Recurrent Nosebleeds: Causes & Treatments

Although nosebleeds seem simple and harmless, they can be the result of underlying health conditions that may require your attention. If you experience a nosebleed once in a blue moon, chances are there is nothing seriously at risk. However, if you experience chronic nosebleeds, it is important to evaluate what could be causing it. Chronic bleeding from the nose can be the result of minor, temporary conditions, but they can also indicate serious underlying health problems. Nosebleeds are classified as either anterior (just inside your nostrils) or posterior (from the back of the nose). The majority of nosebleeds are anterior, resulting from a damaged blood vessel in the septum.

Causes of Anterior Nosebleeds:

• Crooked nose, either present from birth (congenital) or the result of an injury (deviated septum)
• Picking and blowing nose too hard
• Excessive use of nasal decongestants
• Blocked or stuffy nose due to cold or flu
• Sinusitis
• High altitude
• Dry air
• Allergies

Posterior nosebleeds are more serious because the bleeding originates from branches of arteries that supply blood to the nasal cavity. They are more common in adults than in children. If the blood flow is heavy, it can be a dangerous condition that requires medical attention.

Causes of Posterior Nosebleeds:

• Blow to the head or a fall
• Broken or injured nose
• Recent nasal surgery
• Frequent use of aspirin and anticoagulants (Warfarin and Heparin)
• Tumor in the nasal cavity
• Hardened arteries (Atherosclerosis)
• Blood clotting abnormality (Hemophilia or von Willebrand disease)
• Leukemia
• High blood pressure
• Hereditary Hemorrhagic Telangiectasia (HHT), a genetic condition that affects the blood vessels

Home Treatments

There are several at-home treatments you can do to stop a nosebleed if you don’t require medical attention. Sit upright and firmly pinch the soft part of your nose, just above your nostrils (for at least 10-15 minutes). Lean forward and breathe through your mouth, allowing the blood to drain down your nose instead of down the back of your throat. Try applying a soft ice pack (covered with a towel) to the bridge of your nose, as this can slow down the bleeding. It is important to stay upright, instead of laying down, to reduce the blood pressure in the vessels of your nose and prevent further bleeding.

Seek Medical Advice If:

• You have regularly recurring nosebleeds
• You have symptoms of anemia, like heart palpitations, shortness of breath, and a pale complexion
• You take blood thinners or have a clotting disorder
• Children under 2 years of age have nosebleeds (this is rare and can be serious)

Seek Emergency Medical Help Immediately If:

• Bleeding continues for more than 20 minutes
• You have difficulty breathing
• You are swallowing large amounts of blood and/or vomiting
• The bleed occurs after a serious injury to the head or nose
• The bleeding is heavy and you have lost a lot of blood

Medical Treatments for Chronic Nosebleeds:

• Nasal packing – if the doctor cannot identify the specific cause of bleeding, they may pack the nose with gauze or special nasal sponges to stop the flow of blood by applying pressure to the source of the bleeding. This procedure can be done with or without anesthesia.
• Ligation – a procedure using small instruments to tie off bleeding blood vessels in the back of the nose (posterior)
• Cautery/Electrocautery – if the doctor can identify where the bleeding is coming from, they can do a minor procedure to seal the bleeding vessel.
• Blood transfusion – your doctor may recommend this if you have lost a lot of blood
• Tranexamic acid – a medication that can reduce bleeding by helping your blood to clot

Recovery & Prevention

There are several precautions you can take to avoid recurrent nosebleeds and the need for medical attention. Avoid blowing or picking the nose, as well as heavy lifting, strenuous exercise, lying flat, and drinking alcohol or hot beverages for 24 hours after the bleed. Try to sneeze with your mouth open to reduce the pressure in the nose. Do not remove any crusts that form inside of the nose; although they may be unpleasant, it is a helpful part of the healing process. Additionally, avoid people with coughs and colds to avoid getting sick, which can worsen the condition.

If you experience recurrent nosebleeds, we can help you get to the bottom of it. Call Vitale ENT today at (813) 406- 4400 or schedule an appointment online!