Epistaxis or “nosebleeds” are very common and can occur for a variety of reasons. The inside lining of the nose has a rich blood supply, with blood vessels located very close to the surface. When these vessels break, it can cause the nose to bleed. Most of the time, a nosebleed resolves on their own. Keeping your head elevated and a constant pinching the front of your nose (like you are diving underwater) for 15 to 20 minutes will help control the bleeding.
In dry climates (such as the Northeast during winter months), the lining of the nasal cavity in front of the nose may become too dry and damage the blood vessels. Preventing this with humidifiers in the home can be helpful and also reduce frequency of upper respiratory infections.
When the bleeding is aggressive and persists beyond the above measures, patients should seek emergency care. In some cases, packing the nasal cavity in the emergency room setting will stop the bleeding.
If that is not enough, the broken blood vessel may need to be treated. This is sometimes done through cautery, a minor procedure in which the area that’s bleeding is slightly burned to block the vessel from bleeding. Sometimes, an operative procedure that identifies and clips the problematic blood vessel may be necessary. In rare cases, embolization is recommended to stop the bleeding, in which a radiologist will perform an angiogram and inject particles into the blood vessels.
If you experience recurrent episodes of brisk bleeding, you should be evaluated by an ear, nose, and throat specialist. There can be other underlying reasons for recurrent nosebleeds, such as vascular abnormalities or tumors. An endoscopic exam and CT or MRI scan may be needed to further evaluate the bleeding.
If you or a loved one experiences recurrent nosebleeds, request an appointment online or call us at 617-573-3030. If an aggressive nosebleed needs to be treated, please seek immediate medical attention at the Mass. Eye and Ear Emergency Room.