Causes of Nosebleeds

The medical term used for nosebleed is epistaxis. The nose is located right in the centre of the face and has very high density blood vessels due to which most people have experienced nosebleeds at least once in their lifetime.

Nosebleed is not a life-threatening problem and therefore not a cause of worry. It is mostly caused by local trauma and the other factors are foreign bodies, nasal or sinus infections and inhalation of dry air for a long time. Nosebleed can also be due to tumors or vascular malformations but this is in rare cases.         

Sudden nosebleed is very common, particularly among children. This occurs when the mucus membrane which is the mucus secreting tissue; gets dried or cracked and this gets further affected with nose picking due to which there is nosebleed. Also, since the nose is full of blood vessels, even a slight injury on the face can cause the nose to bleed.

Nosebleed is also a common in individuals who take medications for blood-thinning (anticoagulants) like Aspirin and also among older individuals whose blood takes more time to clot. If a person having nosebleed is taking anticoagulants, or has high blood pressure, or a bloods-clotting illness then it becomes more difficult to stop the nosebleed and it may last for more than 20 minutes.

What are the types of nosebleed?

There are two types of nosebleed – anterior and posterior. The most common type of nosebleed is anterior nosebleed.

Anterior nosebleed

In this the bleeding occurs from the lower part of the nasal septum which is the nasal partition. This is because, this portion of the nose consists of a lot of delicate blood vessels which receive blood from the carotid arteries and two main arteries which are located in the front of the neck that provide blood to the head and neck.

Even a minor hit or bump can lead to these blood vessels to bleed. This type of nosebleed can be treated at home.

An anterior nosebleed is very commonly seen in children.

Posterior nosebleed

This type of nosebleed is from an area further back and higher up inside the nose, a location where the branches of the artery provide blood to the nose and therefore this is heavier.

Posterior nosebleeds are more serious compared to anterior nosebleeds and may also require medical supervision. This type of nosebleeds is more commonly seen in adults.

What are the causes of nosebleeds?

Given below are the factors that cause nosebleeds;

Causes of anterior nosebleeds

At times it is very difficult to know the actual cause of anterior nosebleeds. However, some of the causes are given below;

Blowing the nose very hard and very often

Picking the nose -And the chances are more if it is done very frequently, if the person has long fingernails or if the inside area of the nose is already tender, dry or injured

A blow or bang to nose leading to injury of the blood vessels of the mucous membrane

  • Sinusitis
  • Nasal allergies
  • Cold or flu – Because in such cases the person will blow their nose more often, the inside area of the nose will be tender making it more likely to bleed
  • Deviated nasal septum
  • Weather conditions – Hot climate with low humidity, change in weather from cold to warm, dry weather causing dryness and cracking inside the nose
  • High altitude – In high altitude, there is less oxygen available making the air thin and dry and this can cause nosebleed.
  • Excessive use of specific medications like anticoagulants or non-steroidal anti-inflammatory drugs
  • Excessive use of illegal drugs
  • Liver problems can hinder blood clothing causing frequent and at times severe nosebleeds

Causes of posterior nosebleeds

  1. High blood pressure
  2. urgery of the nose
  3. Calcium deficiency
  4. Over exposure to certain chemicals that can irritate the mucous membrane

Posterior nosebleeds at times can also be symptoms caused due to some other medical conditions like blood diseases for e.g. Leukemia or tumors in the body

What are the risk factors for nosebleeds?

Some of the common risk factors for nosebleeds are as follows:

  • Infection
  • Minor injuries caused by nose picking
  • High blood pressure
  • Excessive alcohol consumption
  • Bleeding disorders in the family
  • Certain type of sports like boxing, martial arts etc.

What are the treatment options for nosebleeds?

Nosebleeds that are not serious can be treated at home. The nosebleed can be stopped by following these steps;

  1. Sit and relax and pinch the softer parts of the nose firmly
  2. Breath through the mouth
  3. Lean forward to avoid the blood to flow to the sinuses and throat which can cause inhaling of the blood or choking
  4. Continue applying pressure on the nose by leaning forward and sitting in an upright position for at least 5 minutes and one can continue doing so for around 20 minutes. If the bleeding continues above 20 minutes then seek medical attention.
  5. Place an ice pack on the nose and cheek portion to soothe the area
  6. Avoid any tiring and exhausting activities for a couple of days
  7. One must seek medical attention if he/she has nosebleeds frequently, has had any injury on the head, taking anticoagulants and when the nosebleed continues for more than 20 minutes.
  8. In cases where the doctor suspects that the nosebleed is due to some problems like high blood pressure, anemia or nasal fracture; they will suggest some tests like blood pressure and pulse rate check and at times even an X-ray before recommending any treatment options.

Given below are some of the treatment options that the doctor will suggest basis the cause of the problem.

  • Nasal packing – In this option a ribbon gauze or nasal sponge is stuffed deep inside the nose to put pressure on the source that causes bleeding
  • Nasal Cauterization – In this the area which is bleeding is cauterized to seal it off. This procedure is possible if the blood vessel which is affected can be identified.
  • Septal surgery – In this the deviated nasal septum is straightened and this will reduce the occurrence of nosebleeds
  • Ligation – In this the ends of the blood vessels which are identified to cause the nose bleed are tied through a surgical procedure. At times even the arteries are tied from which the blood vessels stem. And if the affected area is way inside the nose, then a major surgery will be required.
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