Nose bleeds

The nose is a very vascular area of the body, which makes the nose more susceptible to bleeding.

Causes

We can prevent several factors that increase the chance of a nose bleed:

• high blood pressure
• taking blood thinners
• irritation or inflammation of the nose due to allergies, common colds, sinusitis, etcetera
• nasal septum deviation: the change in the air circulation around a nasal septum deviation can irritate the nasal mucosa.
• age: at a young age (typically during puberty), there is a strong flow of nasal mucous.

Prevention

• A nose bleed can really look scary even though you are actually only losing a small amount of your total blood volume. Panic only increases the bleeding pressure, which only makes the nose bleed more.
• Bend your head over so that the blood runs out along the nose and not down your throat.
• Blow your nose until all the blood clots are out of your nose.
• If you have fast-acting nasal drops or sprays, you may use these. You may also place cotton balls in the nose to stop the bleeding.
• Pinch your nose completely shut for twenty minutes (continuously). It is important to pinch your nose shut at the nostrils (the soft part of your nose). Pinching the bony (hard) part of your nose does not have any effect at all.
• Place an ice pack on your neck and drink a glass of ice-cold water.

If the nose bleed continues despite these measures, you should seek medical attention.

The ENT physician will look at your nose with a forehead lamp and/or an endoscope.

After local anaesthetic, the vessels responsible for the bleeding will be closed with a product. Afterwards, the wound in your nose will be cared for with a salve. It is sometimes necessary to use a bit of electricity to ‘burn’ the blood vessels. This is called bipolar cauterisation.

The nose may also be temporary packed (with a tamponade) using a gauze sponge or with a small balloon that is inflated in the nose. If a tamponade remains in the nose for more than 48 hours, you must take antibiotics to prevent an infection from forming in the nasal sinuses. The nose will continue making mucous as a reaction to a foreign object (in this case, the tamponade) in the nose.

In rare cases, general anaesthesia is necessary to stop severe or recurrent bleeding. This is often the case when the bleeding is caused by a blood vessel in the back of the nose. This type of nose bleed is not easily accessible and, for this reason, not easy to treat at the clinic.

Latest publication date: 13/12/2023
Supervising author: Dr Vermeiren Judith