Epistaxis

What are the causes of nosebleeds?

Nosebleed, also known as epistaxis, can have many possible causes. Most frequently, bleeding is caused by injuries to the nose, for example when blowing or picking one's nose. But also dry and irritated nasal mucosa, as it can arise from air conditioning, heated air or allergies, can often result in nosebleeds.

Other more rare causes include local and febrile infections, tumors, atherosclerosis ("hardening of arteries") as well as so-called systemic diseases, meaning conditions that affect the entire body, such as liver diseases.

Patients taking "blood thinners," such as aspirin or oral anticoagulants, may also have a stronger tendency for nosebleeds.

In children, foreign bodies lodged in the nose are a frequent cause.

How to stop nosebleeds?

Following steps should be taken in the event of a nosebleed: Sit in an upright position and if possible allow your head to lean forward and DO NOT tilt your neck backwards, as this will allow the blood to run down your throat and esophagus into your stomach, causing nausea and vomiting. Therefore, you should always spit out the blood and not swallow it. Beyond that, blood may also enter the respiratory tract this way, which could become dangerous.

An ice pack or a cold cloth placed on the back of the neck will help to constrict the nasal blood vessels and stop the bleeding.

You can also use your fingers or a clamp to compress the nostrils. The pressure also helps to stop the bleeding.

Usually, the nosebleed should end after a few minutes.

When should you seek medical attention for a nosebleed?

A doctor should be consulted if there is a visible injury to the nose, if the bleeding is abnormally severe or if it continues for more than 20 minutes, since there is a risk of losing a lot of blood.

In case the blood mostly drains down the throat instead of coming out of the nose, you should also see a doctor. In that case, the bleeding is likely localized in the back, upper part of the nose. Stopping the nosebleed in such cases is often more challenging.

If nosebleeds appear frequently without any obvious reason, a doctor should also be consulted.

Frequent nosebleeds: Cauterization

If the above mentioned urgent measures fail to stop the bleeding, or if the nosebleed happens repetitively, the doctor can cauterize the blood vessels (sclerotherapy). This is done under "local anesthesia" or local numbing, by means of electrocautery, laser or chemical cauterization with silver nitrate. Whenever possible, sclerotherapy should be performed on one side only, as otherwise the nasal septum may be harmed. The bleeding can be stopped this way in about 80% of the cases.

Nasal cautery - follow-up care

After sclerotherapy, an ointment should be applied to the nose to avoid drying out and damage to the nasal mucosa. This can prevent another bleeding.

For the first 1-2 weeks following nasal cautery, patients should avoid blowing their nose vigorously and refrain from sports, sauna visits, etc. It may also be advisable to arrange for a check-up by an ENT specialist.

What clinics and doctors specialize in nosebleeds?

If you're in need of a doctor, you expect the best medical care possible. So of course patients are curious to find out what clinic to go to. As there is no objective way to answer this question and a legitimate doctor would never claim to be the best, patients must rely on a doctor's experience.

Let us help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in the field of nosebleeds and are looking forward to your inquiry or wish for treatment.