Let’s Talk Nosebleeds
Bleeding from the nose can be a minor irritation or sometimes, it can be severe enough to hospitalize a patient.
The tissues of the nose have a very rich blood supply. Almost everyone has had minor injuries to their nasal tissues causing a small amount of bleeding that usually stops within a few minutes. Many children under the age of 8 have temporary nasal bleeding often associated with allergies. Usually, these will stop on their own after a few minutes.
More severe or prolonged bleeding from the nose is rare in the general population but does occur, especially over the age of 50. Almost all bleeding is from the nasal septum, which is the wall between the two nasal passages in the middle. The nasal septum has a particularly excellent blood supply coming from three different small arteries. The area that bleeds is usually in the front, which is a transition zone between the dry scan of the external nose and the more moist nucleus-coated membrane farther back.
Nosebleeds are usually associated with cooler, dry air. When winter arrives in Texas, the humidity will drop and we start turning on the heat indoors, which is usually very dry. This contributes to cracking of the membranes, especially in the front of the septum, with tiny blood vessels opening up if they are close to the surface.
Another very large factor contributing to nasal bleeding is the use of medications which we think of as “blood thinners.” These include prescription drugs such as Coumadin, Eliquis, or Plavix but also include the use of aspirin. Even so-called low dose or baby aspirin of 81mg a day is enough to contribute to nasal bleeding.
Controlling the nosebleed at home is usually not that difficult. If you or a family member is prone to nosebleeds, Afrin (oxymetazoline 0.05%) nasal spray should be in your home medicine cabinet. This medication acts quickly to constrict blood vessels and can often stop bleeding.
If you are having bleeding from your nose that lasts more than 5 minutes, first blow your nose forcefully to remove all blood clots from the nasal passage. Blood clots actually prolong bleeding in your nose. After blowing out as much blood as possible, spray the side that is bleeding with Afrin, 3 or 4 sprays. Then wait 5 minutes and repeat the process of forceful blowing and 3-4 sprays of Afrin. Then gently pinch the lower half of the nose together. Lean forward (do not lay back flat as this will just make the blood go into your throat). Sometimes, soaking a paper towel rolled up with Afrin and placing it in the bleeding side while adding pressure will also help. Pinching the upper half of the nose (hard bone) does not do any good at all.
Saline nasal sprays containing moisturizers such as xylitol, (Xlear spray) are helpful in keeping the nasal passages moist to prevent bleeding so they can be used very frequently. Keep this information at hand in the upcoming months of cooler, dry air.
