What is Epistaxis: Causes, Treatment and Prevention

Max Lab

Jan 16, 2024

There are a number of blood vessels present in one’s nose, which help warm and moisten the air one breathes. At times, these blood vessels can get irritated or damaged, causing bleeding in the nose or epistaxis. 

What is Epistaxis?

Epistaxis, the medical term for a nosebleed, is a condition that is characterized by bleeding from the blood vessels of one’s nose. The word Epistaxis is derived from the Greek word “epistazein” translating to “bleed from the nose”. It is a common occurrence affecting both children and adults which although bothersome, is usually not a cause for major concern.

Who Can Get Epistaxis?

Although anyone can get epistaxis, some people are more likely to get it than others. They include-

• Children between the ages of 2 to 10

Children in this age group are susceptible to nosebleeds due to colds, dry air and sticking fingers or objects into their noses.

• Adults between the ages of 45 to 80

Epistaxis is common in adults between this age group as blood may take longer to clot over time. Further, conditions such as high blood pressure or a bleeding disorder may also cause the nose to bleed in adults.

• Pregnant Women

Epistaxis is common in one’s pregnancy period as the blood vessels in the nose tend to expand. This expansion leads to more blood flow, and puts pressure on the smaller blood vessels, causing them to rupture and bleed.

• Individuals on Medications

Individuals who are taking certain medications such as blood-thinning drugs may also be susceptible to nosebleeds.

Types of Epistaxis

There are two major types of epistaxis, depending on the site from where they originate.

• Anterior Epistaxis

Anterior Epistaxis refers to a nosebleed that starts from the anterior or frontal part of the nose. There are a number of small capillaries and blood vessels in this part of the nose that are delicate and can be injured easily, causing the nose to bleed. This is the most common type of epistaxis, and a home remedy is enough under most circumstances to treat it.

• Posterior Epistaxis

A posterior epistaxis originates from a deeper part of the nose. It usually occurs due to a bleed from larger blood vessels located at the back of the nose, and may result in heavy bleeding. This type of nosebleed may also cause the blood to flow down the back of one’s throat, leaving a metallic taste in one’s mouth. Medical treatments may be required for the management of posterior epistaxis.

Causes of Epistaxis

There can be a number of factors causing bleeding from the nose, the most common causes include: -

• Dry Air

Exposure to dry air or heated indoor air can lead to nasal dryness and irritation. This makes the blood vessels more prone to rupturing when rubbed or picked.

• Trauma

Injury to the nose, resulting from accidents, sports activities, or nose-picking can also cause bleeding.

• Infections and Allergies

Respiratory infections such as colds or sinusitis, which have repeated episodes of sneezing, coughing or nose blowing, can lead to epistaxis. Further, allergic reactions that cause inflammation of the nasal lining can cause bleeding as well.

• Medications, Drugs and Nasal Sprays

Taking blood thinner medications such as painkillers can also cause one’s nose to bleed. Additionally, the use of recreational drugs inhaled through the nose leads to bleeding. Nasal sprays may also irritate the nasal membranes, causing a nosebleed.

• Deviated Septum

The thin wall of cartilage found at the centre of one’s nose that divides it into two nasal chambers is called the septum. An abnormal or displaced shape of the septum may result in frequent nosebleeds.

• Disorders and Pre-existing Health Conditions

Bleeding disorders such as haemophilia or pre-existing health conditions such as hypertension, or nasal polyps, may lead to epistaxis.

• Pregnancy

The expanded blood vessels in the nose during pregnancy can create more pressure on smaller blood vessels, leading to rupture.

Treatment of Epistaxis

Depending on the severity, the treatments for epistaxis can be divided into at-home treatment and hospital-setting treatment.

At-home Treatment

Treating epistaxis at home includes the following steps-

• Start breathing through your mouth and sit in an upright position.
• Lean slightly forward, tilting the head forward as well.
• Pinch the soft part of the nose for about 15-20 minutes, making sure that the soft part is pressed against the hard centre of the nose.
• Applying an ice pack on the bridge of the nose can also help slow down the bleeding.
• In case the bleeding does not stop, an over-the-counter nasal spray may be used. However, prolonged use of nasal sprays may increase the chances of a nosebleed.

Under most circumstances, this simple home remedy for treating epistaxis is enough.  However, one should see a healthcare practitioner in case of recurrent episodes or non-stop bleeding.

Medical Treatment

Treatment for epistaxis in a hospital setting may include: -

• Nasal packing involves the insertion of gauze or nasal sponges to create pressure at the site of the bleeding.
• The healthcare professionals may also stop the bleeding through a procedure called cauterization. This procedure involves the use of heat energy to seal the blood vessel.
• Surgery may also be done, in case of a broken nose or a deviated septum.
• Lastly, certain medications may be prescribed to manage epistaxis.

Prevention of Epistaxis

There are some tips that one can follow to prevent epistaxis from occurring. These include-

• Using a saline nasal spray 2-3 times a day can help in keeping the nasal passages moist.
• Avoid blowing one’s nose too hard.
• Adding a humidifier to one’s room at night.
• Avoid inserting anything solid and sharp in one’s nose, including fingers.
• Using protective gear while engaging in activities that may result in injury to the face.
• Avoiding excessive use of nasal sprays.
• Keeping one’s fingernails short.

Thus, while epistaxis may be common, understanding its causes and adopting preventive measures can help one minimize its frequency, and promote overall health.