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Alternative Names
epistaxis treatment

Bleeding from the nose, sometimes called epistaxis, is usually due to a damaged blood vessel that leaks blood. Nosebleeds can affect all ages, but are twice as common in children as in adults.

What is going on in the body?
When the blood vessels in the nose are damaged due to trauma or an underlying condition, they can bleed. Bleeding is most often limited to one nostril. If there is severe trauma to the nose or in certain kinds of blood disorders both nostrils may bleed.

What are the signs and symptoms of the disease?
Symptoms of a nosebleed include:
  • blood dripping from the nose
  • blood seen on a tissue paper after wiping or blowing the nose
  • tasting blood in the mouth without seeing it
What are the causes and risks of the disease?
There are several possible causes of a nosebleed. These include:
  • trauma or injury to the nose, which is the most common cause
  • nasal or sinus infection
  • excessive nose-blowing
  • uncontrolled high blood pressure
  • bleeding or clotting problem
  • tumour
  • cocaine use
  • the use of topical nasal steroid medications
  • dry mucous membranes in the nose due to low humidity
What can be done to prevent the disease?
A person should do the following to help prevent a nosebleed:
  • avoid trauma, if possible
  • avoid picking the nose
  • avoid excessive nose blowing
  • limit the use of topical nasal steroids or nose sprays
  • avoid cocaine use
  • get treatment for underlying causes such as high blood pressure
  • use a cool-mist humidifier to add moisture to the air
How is the disease diagnosed?
Nosebleeds are easily diagnosed when the person reports bleeding from the nose, or blood is seen coming from the nose during an examination.

What are the long-term effects of the disease?
Excessive blood loss can cause anaemia, or low blood counts, but this is extremely rare with nosebleeds. Repeated nosebleeds can be socially embarrassing. In the older and hypersensitive patient, the bleeding can be life-threatening.

What are the risks to others?
There are no risks to others because nosebleeds are not contagious.

What are the treatments for the disease?
The treatment of a nosebleed depends on the cause and severity. For a mild nosebleed, pinching the nose may be all that is needed to stop the bleeding. A person who has repeated nosebleeds or a nosebleed that doesn't stop needs further treatment. A doctor will examine the inside of the nose to find the source of the bleeding to figure out the best way to stop the bleeding.

Packing the nose with gauze or cotton can often stop a nosebleed, at least temporarily. If the nosebleed was due to simple trauma, this is often all the treatment that is needed. When the packing is removed, the bleeding has usually stopped.

If packing the nose doesn't stop the bleeding, topical anaesthesia and topical medication to shrink blood vessels may be given. Next, the doctor looks into the nose. If the doctor can see the broken blood vessel, it can be cauterised by applyinig a heat or electrical probe to stop the bleeding.

Sometimes the source of the bleeding cannot be seen easily. In these cases, a special tube is inserted into the nose to let the doctor see better. The vessel can be cauterised through the tube if needed.

If the cause of the nosebleed is a bleeding or clotting problem, sometimes transfusions or medications can stop the problem. If the cause is a tumour, surgery to remove the tumour may be required.

What are the side effects of the treatments?
Medications have side effects, such as stomach upset or allergic reactions. Transfusions may cause an allergic reaction or rarely, an infection. Any surgery can result in bleeding or infection.

What happens after treatment for the disease?
What happens after treatment depends on the cause of the nosebleed and the response to treatment. If the cause is trauma and the bleeding stops, no further treatment is required and the person can go back to their regular activities.

How is the disease monitored?
No monitoring is required unless nosebleeds happen over and over again or do not respond to treatment.

Author: Adam Brochert, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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