Nose Bleed

About 60% of all people will have a nosebleed (called epistaxis) at some point in their life. The good news is that there are easy and painless ways to get almost all forms of recurrent nosebleeds to stop.  Nosebleeds are caused when very tiny vessels, usually on the septum, in the nose break open.

Epistaxis can occur due to a variety of reasons. Some of the most common causes include trauma,  insertion of a foreign object, lack of humidity (including centrally heating), allergies, sinus infections and even environmental irritants can cause the nasal mucosa to become more inflamed and friable. Anticoagulant medications such as coumadin/warfarin, eliquis and xarelto can cause nose bleeds. Anti-inflammatory drugs such as aspirin and ibuprofen may also contribute to nosebleeds.

There are two different areas where nosebleeds can occur. Anterior nosebleeds happen when the bleeding is coming from the front of the nose. The vast majority (80% or more) of nosebleeds occur in the anterior (front) part of the nose from the nasal septum. This will cause the blood to drip or pour out the front of the nose. This area is filled with very tiny blood vessels in an area called Kiesselbach’s plexus. Posterior nosebleeds occur when the bleeding originates from the back of the nose. A posterior bleed is usually due to bleeding from Woodruff’s plexus. Posterior bleeds are associated with bleeding from both nostrils and with a greater flow of blood down the back and into the throat and back of the mouth.

Treatment Options

There are several different options to treat a nosebleed. Patients with uncomplicated nosebleeds can utilize conservative methods to prevent future nosebleeds such as sleeping in a humidified environment or applying petroleum jelly to the nasal nares two to three times a day. If your having an active nosebleed. sit down and firmly pinch the soft part of your nose, just above your nostrils, for at least 10-15 minutes and apply ice to the bridge of your nose. If your having continual episodes of bleeding you may need to have the area which is bleeding cauterized or have nasal packing placed. Cautery can be performed by a physician in the office. This is a brief, painless procedure which only takes a few minutes to complete. For anterior nosebleeds usually only one cautery procedure is required to stop recurrent bleeding. If none of these options eliminate your episodes of epistaxis, surgery may be considered.