Nosebleed Treatment

In Denver and Lone Tree, Colorado

The nose is an area of the body that contains many tiny blood vessels (or arterioles) that can break easilyIn the United Statesone of every seven people will develop a nosebleed some time in their lifetimeNosebleeds can occur at any age but are most common in children aged 2-10 years and adults aged 50-80 yearsNosebleeds are divided into two typesdepending on whether the bleeding is coming from the front or back of the nose.

What is an anterior nosebleed?

Most nosebleeds (or epistaxes) begin in the lower part of the septumthe semi-rigid wall that separates the two nostrils of the noseThe septum contains blood vessels that can be broken by a blow to the nose or the edge of a sharp fingernailNosebleeds coming from the front of the nose(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 dryheatedindoor air dehydrates the nasal membranesDryness may result in crustingcrackingand bleedingThis can be prevented by placing a light coating of petroleum jelly or an antibiotic ointment on the end of a fingertip and then rubbing it inside the noseespecially on the middle portion of the nose (the septum).

How do I stop an anterior nosebleed?

  • Stay calm or help a young child stay calmA person who is agitated may bleed more profusely than someone who’s been reassured and supported.
  • Keep head higher than the level of the heartSit up.
  • Lean slightly forward so the blood won’t drain in the back of the throat.
  • Gently blow any clotted blood out of the noseSpray a nasal decongestant in the nose.
  • Using the thumb and index fingerpinch all the soft parts of the noseDo not pack the inside of the nose with gauze or cotton.
  • Hold the position for five minutesIf it’s still bleedinghold it again for an additional 10 minutes.

What is a posterior nosebleed?

More rarelya 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.

Obviouslywhen lying downeven anterior (front of nasal cavity) nosebleeds may seem to flow toward the back of the throatespecially if coughing or blowing the noseIt 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 carePosterior nosebleeds are more likely to occur in older peoplepersons with high blood pressureand in cases of injury to the nose or face.

Causes of recurring nosebleeds

  • Allergiesinfectionsor 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 skullHead injuries that cause nosebleeds should be regarded seriously.
  • Hereditary hemorrhagic telangiectasiaa disorder involving a blood vessel growth similar to a birthmark in the back of the nose.
  • Tumorsboth malignant and nonmalignanthave to be consideredparticularly in the older patient or in smokers.

When should an ENT Specialist be consulted?

If frequent nosebleeds are a problemit is important to consult one of our doctorsAn earnoseand throat specialist will carefully examine the nose using an endoscopea tube with a light for seeing inside the noseprior to making a treatment recommendationTwo of the most common treatments are cautery and packing the noseCautery is a technique in which the blood vessel is burned with an electric currentsilver nitrateor a laserSometimesa doctor may just pack the nose with a special gauze or an inflatable latex balloon to put pressure on the blood vessel.

How to prevent a nosebleed 

Keep the lining of the nose moist by gently applying a light coating of petroleum jelly or an antibiotic ointment with a cotton swab three times dailyincluding at bedtimeCommonly used products include BacitracinA and D OintmentEucerinPolysporinand Vaseline.

  • Keep children’s fingernails short to discourage nose-picking.
  • Counteract the effects of dry air by using a humidifier.
  • Use a saline nasal spray to moisten dry nasal membranes.
  • Quit smokingSmoking dries out the nose and irritates it.

Tips to prevent rebleeding after initial bleeding has stopped:

  • Do not pick or blow nose.
  • Do not strain or bend down to lift anything heavy.
  • Keep head higher than the heart.

If rebleeding occurs:

  • Attempt to clear nose of all blood clots.
  • Spray nose four times in the bleeding nostril(s) with a decongestant spray.
  • Repeat the steps to stop an anterior nosebleed.

Call our office if bleeding persists after 30 minutes or if nosebleed occurs after an injury to the head.