Nosebleeds - Causes, Symptoms, and Treatment

What Is a Nosebleed?

In medical terms, nosebleed is called epistaxis. Bleeding occurs from inside the lining of the nose. Blood vessels inside the nose are very delicate and smooth; even a small irritation or trauma can cause nose bleeding. It can occur in a single or both nostrils and is not a life-threatening condition. However, the majority of people would have faced nose bleeds once in their lifetime.

What Are the Causes of Nosebleeds?

Blood vessels lining the nostril are smooth and delicate. Any irritation would cause damage to the blood vessels, thereby leading to a nosebleed. The common reason for injury could be:

• Dryness: Dryness in the nostril causes nosebleeds. This is mostly seen during winters; because of the cold atmosphere, nostrils become dry and are easily prone to bleeding.

• Nose Picking: Children usually have the habit of inserting fingers into their nostrils. This causes irritation to the membrane leading to bleeding.

• Nasal Obstruction: Placing foreign bodies inside the nose also causes bleeding.

• Nasal Fracture: Fracture of the nasal cavity and deviation of the septum due to trauma would result in bleeding.

• Allergies: These would end up in inflammation (reddening, swelling) and infection, which could damage the minor blood vessels in the nose.

• Medications: Persons using anticoagulants (blood thinners) such as Warfarin, Heparin, and Aspirin are more prone to nosebleeds. Because these medications tend to prevent clot formation and thereby lead to excessive bleeding.

• Hemophilia: This is a rare inherited disorder of the blood, where the clotting factors are absent in the blood leading to prolonged bleeding time.

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• Skull Fractures: Are usually seen in road accidents. In such conditions, if bleeding is observed from the nasal cavity, the person has to be immediately rushed to the hospital.

• Sinusitis: Inflammation is seen along the walls of the sinus cavities. Both in acute and chronic conditions, this inflammation could result in nosebleeds.

• Nasal Irritants: Inhalation of smoke, fumes, room sprays, and deodorants can irritate the nose lining, which ends up bleeding.

The other less-known common reasons for nosebleeds include:

• Alcohol and tobacco usage.

• Patients suffering from leukemia (blood cancer).

• Nasal cancers, nasal polyps, and nasal surgeries.

• Thrombocytopenia: People with thrombocytopenia suffer from a lack of platelets (thrombocytes). This could prevent blood from clotting and leads to excessive blood loss.

How to Treat a Nosebleed?

Treatment depends upon the etiology (cause) and includes:

1. Applying Pressure: Tight pressure is applied to the bleeding spot with the help of a gauze sponge. The material is left in place until the bleeding stops.

2. Sealing the Blood Vessel: In this process, the anesthetic spray is first applied onto the bleeding site, and then the bleeding vessel is closed by applying heat (electrocautery) or chemical cauterization (a chemical known as silver nitrate is used to cease the bleeding).

3. Blood Thinners: If the person is on blood thinners under the supervision of the doctor, it is advised to stop anticoagulants for a few days. In the case of heart patients, the dosages are decreased.

4. Hypertension: In patients with high blood pressure, medications are used to control and normalize the blood pressure because uncontrolled blood pressure causes the rupture of tiny blood vessels in the nose.

5. Removal of Object: In cases where the bleeding is because of the foreign body insertion into the nose, it should be removed immediately to prevent further bleeding.

6. Surgery: Nosebleeds are common in nasal fractures and septum deviation. Hence they must be corrected to prevent nosebleeds.

What Are Some Home Remedies to Avoid Nose Bleeding?

1. Cutting Nails: Children might put their fingers into the nose. The sharp nails cause rupture of the membrane leading to bleeding of the nose. Hence, the fingernails should always be cut short to avoid damage.

2. Maintaining the Nose in Moist Condition: Especially in winter, the air is very cool, which causes dryness of the nose, and the dryness aggravates the bleeding in the nose. Hence the lining of the nose should always be moist. Moisture in the nose can be maintained by applying Vaseline (petroleum jelly) with the help of a cotton swab, nasal sprays, or saline sprays.

3. Humidifier: A humidifier always moistens the dry air. Hence they are recommended in the house.

4. Smoking: Smoking causes dryness of the nose. Hence quitting could avoid dryness and bleeding from the nose.

When to Consult a Doctor?

Usually, nosebleeds are not an emergency, though the situation seems frightening. But an emergency consultation must be made in case of the following situations:

• Continuous bleeding from the nose for more than twenty minutes.

• When bleeding is noticed immediately after a head injury. Trauma to the head causes fractures in the skull which leads to nosebleeds.

• When there is a direct blow to the nose, it leads to nasal fracture, which causes bleeding.

• In cases where the patient is using anticoagulants (blood thinners).

• In cases of frequent and regular nosebleeds.

What Are the Tips to Stop Nosebleeds?

If a person notices bleeding from the nose, following steps should to followed:

1. Up-Right Position: A person is made to sit in a forward and upright position. This prevents the swallowing of the blood, which leads to gut irritation.

2. Blow Through Nose: A gentle blow in the nostril clears away the blood clot.

3. Closing the Nostrils: In the case of nosebleeds, both nostrils are closed with the help of the thumb and index finger, and then breathing is done from the oral cavity. One must continue to do so for about ten minutes. This closing of the nostrils puts pressure on the bleeding point in the lining of the nose, and the blood flow is ceased. Enough time must be given for the bleeding to stop. Repeat the same if the bleeding doesn't stop.

4. Sneezing and Sniffing: Must be strictly avoided after controlling the nosebleed.

Conclusion:

Nosebleeds are usually seen in children and occur because of the rupture of the thin, delicate blood vessels in the lining of the nostril. Generally, nosebleeds do not cause any emergency situations and can be controlled by applying pressure packs. If the bleeding exceeds 20 minutes of time, then the person should be immediately taken to the doctor.