When a Nosebleed Is Something More Than Just a Nosebleed

You think you have a runny nose and dab it with a tissue or your hand then, to your horror, you realize blood is coming out of your nose. Whether it is a little spot of blood or it is gushing out, a nosebleed is always a little unnerving. How do you know if you need a tissue or a trip to the emergency room? Chances are good that it is just a harmless event as about 60 percent of all people have experienced a nosebleed, according to the American Rhinologic Society, with only about 6 percent requiring medical attention.

About Nosebleeds and Their Causes

The medical name for a nosebleed is epistaxis and is defined as any bleeding from the nostril, nasal cavity or the nasopharynx area lying just behind the nose. Nosebleeds occur when a blood vessel in the nose bursts. A nosebleed can be spontaneous or the result of trauma.

The main causes of nosebleeds include:

Irritation associated with colds, allergies, sneezing or sinus problems
Very cold or dry air
Blowing the nose very hard
Nose picking
Injury to the nose, such as a broken nose or an object stuck into the nose
Deviated or perforated septum
Chemical irritants
Cocaine use
Overuse of decongestant nasal sprays

Chances are good that a nosebleed is just a harmless event as about 60 percent of all people have experienced a nosebleed, according to the American Rhinologic Society, with only about 6 percent requiring medical attention.

Most nosebleeds are the result of minor irritation or a cold, according to the U.S. National Library of Medicine (NLM). KidsHealth from Nemours says that nosebleeds are common in children aged 3 to 10, and that cold air and nose picking cause most cases in kids. Most of the time, there is no known cause for a nosebleed.

Nosebleeds, especially repeated nosebleeds, may be a symptom of a more serious condition. Tumors of the sinuses or nose may cause nosebleeds that keep coming back. High blood pressure does not cause nosebleeds, according to the American College of Emergency Physicians, but hypertension can prolong bleeding. Some types of bleeding disorders can also prolong bleeding during a nosebleed.

Some types of topical nasal medications, including corticosteroids and antihistamines, may sometimes lead to nosebleeds. Other medications can cause or worsen nosebleeds. This is especially true for blood thinners, such as clopidogrel (Plavix), warfarin (Coumadin), nonsteroidal anti-inflammatory drugs (NSAIDs), and aspirin, used to stop the formation of dangerous blood clots.

Certain medical problems, such as liver or kidney disease, chronic alcohol abuse, platelet disorders and inherited clotting disorders can lead to nosebleeds. Malformed blood vessels in the nose and nasal tumors are rare causes of epistaxis. Nasal or sinus surgery can also cause epistaxis.

When a Nosebleed is More than Just a Nosebleed

While most nosebleeds are nothing to worry about, some cases of epistaxis are cause for concern. Frequent nosebleeds occur more than once a week, according to Mayo Clinic. Frequent nosebleeds may be a sign of a problem.

Seek professional medical attention right away if:

Bleeding does not stop after 20 minutes
Nose bleeding is the result of a head injury, which suggests a skull fracture has occurred
Your think your nose may be broken or if your nose takes on an odd shape after an injury to the nose or head
Schedule an appointment with your doctor if:
You suffer repeated nosebleeds
Your nose bleeds frequently
Nosebleed episodes are not associated with a cold or other minor irritation

While most nosebleeds are nothing to worry about, some cases of epistaxis are cause for concern. Frequent nosebleeds occur more than once a week, according to Mayo Clinic. Frequent nosebleeds may be a sign of a problem.

Treatment for Nosebleeds

Treatment for nosebleeds usually involves applying pressure to stop the bleeding. Pinching the lower, fleshy portion of the nose works well. Other conservative measures, such as decongestant nasal sprays and topical therapies, can help stop stubborn mild to moderate nosebleeds. Rolling a silver nitrate stick in the affected nostril can also help.

Nosebleeds that do not stop with conventional care require further treatment. The doctor may insert gauze or cotton into your nose, a procedure known as nasal packing. If the doctor can see the source of your bleeding, she may use a silver nitrate chemical or heat to seal the blood vessel. Surgical options include arterial ligation to tie off the vessel and embolization to place material inside a vessel to prevent blood from flowing through it.

If you or someone you know suffers from frequent or prolonged nosebleeds, or are experiencing bleeding from the nose after head trauma, you need professional medical care. Contact Revere Health to learn more about knowing when a nosebleed needs ENT care.

 

Our specialists have received extensive training and completed a variety of procedures, offering the best ENT care for our patients. Our team also has access to a variety of specialties to ensure that patients receive coordinated care.