What causes nosebleeds (epistaxis)?

The nose has many blood vessels and is situated in a prominent position on our faces. This means that any trauma to the face often involves the nose and consequently nosebleeds. This bleeding may only be slight, or in many cases, profuse.

Another cause of nosebleeds is when the nasal membranes dry out, leading to cracking of the membranes and subsequent bleeding. This problem is often seen in the drier areas of the country or in winter months when the air is drier and we use heating in our homes. There are also a number of medications that can make people more susceptible to nosebleeds.

These include:

• medications such as warfarin
• some types of aspirin
• and several types of anti-inflammatory medications.

Colds and flu can often increase the incidence of nosebleeds and in the colder months the fluctuations in hot and cold temperatures - particularly from being outside and then going inside heated buildings - can trigger nosebleeds in many people.

Known causes of nosebleeds

• infection in the nasal membranes
• respiratory infections
• trauma
• allergies and hay fever
• high blood pressure
• constipation causing straining
• medications such as the 'blood thinners' (eg, warfarin)
• excessive alcohol intake
• some types of tumours
• inherited bleeding disorders.

First aid for nosebleeds

Most nosebleeds cause only minor discomfort and inconvenience and can be handled at home. However, if the bleeding is severe and the nosebleeds happen regularly, you should speak to your doctor to make sure that there is no underlying serious cause.

To stop nosebleeds:

• Squeeze or pinch the soft parts of the nose together gently with your thumb and index finger.
• Firmly press the pinched parts of the nose towards the bones of the face.
• If possible, hold the nose in this position for about five minutes. You may have to repeat this technique until the bleeding ceases.
• Sit and relax, keeping the head elevated - do not lie down or put your head between your legs.
• Apply crushed ice to the nose and cheek areas.
• After a nosebleed, rest with the head elevated.

Preventing nosebleeds

If you have had a nosebleed you should try to minimise the likelihood of it happening again. Here are some guidelines that may be of help.

• Try not to blow your nose.
• If you need to sneeze, open your mouth so that the air escapes from the mouth and not the nose.
• Constipation can be a cause of nosebleeds, so you may need a stool softener to prevent straining.
• Avoid straining or bending to lift anything heavy.
• Avoid smoking.
• Avoid hot liquids for at least 24 hours after a nosebleed.
• Avoid aspirin if possible.
• If your doctor has prescribed aspirin for a specific condition ask what can be done for the nosebleeds.
• A lubricating ointment may be of benefit. Check with your pharmacist for the best one for you.
• Some people may benefit from the use of a nasal decongestant spray, but these should be used only for a short period (one to two days).

When to see a doctor

Always remember that if the bleeding is profuse and persists, you should contact your doctor or hospital emergency department.

Original material supplied by MyDr. Edited by everybody.