picking or scratching. If you experience difficulty stopping the bleeding, it’s best to seek medical attention from your doctor.
While most nosebleeds aren’t severe and can be treated at home, it’s important to note that posterior nosebleeds can be more severe. If you suspect a posterior nosebleed, it’s crucial to contact your doctor immediately or go to the emergency room.
It’s recommended to keep the air in your home humidified, avoid picking your nose, and use nasal mists to moisten your nasal passages. These simple measures can go a long way in preventing nosebleeds from occurring.

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