The Science Behind Nosebleeds

Nosebleeds are common, messy, and sometimes scary-but how serious are they? Fortunately, most of the time a bloody nose is just a nuisance.  Occasionally, however it can signal more serious medical conditions. 

The formal medical names for a nosebleed is epistaxis or nasal hemorrhage.  Nosebleeds are more common in children than adults but grown-ups aren't immune to them. The nose receives a healthy blood supply from the carotid arteries on both sides of the neck.  The inside of the nose is lined with delicate skin and mucous membranes that are supplied with lots of tiny blood vessels. These tissues are easily irritated and inflamed due to common colds, allergies, sinus infections, chemical irritation, and dry or cold air. 

If someone blows too hard, scratches or picks the inside of his nose, the blood vessels break and blood leaks out of the nostrils or down the back of the throat.  Since the nose sticks out right in the middle of the face, it is vulnerable to injury.  Even a mild bang on the nose can cause bleeding. Nosebleeds often seem scarier than they actually are.  Because they receive so much blood supply, noses can bleed a lot and still not be a medical emergency

There are two types of nosebleeds:

  • Anterior nosebleeds are the most common kind (especially in children) and come from irritation of the front of the nasal septum, the tissue that separates the two sides of the nose. In addition to the common irritants described above, anterior nosebleeds can occur with overuse of nasal decongestants, at high altitude or due to medications that slow blood clotting time (including aspirin, nonsteroidal anti-inflammatories and anticoagulant medications). Most anterior nosebleeds are easy to treat at home and quit bleeding within five to ten minutes.  
  • Posterior nosebleeds start further back in the nose and sinuses (the nasal cavities behind your facial bones) and are more common in adults.  This type of nosebleed might produce more blood, be more difficult to control, and may require more serious medical attention.  They might be caused by sinus infection, high blood pressure and rarely, serious diseases like leukemia, liver disease, or calcium deficiency. 

How do you know if you need medical attention?  Follow our tips (listed below) on how to stop a nosebleed.  If bleeding doesn't stop, it seems like too much blood is being lost, or nosebleeds occur frequently, call your physician.  If nosebleeds ever include symptoms like dizziness, loss of consciousness, extreme pain, or profuse bleeding, seek immediate emergency medical treatment.

How do you stop a nosebleed?

  • Grab a towel and place it in front of the nose to catch blood.
  • Pinch the soft tissue about halfway between the tip of the nose and the bridge.  Continue applying pressure for at least five to ten minutes. 
  • Lean forward to allow blood to drain out of the nose onto the towel, instead of down the throat and into the stomach. 
  • Don't lie down, and be sure to keep your head above your heart.
  • Apply an ice pack to the nose and face to reduce inflammation and help constrict blood vessels.

If bleeding doesn't stop after 20 minutes, go to the doctor or emergency room.  He may apply nasal packing (gauze inside the nose), use cautery to seal blood vessels with heat, or even perform surgery if needed.   



Sources:

Medical News Today, What Is a Nosebleed? What Causes Nosebleeds?
Article Date: 22 Sep 2009
http://www.medicalnewstoday.com/articles/164823.php

American Academy of Family Physicians, Family Doctor.org, Nosebleeds
Written by familydoctor.org editorial staff.
American Academy of Family Physicians
Reviewed/Updated: 11/09
Created: 09/96

Medline Plus - National Institutes of Health
Nosebleeds
http://www.nlm.nih.gov/medlineplus/ency/article/003106.htm

Updated 10/18/09