Epistaxis - Causes and How to Handle Nosebleeds
19/4/2025
We have all experienced a nosebleed at least once, commonly known as epistaxis. It is a frequent condition that can affect many people suddenly. But what is epistaxis? How does it happen?
The causes of epistaxis range from environmental to health-related factors. While it may seem alarming at first, handling it properly can help prevent serious complications later.
Epistaxis is defined as bleeding that occurs from the inner tissues of the nose. It is a common medical condition that happens for various reasons. It results from the rupture or irritation of small blood vessels in the nasal mucosa. Epistaxis can appear suddenly and is generally classified into two types:
– **Anterior epistaxis**: The most common form, occurring in the front part of the nose.
– **Posterior epistaxis**: Occurs in the back part of the nose and is often more complex.
2. Common causes of epistaxis
The causes of epistaxis are classified into local and systemic causes.
1.2. Local causes
– Traumatic causes: Such as nose picking with fingernails, which is one of the most common causes, especially in children.
– Post-surgical nasal bleeding
– Foreign body inside the nasal cavity
– Epistaxis after intense nose blowing, sneezing, or coughing
– Environmental factors leading to nasal mucosa dryness (e.g., cold and dry air, central heating, prolonged sun exposure)
2.2. Systemic causes
– Hypertension, the most common cause of epistaxis in adults.
– Coagulation disorders, such as Von Willebrand disease, sickle cell anemia, and others.
– Medication-related causes, including aspirin, clopidogrel, and nonsteroidal anti-inflammatory drugs (NSAIDs).
– Vascular causes, such as atherosclerosis.
3. How to manage cases of epistaxis
When experiencing a sudden nosebleed, try to stay calm and follow these steps:
– Sit upright and lean slightly forward to prevent blood from flowing into the throat, which can cause nausea or choking and worsen the bleeding.
– Pinch the soft part of the nose (known as the nasal wings) using the thumb and index finger for 5–10 minutes to help stop the bleeding.
– Avoid blowing the nose, talking, coughing, or applying any abdominal pressure, such as vomiting.
– If the bleeding persists for more than 15 minutes or is heavy, seek medical assistance immediately.
These simple steps are often effective in controlling most cases of epistaxis.
4. When should you see a doctor for epistaxis?
You should see a doctor for epistaxis when:
– Bleeding lasts more than 15–20 minutes despite home treatment attempts.
– Heavy bleeding that seems abnormal.
– Frequent nosebleeds without a clear cause.
– Nosebleeds following a severe injury, such as nasal fractures.
– Use of anticoagulant medications.
5. How to prevent epistaxis
To reduce the likelihood of epistaxis, follow these tips:
– Keep the air humid regularly.
– Take care of your nose and avoid excessive rubbing or inserting objects into it.
– Avoid irritants such as strong odors, smoke, or chemicals.
– Protect yourself from injuries by wearing protective gear during sports or activities that may pose a risk to the nose.
– Monitor blood pressure, especially in older adults, as high blood pressure can increase the risk of epistaxis.
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