Nosebleed (Epistaxis): What Is It?
A nosebleed (epistaxis) occurs when the delicate blood vessels inside the nose rupture and cause bleeding. In most cases, these are mild bleeds that stop on their own, but sometimes severe bleeding may occur, requiring medical intervention.
Nosebleeds are among the most common reasons for ENT (Ear, Nose, Throat) emergency visits. Especially in cases of frequent or prolonged bleeding, it is important to investigate whether there is an underlying serious condition.
Types of Nosebleeds
Nosebleeds are categorized into two types: anterior and posterior nosebleeds.
Anterior Nosebleeds
- Originate in the front part of the nose, especially in an area called the Kiesselbach’s plexus.
- Generally mild and controllable.
- More common in children and young adults.
- Often caused by dry air, trauma, or nose picking.
Posterior Nosebleeds
- Originate from deeper and more posterior regions of the nasal cavity.
- Usually seen in elderly patients and those with high blood pressure.
- Bleeding tends to be heavier and more difficult to control.
- Blood may flow into the throat, leading to swallowing or coughing up blood.
- Requires medical attention and possible hospitalization.
Causes of Nosebleeds
Many factors can lead to nosebleeds:
Environmental Factors
- Dry and warm air, especially in winter or heated rooms, dries out the nasal mucosa.
- Sudden temperature changes can make blood vessels more fragile.
- Exposure to smoke and chemicals can irritate the nasal lining.
Physical Causes
- Nose picking or forceful nose blowing.
- Nasal trauma (falls, impacts, post-surgical effects).
- Foreign objects entering the nose (especially in children).
Medical Causes
- High blood pressure (hypertension).
- Bleeding disorders (hemophilia, liver diseases, vitamin K deficiency).
- Use of blood thinners (such as Aspirin, Warfarin).
- Nasal infections or sinusitis.
- Nasal tumors or polyps (rare but should not be ignored).
When to See a Doctor?
Seek medical attention in the following situations:
- Bleeding lasts more than 10 minutes and does not stop despite pinching the nose.
- Frequent or recurrent nosebleeds occur.
- Dizziness, fainting, or difficulty breathing accompany the bleeding.
- Blood is being swallowed, coughed up, or vomited.
- Bruising or bleeding occurs in other parts of the body.
- If you are undergoing chemotherapy or have a serious blood disorder.
How to Stop an Anterior Nosebleed?
You can apply the following first aid steps at home:
- Stay calm – Panic can increase blood pressure and worsen bleeding.
- Tilt your head slightly forward – Do not lean back to avoid swallowing blood.
- Sit upright – This helps prevent blood from flowing down the throat.
- Pinch your nose – Firmly pinch the soft part of the nose with your thumb and index finger for 5-10 minutes.
- Apply a cold compress – Placing an ice pack on the nasal bridge helps constrict blood vessels.
- Do not blow your nose – This can trigger rebleeding.
If bleeding does not stop or recurs frequently, consult an ENT specialist.
Treatment of Nosebleeds
If the nosebleed does not stop on its own or occurs frequently, a specialist evaluation is needed.
Nasal Cauterization
Bleeding vessels can be sealed with silver nitrate or electrocautery.
Nasal Packing
In cases of heavy bleeding, special nasal tampons may be inserted to control bleeding.
Blood Pressure Control
For nosebleeds caused by hypertension, blood pressure-lowering medications may be required.
Surgical Intervention
Rarely, surgical techniques such as arterial ligation or endovascular embolization may be used for severe, recurrent bleeding.
How to Prevent Nosebleeds?
- Humidify your environment – Dry air irritates the nasal mucosa.
- Protect your nose from irritants – Avoid smoke, perfumes, and chemicals.
- Avoid nose picking – Common in children and a frequent cause of bleeding.
- Use blood thinners cautiously – Only take them under doctor supervision.
- Monitor your blood pressure regularly – Hypertension is a major risk factor.
- Stay well hydrated – Dehydration can dry out the nasal tissues.
Conclusion
Although most nosebleeds result from minor causes, frequent or prolonged bleeding may indicate a more serious underlying condition. With early intervention and proper treatment, most nosebleeds can be effectively controlled.
If you or a loved one experiences frequent nosebleeds, we recommend scheduling a thorough evaluation at our clinic.
Prof. Dr. Elif Aksoy
ENT Specialist – Swallowing and Voice Disorders
