Nasal bleeds scientifically termed as epistaxis can be dramatic and frightening.

In most circumstances nose bleeds are not serious and usually can be managed domestically, although sometimes medical intervention may be necessary.

 Nose bleeds are categorized based on where they originate, and are described as either anterior when originating from the front of the nose or posterior when originating from the back of the nose.

Anterior nose bleeds make up more than 90 percent of all nose bleeds. The bleeding usually originates from a blood vessel on the nasal septum, where a network of vessels meets.

 Anterior nose bleeds are usually easy to control, either by measures that can be performed at home or by a health care practitioner.

Posterior nose bleeds are much less common than anterior nose bleeds. They tend to occur more often in elderly people. The bleeding usually originates from an artery in the back part of the nose. These nosebleeds are more complicated and usually require admission to the hospital and management by an Ear, Nose and throat specialist (E.N.T Specialist).

Nasal bleeding can occur at any age, but are more common in children below 10 years and adults above 50 years of age.

Currently Scientific researchers are working hard to trace the exact cause of frequent nasal bleeding complaints in some families and not in others.

Though genetic factors might be considered in this case, environmental influence and some circulating allergens might contribute to this difference.

Some people bleed when exposed to high temperatures whereas others bleed under normal circumstances. 

It is important to notice that most nose bleeds do not have an easily identifiable cause. Trauma is one of the identifiable causes of nasal bleeding. Nasal bleeding can be caused by trauma to the outside of the nose from a blow to the face or trauma to the inside of the nose.

Other factors that may predispose a person to nosebleeds include nasal and sinus infections, exposure to warm, dry air for prolonged periods of time, allergic rhinitis due to circulating allergens in the air that cause an irritation and consequent inflammatory reactions to the nasal cavity.

Other conditions to consider in nasal bleeds include foreign body invasion, nasal surgery, perforated nasal septum and cocaine use.

In some rare circumstances an underlying disease might lead to nose bleeds or taking certain medications may cause a nose bleed and sometimes make it more difficult to control.

From the medical perspective, inability of the blood to clot is most often due to blood-thinning medications such as warfarin (Coumadin), clopidogrel bisulfate (Plavix), nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin. Topical nasal medications, such as corticosteroids and antihistamines, may sometimes lead to nose bleeds.

Liver disease, chronic alcohol abuse, kidney disease, platelet disorders, and inherited blood clotting disorders can also interfere with blood clotting and predispose to nosebleeds.

Vascular malformations in the nose and nasal tumours have contributed to nose bleeds.

High blood pressure may contribute to bleeding, but is rarely the sole reason for a nosebleed. It is often the anxiety associated with the nosebleed that leads to the elevation in blood pressure.

Our above discussion has mainly focused on nose bleeds in adults yet nose bleeds are more common in children than adults.

Nosebleeds in children can be an anxiety-provoking event, both for the parent and the child. However, most nosebleeds in children are self-limiting and benign, and can typically be managed at home.

 Nosebleeds in infants are unusual and require further evaluation by a health care practitioner. Though most nosebleeds in children are spontaneous and occur infrequently, some children may experience more frequent, recurrent nosebleeds.

The most common cause of nosebleeds in children is from minor trauma, upper respiratory infections, allergic rhinitis, exposure to warm, dry air and nasal medications such as corticosteroids.

 Less common causes of nosebleeds in children include vascular malformations, leukaemia, nasal tumours, and various blood clotting abnormalities. An accidental ingestion of blood-thinning medication for example, warfarin is also a rare cause of nosebleeds in children.

Prevention of nasal bleeding in both children and adults is to counteract the above causes. Most nosebleeds occur during the winter in cold, dry climates. If a person is prone to nosebleeds, use a humidifier in the home. Petroleum jelly (Vaseline), antibiotic ointment, or a saline nasal spray may also be used to keep the nasal passages moist.

If the nose bleed is related to an underlying medical condition such as liver disease or a chronic sinus condition need to follow the health care practitioner’s instructions to keep these medical problems under control.

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