Nosebleeds

When do nosebleeds require medical intervention?

Nosebleeds that occur following a head injury, that won’t stop after 20 minutes, or that may be accompanied by a broken nose require evaluation and treatment from a qualified medical provider. Additionally, patients who experience frequent unexplained nosebleeds should be evaluated by a healthcare professional. Finally, patients who are experiencing nosebleeds in conjunction with other symptoms should seek prompt medical attention.

Why is there so much blood?

The inside of the nose is lined with thin, fragile skin with many small blood vessels near the surface. This rich blood supply can result in voluminous nosebleeds if the skin is broken or compromised.

What causes nosebleeds?

Nosebleeds can result from a number of causes, including:

• Underlying medical problems like kidney disease, liver disease, high blood pressure, hypertensive crisis, congestive heart failure, leukemia and alcohol abuse
• Cracked skin in the lining of the nose due to dry weather or dry air
• Medications that thin the blood and prevent clotting
• Scratching inside the nose or nose picking
• A foreign body in the nose, which is most common in children who might insert beads, vegetables, etc. out of curiosity
• Allergies and allergic rhinitis, which causes inflammation of the lining of the nose

Who can treat a nosebleed?

In general, nosebleeds can be treated and stopped at home. In some cases, medical intervention is necessary. Most nosebleeds can be treated by primary care, family practice, or emergency room doctors. When nosebleeds are frequent, dangerous, or unexplained, the patient may be referred to an ENT, who has specialized training and extensive experiences in these kinds of cases.

What measures should be taken to stop a nosebleed at home?

Patients can attempt to stop a nosebleed by:

• Leaning forward rather than tilting the head back
• Pinching the nose at the bridge, applying firm pressure for 10 minutes or more
• Applying ice to the lower forehead

Patients should try to avoid swallowing blood as it can result in upset stomach and vomiting.

How are nosebleeds treated?

When nosebleeds can’t be stopped using traditional, non-invasive methods, a doctor can stop the bleeding by cauterizing the vessels in the nose. When patients experience frequent, unexplained nosebleeds, ruling out or identifying underlying medical conditions that may contribute is a critical component of comprehensive care.