Nosebleeds can be profuse and dramatic, but the good news is that most of them are not serious. They can certainly be frightening at times, but they are rarely life-threatening. They can occur at any age but are most common under age 10 and over age 50.

But have you ever wondered what causes nosebleeds? We’ll take a look at this issue and, even more importantly, examine how to prevent nosebleeds. 

What Causes Nosebleeds?

Often, there is no obvious reason for the bleeding and it may seem very random.

However, there are some factors that can cause bleeding. These include:

  • Dry air
  • Picking the nose
  • Chemical irritants
  • Nasal septal deformities
  • Allergies 
  • Trauma or injury
  • The common cold
  • Overuse of nasal spray
  • Upper respiratory infections
  • Medication such as aspirin and other blood thinners
  • Hypertension (high blood pressure)
  • Vascular diseases

The medical term for a nosebleed is epistaxis.

The nasal mucous membranes warm and humidify air as it passes through the nose. To accomplish this, the nose has a very rich vascular supply. There is a collection of blood vessels on the anterior septum—the bone that divides the nose-- called Kiesselbach’s plexus-- where the vast majority of nosebleeds occur.

Have you noticed that nosebleeds are more common in winter? 

Heated air and chronic colds can irritate and dry the delicate blood vessels of the nose. Excessive picking, scratching, nose-blowing and sneezing—which are more common in winter—contribute to nosebleeds. 

Why Do Allergies Cause Nosebleeds?

If you or your child has chronic allergies, your nose may bleed frequently. Those with allergies are very susceptible to nosebleeds.
Why?  To answer this question, it helps if you know how allergens affect the inside of your nose. An allergen is any substance—such as pollen or ragweed—that prompts an allergic reaction.

There are many tiny blood vessels in the nose, and these vessels can be easily damaged, which leads to nosebleeds. 

Even something as simple as air moving through the nose can contribute to the problem by irritating the nasal membranes, which in turn, can damage the tiny blood vessels. Allergens dry out your nose, which leads to irritation and nosebleeds.

Antihistamines or decongestants, often used to alleviate allergy symptoms, may also cause a dry nose and create nosebleeds.
In the winter, when the common cold and viruses are more prevalent, nosebleeds are common. Nosebleeds can occur in the nasal septum (the piece of tissue that separates your nose into two nasal passages) or farther back in the nasal cavity. Infections that are the result of allergies increase the likelihood of a nosebleed.

Can Stress Cause Nosebleeds?

By itself, stress is not likely to cause nosebleeds. In many cases, it is the response to stress---not the stress itself---that causes the nosebleeds.

When some people are stressed they may tend to blow their nose frequently or pick at it. This can trigger a nosebleed. Stress can also contribute to high blood pressure, which can be a potential cause of nosebleeds.

Why Are There So Many Nosebleeds in Kids?

Most often, these are caused by dry air or picking the nose. Children may also have minor injuries to their nose from sports or the playground. These are rarely serious but can be very scary for your child. 

If your child has a nosebleed, reassure them. However, if the nosebleed doesn’t stop after 20 minutes, or if you feel your child has something stuck in their nose, contact a Raleigh ear, nose and throat doctor near you, such as a member of our compassionate, dedicated team at Raleigh Capitol ENT. 

We offer extensive pediatric ENT services. In fact, if your child is experiencing any of the following, we recommend schedule an appointment with one of our ear, nose and throat physicians in the Raleigh area:

  • Frequent or chronic nosebleeds
  • A new medication
  • Bruises easily

While nosebleeds are rarely serious, there are some occasions when you should seek emergency treatment.  

Get immediate medical care if your child:

  • Has heavy bleeding in addition to dizziness or weakness
  • Has hit their head
  • Has bleeding as the result of a fall
  • Has bleeding so severe they have difficulty breathing
  • Has bleeding that hasn’t stopped after two attempts of applying pressure for 10 minutes each

How to Stop Your Child’s Nosebleed

First, calm your child. While most nosebleeds are easily controlled, the sight of gushing blood is unsettling.

Be sure the child is standing up or sitting forward.

Do not allow your child to lean back: This can cause the child to cough or choke on the blood. If the blood is swallowed, it can cause nausea.

Take a cotton ball and soak it with Afrin, Neo-Synephrine, or Dura-Vent. Then place the cotton ball into the nostril. If you don’t have access to these medications, pinch the tip of the nose and the portion of the nostrils below the bone.

Pinch the soft part of the nose for 5 to 10 minutes until the bleeding stops.

When the bleeding stops, make sure your child does not dislodge the blood clot by picking, rubbing or blowing the nose.

Apply an ice pack to the cheeks and the bridge of the nose.

If you or your child has frequent nosebleeds, it’s important to address the underlying cause. Through allergy testing, we can determine what may be the reason behind children’s allergies.

Are There Different Types of Nosebleeds?

Yes. In fact, they can be divided into two types: anterior and posterior. 

Anterior epistaxis represents about 90% of nosebleeds and tends to be easier to manage. With an anterior nosebleed, the blood will tend to come out the front of the nose. 

Bleeding that is more profuse and going down the back of the throat is more likely to be posterior.

What to Do in Case of a Nosebleed

It’s always a good idea to understand basic first aid when it comes to nosebleeds. As we’ve said, most nosebleeds are not serious and can be easily managed.

First, we want to emphasize that you should not lean your head back. This can lead to gagging, coughing or, in some cases, even vomiting. Swallowing blood can upset your stomach.

If bleeding occurs, sit down and lean forward and relax. 

Pinch the nose firmly on the soft part of the nose so that pressure is applied against the septum. 

Apply ice or cold cloths to the nose. Pinch the nose for 5 minutes, watching the clock. 

If it is still bleeding, then pinch the nose for another 10-15 minutes. 

If bleeding continues, then medical attention may be necessary. 

Topical over-the-counter nasal sprays containing oxymetazoline or phenylephrine may help to decrease bleeding.

If your nosebleed doesn’t stop after doing this repeatedly, contact us immediately. 

How to Prevent Nosebleeds

Fortunately, nosebleeds are easy to prevent by following a few simple steps. We recommend:

  • Humidifying the air 
  • Applying nasal saline sprays
  • Avoiding blowing your nose hard or picking the nose
  • Avoiding hot and spicy foods
  • Avoiding hot showers
  • Not taking  aspirin or other blood thinners unless they are medically necessary

In addition, trimming your child’s nails can prevent nosebleeds from nose-picking. It’s also helpful to place a light coating of petroleum jelly gently around the nostril.

Procedures Help Alleviate Chronic Nosebleeds

If you have had chronic nosebleeds, it’s important to schedule an appointment with one of our experienced otolaryngologists. While you can effectively stop a nosebleed, you must treat the underlying cause to keep it from happening repeatedly. 

If chronic allergies are the root of your problem, we have an extensive array of successful treatment plans. 

We’ll tailor one to fit your needs or those of your child.

If a nosebleed occurs two to three times a month, you may have chronic nosebleeds. Sometimes these require a procedure. 

Anterior bleeding can sometimes be managed with chemical cauterization using silver nitrate. Occasionally, persistent bleeding will require nasal packing and, more rarely, surgical management or embolization. Once such procedure is sclerotherapy.

During this procedure, a solution is injected into certain nasal blood vessels. As a result, they collapse. Then, the blood flow is rerouted through healthier veins. The collapsed vessels will eventually disappear. 

Need Help for Chronic Nosebleeds? See Our Ear Nose and Throat Doctors in Raleigh

Most nosebleeds are nothing more than a nuisance. However, we can treat the underlying problems—such as allergies—that are behind these annoying incidents.

 In certain cases, nosebleeds can be caused by structural problems within the nose itself. If that’s the case, our nationally recognized surgeons will work with you to solve the issue.

For decades, Raleigh Capitol Ear Nose and Throat has been the premiere provider of choice for the region. See for yourself how our dedication and compassion makes a difference. We’d love the opportunity to be partners in your care. 

Schedule your appointment today. 

 

Raleigh Capitol Ear, Nose, and Throat is the area's premier physician-owned ENT practice with seven convenient locations throughout Wake County. Our board-certified physicians have extensive experience in treating both common and complex cases to help adults and children alike. For more information or to schedule an appointment, contact us.