Nose Bleeds

Nosebleeds are a common, but fortunately, usually self limited problem which affect either the younger or elderly population of patients.

There are two types of nosebleeds : anterior and posterior.

Anterior nosebleeds may present with blood dripping mostly from ONE side and the FRONT of the nose. These bleeds are related to the prominent blood vessels on the septum or the divider of the nose. With a headlight and nasal speculum ( anterior rhinoscopy) or with a nasal camera (rigid nasal endoscopy) they may be visible. If a prominent or identifiable blood vessel or bleeding source is seen, it may be cauterized (with a silver nitrate stick leading to a chemical burning) in the office. Often, this can lead to a lessening or resolution of the nosebleed problem.This anterior one sided type of nosebleed can be controlled frequently with pressure application- Pinching or placement of tissue in the nose. We recommend keeping the nose moist especially during the winter months (with dry heat and air) using saline spray and AYR gel twice a day. We also recommend use of afrin sprayed directly into the nose or on cotton which can be inserted into the nose to control anterior bleeding. Rarely this type of nose bleed requires a packing in the office.

Posterior nosebleeds can present with heavy blood flow that can pool in the back of the nose and back of the mouth and throat. Often, it is difficult to identify the site of the bleed. This type of bleeding is more serious and can often require a visit to the emergency department. A patient with a true posterior nosebleed may need to have a formal packing and be admitted for further evaluation and observation. This type of bleed is related to a problem with blood vessel called the sphenopalatine artery which supplies blood to the back of the nose.

If you are having a problem with nosebleeds please feel free to call our office to set up an appointment for further evaluation.

When the nosebleeds, it should not last longer than 10 or 15 minutes, although it can bleed for as long as 30 minutes. If the nosebleed has not stopped within 30 minutes, medical attention is required. Most nosebleeds can be treated at home. Young children and even some adults will start to panic if they have a nosebleed. Keeping them calm is priority. When a person gets upset and the flight or fight response occurs, the adrenaline starts to pump. This can cause the nose to bleed more or for a longer period of time. Some tips for caring for a nosebleed include:

  • Pinch the soft spot on the bridge of the nose using your index finger and thumb
  • Sit up or stand up (never lie down during a nosebleed)
  • Lean forward slightly, so the blood does not drain down the back of the throat
  • If you have a decongestant nasal spray, squirt a few drops in the nostril that is bleeding