David Poon, BSc Immunology and Infection, PharmD Student
Ugh… Not Again
I’ve been a victim of epistaxis all my life. Also, I can barely pronounce epistaxis, so I’m going to refer to it by its common name: a bloody nose. Most of us had a nose bleed before – maybe once or twice in the past year. However, if you’re like me, you might get them more frequently. The question is: should you be concerned? Join me today as we discuss the causes of a bloody nose and things you can do to reduce its frequency.
There are many small blood vessels close to the surface inside of the nose. These small blood vessels are fragile and can be easily damaged. Once damaged, blood can freely flow out of these blood vessels, and we experience what is known as a bloody nose. Although bloody noses are more common in children ≤10 years old, they usually resolve on their own and don’t require hospitalization.1 The average age of hospitalization is about 70 years old for a bloody nose, and these episodes are often associated with medication-related factors. The following table outlines other factors that may increase the risk of a nose bleed:
Never Fear, Treatment Options are Here
You have probably already heard of some treatment options for a bloody nose, whether it be from what your parents told you when you were younger or something you found online. First, I’ll provide some recommendations made by the French Society of Otorhinolaryngology. Afterwards, I will provide some tips that have worked well for me in the past.
French Society of Otorhinolaryngology Recommendations:
- Sit with head raised while leaning slightly forward
- Pinch the narrow, soft part of the nose, above the nostril, for 10 minutes
- Remove any blood clots
- Repeat steps 1-3 as required
David’s Personal Therapeutic Tips:
While following the above process outlined by the French Society of Otorhinolaryngology, I find it helpful to use rolled up gauze/tissue to stop the flow of blood. I recommend soaking the gauze/tissue in cold water and wringing it out before use. Roll the gauze into a cylindrical shape and insert into the nostril(s) that’s bleeding. Pinch the narrow, soft part of the nose just above the nostrils, as outlined above. Repeat these steps when the gauze/tissue becomes visibly bloody. I also recommend applying cold water to the face, neck and wrists to cool the body’s temperature.
Drug Therapy Options:
In terms of drug options, you can purchase 0.05% oxymetazoline, which is a topical decongestant in the form of a nasal spray. It works by constricting the small blood vessels of the nose. You can purchase this nasal spray without a prescription from a pharmacy. Use 2 sprays into each nostril, and pinch the narrow soft part of the nose above the nostrils for 10-15 minutes. To prevent rebound congestion, avoid using oxymetazoline for more than 5 days. Be sure to consult your pharmacist or another healthcare provider before trying this option to ensure the medication is a safe option for you.
- If bleeding persists
- If the person feels weak and presents with pale, cold/clammy skin, rapid heart rate and shallow breathing
The Bottom Line
Whether you follow the French Society of Otorhinolaryngology recommendations or David’s Therapeutic Tips, there is hope to treat a nose bleed! Next time you or someone you know has an epistaxis episode, you’ll know exactly what to do.
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- DynaMed Plus [Internet]. Ipswich (MA): EBSCO Information Services. 1995 – . Record No. 115407, Epistaxis; [updated 2018 Mar 28]; [about 20 screens]. Available from http://www.dynamed.com/login.aspx?direct=true&site=DynaMed&id=115407. Registration and login required.