Epistaxis

Epistaxis, or nosebleed, is a common condition affecting individuals of all ages for various reasons. According to medical research, approximately 60% of people worldwide have experienced a nosebleed at least once in their lives, yet only 10% of these cases require medical attention.

Epistaxis occurs due to bleeding from the tissues lining the inside of the nose, and it may come from one or both nostrils. This condition affects both children—especially those aged 2 to 10 years—and adults between the ages of 45 and 80. While nosebleeds can be distressing, most cases are not serious.

  • Causes of Epistaxis
  • What’s the Link Between Weather and Epistaxis?
  • Types of Epistaxis
  • Symptoms of Epistaxis
  • Diagnosis of Epistaxis
  • Treatment of Epistaxis
  • How to Prevent Epistaxis

Causes of Epistaxis:

Some individuals may experience bleeding from one nostril, while others may have it from both—this is more common. Among the frequent causes of epistaxis:

  • Repeated sneezing

  • Foreign objects entering the nose

  • High blood pressure during sleep

  • Prolonged sun exposure

  • Cold or dry air, particularly in winter

  • Exposure to irritating chemicals

  • Facial trauma or accidents

  • Use of heaters during winter, which dry out the air

  • Certain medications such as decongestants and antihistamines

  • Sinus infections

  • Colds and allergies

  • Low platelet count, vascular inflammation, and capillary dilation

  • Vascular diseases like sudden high blood pressure with heart, lung, or liver complications

  • Sleep apnea


Less common causes include:

  • Pregnancy

  • Leukemia

  • Menstrual cycle

  • Elevated body temperature

  • Intense physical exertion

  • Nasal or facial surgeries

  • Vitamin deficiencies, especially vitamin C

What’s the Link Between Weather and Epistaxis?

Experts confirm that changes in temperature—whether hot or cold—can irritate the nasal passages and dry out the mucous membranes, leading to epistaxis. Proper hydration and nasal hygiene help reduce the risk of nosebleeds.

Types of Epistaxis:

There are two types of epistaxis:

Anterior Epistaxis:

Bleeding occurs from the front part of the nose due to rupture of surface blood vessels. This type is most common among children and often caused by minor trauma or injury.

Posterior Epistaxis:

Bleeding originates from deeper within the nasal cavity, affecting blood vessels near the throat. This form tends to be more severe, affecting adults and usually requiring urgent medical care.

Symptoms of Epistaxis:

Nosebleeds may occur suddenly, without warning, but can be accompanied by:

  • Headache

  • Tinnitus (ringing in the ears)

  • Dizziness or lightheadedness


Diagnosis of Epistaxis:

Diagnosis begins with a clinical examination by an ENT specialist to ensure no foreign object is present. The doctor will also ask about the patient’s medical history and may order:

  • Complete blood count (CBC) to detect blood disorders

  • Imaging tests like X-rays or CT scans of the nose and face

  • Blood pressure and heart rate monitoring

Treatment of Epistaxis:

Before treating a nosebleed, it is important to assess the amount and duration of bleeding. If bleeding lasts between 10 to 15 minutes, it typically resolves with home care. However, if it exceeds 20 minutes, immediate medical attention is advised.

Home treatment includes:

  • Wiping blood with a cloth or tissue

  • Avoiding lying down to prevent swallowing blood, which can irritate the stomach

  • Applying a cold compress on the nose

  • Pinching the nostrils forward and applying pressure with gauze for 10 minutes

  • Using nasal decongestant spray to constrict blood vessels

  • Avoiding bending backward, heavy lifting, or physical exertion for a few days

Medical treatments vary based on the cause and severity:

  • Removal of foreign objects by the doctor

  • Applying gauze or cotton to compress bleeding vessels

  • Cauterization of nasal blood vessels for recurrent bleeding

  • Surgery to ligate arteries near the bleeding site

How to Prevent Epistaxis:

To prevent epistaxis, follow these recommendations:

  • Maintain good home ventilation and avoid dry air

  • Avoid aspirin unless prescribed

  • Keep nasal passages moist with saline sprays or humidifiers

  • Protect the nose from foreign bodies or trauma

Though epistaxis is generally not dangerous, it should not be ignored if it occurs for more than 20 minutes a day. In such cases, medical consultation is essential to avoid possible complications like:

  • Swallowing blood, leading to nausea or vomiting

  • Significant blood loss

  • Anemia due to repeated or heavy bleeding