What are nosebleeds?

Causes and Symptoms

The nose is a highly vascular area and is therefore a common site of bleeding. Most nosebleeds are benign. They may result from local causes that affect the mucosa of the nose directly. They can also result from systemic causes, which affect the body as a whole.

The major cause of nosebleeds is irritation of the nasal mucosa. Simple trauma from nose picking is the most common in children. Chronic irritation can be associated with allergies, a dry environment or changes in the weather, smoking or the inhalation of smoke, or the inhalation of caustic substances, such as cocaine. Sneezing as a result of recurrent colds or infections of the nose and throat can be associated with nosebleeds. The use of medications such as decongestants, antihistamines, and allergy/cold nasal sprays may also result in nosebleeds because of local irritation.

Trauma to the nose may result from blunt injury, such as associated with sports or other accidents. Occasionally, children may place small objects high in the nose; these objects may go undetected for periods of time before eventually causing infection and bleeding. Rarely, bleeding may be caused by structural problems, such as nasal polyps, malignant growths, or deviation of the midline nasal septum.

Systemic causes of nosebleeds include underlying bleeding disorders, fevers, bacterial or viral infections, high blood pressure, cancer, and liver or kidney problems. Bleeding disorders should be considered in cases where the bleeding is recurrent and/or prolonged or if there is a significant family history of bleeding problems. Medications such as aspirin, ibuprofen (or other anti-inflammatory agents), anticoagulants, or steroids may produce a transient or short-lived coagulation defect that may cause nosebleeds.

Treatment and Therapy

Most nosebleeds can be stopped by sitting upright (or by holding a young child on one’s lap) and gently squeezing the front or anterior of the nose closed for five to ten minutes. It is important to seek medical attention if the bleeding does not stop or if there is continued bleeding or oozing of blood. Occasionally, nasal packing (placement of gauze inside the nose) or other procedures may be required to control severe bleeding. People with coagulation problems need special consideration and require specific medical treatment. Some natural treatments have been suggested to prevent or control nosebleeds.

Efforts to keep the nasal mucosa from becoming too dry may be helpful in preventing recurrent nosebleeds. Applying petroleum jelly or other moisturizing agents inside the nose or using a humidifier in the home to keep the air moist may also be helpful.

Most nosebleeds are not life-threatening, but they can be very frightening for patients, especially children and their parents or caregivers. When caring for a child who is bleeding, it is important to remain calm to help decrease the child’s anxiety and to assess and begin to treat the bleeding.

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