Nosebleed

Causes

Nosebleeds may be caused by:

• An irritated nose lining
• Injury to the nose from:
  • Picking
  • A bump or hit
  • Blowing or rubbing too hard
  • An object in the nose
  • Barotrauma
• Dry nasal tissue
• A loose clot from a past bleed
• A nose or sinus tumor

Risk Factors

Nosebleeds can happen at any age. They are more common in children less than age 11. They are also more common in adults over age 50. Things that raise the risk are:

• Sinusitis, colds, and allergies
• A defect in the nose
• Bleeding or clotting problems
• Blood vessel problems in the nose
• Dry air
• Drugs, such as—blood-thinners, aspirin, and nasal sprays
• Cocaine use

Symptoms

Symptoms are:

• Front nosebleed:
  • Blood flows from one nostril—when sitting or standing
  • Blood may pass down the throat—if coughing or tipping the head back
• Back nosebleed:
  • Blood passes down the back of the mouth and throat
  • Blood may flow from the nostril—if leaning forward

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done.

If bleeding is severe, tests may be done. They may be:

• Blood tests—to check for anemia or clotting problems
• Sinus x-rays—to check for defects or masses
• Endoscopy—to look at nasal tissues

Treatment

Treatment depends on how bad the nosebleed is. Most nosebleeds stop within 15 minutes. Some nosebleeds are more serious. They need medical care. Options are:

• Pinching the nostrils for 15 minutes—until bleeding stops
• Nasal spray or packing
• Sealing off the blood vessel—if bleeding does not stop
• A nasal balloon—uses pressure to stop bleeding
• Surgery—if other methods do not work

Prevention

Some nosebleeds may be prevented by:

• Keeping the inner nose moist with:
  • Creams or saline nasal sprays
  • A humidifier
• Not picking the nose
• Keeping children's fingernails short