Nosebleeds can be quite frightening. They occur in children and adults. They can be caused by: nose picking, blood thinning medications (e.g. aspirin, warfarin, rivaroxaban, clopidogrel), high blood pressure, a dry nose, steroid nasal sprays, inherited diseases, nasal fractures, and cancers or benign tumours of the nose.
There are many blood vessels that join up in the front of the nose. This is a weak point, in the body, for bleeding to happen.
If you come to see me, I would ask you about all these risk factors. I would then examine the front of your nose to check for areas that might have been bleeding. I also use a camera (nasendoscope), to look further into the nose, to check there are no cancers or tumours which have been causing bleeding.
If a nose bleeds happens keep calm. Panic will send your blood pressure up, making the bleeding worse. Sit upright, and grip the fleshy part of the nose, with a tissue, between thumb and forefinger, for 5 minutes. Applying pressure helps the bleeding points clot. After 5 minutes, release the pressure and see if the nose bleed has settled. Sometimes sucking ice for a few minutes may make the blood vessels in the nose constrict, and stop the bleeding. If the nose bleed does not stop with simple measures, make your way to A+E, or call an ambulance in particularly bad cases.
There is a ladder of interventions I use to deal with nose bleeds. I start off at the bottom of the ladder with medications and then, if these don’t work, we go up the ladder with various surgical procedures until the nose bleeds stop. I can deal with most nose bleeds in clinic, but some can be so severe, especially in older adults, that they require a trip to the Accident and Emergency department and admission into hospital.
If your nose bleeds are recurrent, it is definitely worth seeing me to make sure there is nothing serious to account for them.