Nose Bleeds (Epistaxis)

Bleeding from the nose is fairly common and can occur at any age. The nose has a rich blood supply and those patients who have had nose bleeds are well aware of how severe it can be. Though most nose bleeding is minor and will stop on its own, some bleeding can be life threatening and should be taken seriously.

Nosebleeds can be occur for many reasons. The most common causes are: dry nose (especially in the winter time and dry climates), trauma and nose picking, anticoagulant therapy such as aspirin or coumadin use, anatomic deformities such as deviated septum or vascular malformations, cocaine use or other medications. Rarely, nose bleeds can be the initial sign of serious blood disorders or hemophilia-like conditions.

Evaluating a nosebleed involves a thorough head and neck examination as well as a nasal examination with a fiberoptic scope to help find the source of the bleeding. Sometimes blood tests may be performed.

Treatment is dependent on finding the source of the bleeding. If there is active bleeding, the site may be cauterized with several methods. Sometimes packing is applied to the nasal cavity to keep some pressure on the bleeding site as it heals. Of there are anatomic causes, they may need to be treated at a later date. Anticoagulant therapy may also be discontinued if necessary.