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Nosebleed causes and how to stop them

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Whether you’re catching a new blockbuster at the cinema, enjoying a first date at a restaurant, or giving a presentation at work, the last thing you need is a nosebleed. Nosebleeds — also known as epistaxis — are common and thankfully rare. However, their normality does not prevent them from interrupting your daily life.

Read on to learn what causes nosebleeds, how to stop it, and steps you can take to prevent it.

Why do we get nosebleeds?

First, let’s talk about the anatomy of our nose and why nosebleeds occur. The nose can do more than just smell. It acts like a filter, removing toxins and bacteria from the air we breathe so we don’t get sick, while also warming and humidifying the air to prevent lung irritation.

To condition the air, our nasal passages are lined with blood vessels. These delicate blood vessels lie close to the surface of the nasal passage and transfer heat from our blood to the air when we breathe in.

Blood vessels in the nose usually rupture when they are disturbed in any way – either by environmental conditions or by something solid being inserted into your nose – leading to nosebleeds.

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causes nosebleeds

The two most common causes of nosebleeds are dry air and nose picking. Dry air causes the normally moist membranes in our nasal passages to dry out. When these membranes rupture and crust, they expose the underlying blood vessels and rupture. The reason nosebleeds are so common in winter is because heated indoor air contains almost no moisture.

Nose picking causes trauma to the delicate membranes in your nose, especially if your or your child’s fingernails are long – which is why nosebleeds are so common in children between the ages of 2 and 10. The force of an inserted finger is enough to damage blood vessels.

Nosebleeds can also be caused by:

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  • sinusitis
  • The common cold
  • allergies
  • A deviated septum
  • blood thinner
  • Blood clotting disorders
  • effects on your nose
  • Inserting a foreign object into your nose
  • inhale irritants

How to stop nosebleeds

Nosebleeds can be a frightening event, but it’s important to remain calm as stress can make the bleeding worse. To stop nosebleeds quickly, follow these steps:

Lean forward, not back

Sit up straight and lean your body forward, making sure your head stays over your heart. While it used to be common to tilt your head up and back to treat nosebleeds, this is no longer recommended because it can cause blood to flow to your throat and stomach, causing you to choke or vomit. If your head is tilted forward and slightly downward, blood can drain from your nose.

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Pinch your nostrils

Find the spot on your nose where the bony ridge — the bridge of your nose — transitions into soft cartilage. Place your thumb and forefinger on either side of this area, just above your nostrils, and pinch with firm pressure. However, you should still be able to squeeze your nose under your fingers. Breathe through your mouth with your nostrils closed while squeezing.

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Apply even pressure

Hold your nose for at least 10 minutes before checking to see if your nosebleed has stopped. If you release pressure from your nose before the ruptured blood vessel has had a chance to form a clot, you risk the bleeding starting again. Check the flow after 10 minutes. If you’re still bleeding, keep pinching and holding the pressure for another five minutes.

apply ice

If your nose is still bleeding after 15 minutes, place an ice pack on the bridge of your nose. This helps narrow the blood vessels and stop the bleeding. Be sure to keep pinching your nose with your fingers while using the ice pack.

Types of Nosebleeds

There are two different types of nosebleeds based on the location of the broken blood vessel in your nasal passages.

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Front nosebleed

Anterior nosebleeds occur at the front of the nose where the blood vessels are relatively small. Blood flows from one or both nostrils. Anterior nosebleeds are more common and less severe than the posterior type. They can almost always be solved at home.

Posterior nosebleed

Posterior nosebleeds occur at the bridge of the nose, where the blood vessels are larger. The blood flow is stronger and you can feel blood trickling down your throat instead of just coming out of your nose. A back nosebleed can indicate a larger health problem and usually requires medical attention.

How to prevent nosebleeds

Nosebleeds occur. In fact, around 60% of people will experience a nosebleed at least once in their lifetime. However, that doesn’t mean you have to suffer through them. There are several things you can do to prevent nosebleeds:

  • Use a humidifier in winter or year-round if you live in a dry climate
  • Do not smoke as cigarette smoke can irritate your nose and sinuses
  • Don’t put anything solid up your nose, including your finger
  • Use saline nasal sprays or nasal drops to keep your nasal passages moist
  • Apply moisturizing gels or ointments like petroleum jelly to the dry nasal passages
  • Avoid aspirin and ibuprofen, both of which act similarly to blood thinners. If pain relief is needed in the days after a nosebleed, use acetaminophen (Tylenol) instead.
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When to worry about nosebleeds

Most nosebleeds aren’t serious and usually go away on their own. However, if you or your child has frequent nosebleeds—it happens more than once a week for several weeks—you should talk to your family doctor or your child’s pediatrician. Other factors that may warrant talking to your doctor about your nosebleed include:

  • You are currently taking blood thinners (anticoagulants).
  • They show signs of anemia, such as weakness, pale skin, and tremors
  • You have a blood clotting disorder
  • You take medication through your nose

When to seek emergency care

Nosebleeds are rarely a medical emergency, but you should be aware of a few symptoms that make it something more serious. Go to the emergency room or emergency room if you have any of the following symptoms with your nosebleed:

  • You can’t stop the bleeding even after 20 minutes of pressure
  • You’re bleeding so bad it’s hard to breathe
  • The amount of blood is a cup or more
  • You feel dizzy and weak

Treatment of chronic nosebleeds

Your GP may refer you to an ear, nose and throat (ENT) specialist if your nosebleeds are frequent enough to interrupt your daily life. The otolaryngologist will ask questions about the frequency and duration of your nosebleeds, as well as your medical history and current medications.
You can have a nasal endoscopy, a procedure where a thin wire with a camera and a light on the end is inserted into your nose. This allows the ENT doctor to see the inside of your nasal passages and sinuses.

Based on their results, they can recommend the following treatments:

  • nasal cauterization: During this procedure, your doctor uses a chemical or electrical device to cauterize, or seal, abnormal blood vessels in your nose.
  • nose pack: Your doctor will insert gauze coated with an antibiotic ointment into one or both nasal passages to apply direct pressure to the blood vessels. The depth of insertion depends on whether you have an anterior or posterior nosebleed. The gauze will remain in your nose for a few days. Depending on the type of packaging, your doctor will send you back for removal or the gauze will dissolve on its own.
  • Surgery: If a deviated septum is the cause of your nosebleed, your doctor may suggest a procedure called a septoplasty. A septoplasty straightens your septum and allows for better airflow in your nose.

If nosebleeds have become a regular and disruptive part of your life or the life of your child, our ENT doctors are here to help.

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