Who is likely to suffer from nosebleeds?
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Anyone can experience a nosebleed.
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Nosebleeds are slightly more common in men than women.
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Nosebleeds tend to affect the elderly but are also very common in children.
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Over half of children aged between 6 and 15 years old have nosebleeds regularly.
When are nosebleeds likely to occur?
Nosebleeds are likely to occur either in the morning or late evening but can happen at any time and often appear unexpectedly.
What causes nosebleeds?
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We suspect that nosebleeds happen when a fragile blood vessel within the nose breaks, perhaps after a minor injury or infection.
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High blood-pressure and drinking a lot of alcohol may also increase the risk of nosebleeds. It is sensible for all patients to have their blood pressure checked regularly, especially if they are having repeated nosebleeds.
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Nosebleeds are a common side-effect of anti-thrombotic medication. Aspirin, warfarin, clopidogrel and apixaban are common examples of anti-thrombotic medication. Anti-thrombotic medications change the way blood clots in the body and are commonly prescribed for patients with heart disease. If you are taking any of these medications and you develop nosebleeds, do not stop taking your medication unless advised to do so by a doctor.
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In children, crusting inside the nose is common and is caused by a minor skin infection called Staphylococcus aureus. Doctors do not know if this infection actually causes nosebleeds. The infection may simply be introduced into the nose from the child’s finger during nose-picking. This is a common habit in children and can damage the lining of the nose, leading to nosebleeds.
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Nosebleeds can be caused by problems in blood clotting. If you tend to bleed for a long time after a minor cut, tooth extraction or if your skin bruises easily, you might need some simple blood tests to check how long it takes your blood to clot.
What should you do if you have a minor nosebleed?
Minor bleeding can often be controlled by pressing on the fleshy part of the nose for 15 minutes. This is shown in the photograph below. If this is the first time you have had a nosebleed and the bleeding stops after 15 minutes with pressure, no further treatment or tests are likely to be needed. You should avoid straining at the toilet and strenuous exercise for a few days after you have had nosebleeds.
When to see your doctor
If the bleeding is severe and continues after applying pressure for 15 minutes then you need to be seen by a doctor immediately.
How do doctors treat nosebleeds?
‘Direct’ treatment for nosebleeds involves ‘sealing off’ the bleeding area inside your nose. We will do this by applying a chemical called ‘silver nitrate’ to the lining of your nose. This is usually done after putting some local anaesthetic solution into the nose. This procedure is not painful and can be a very effective treatment for nosebleeds.
Another ‘direct treatment’ for nosebleeds is to pass a very weak electric current across the blood vessel. This is called ‘diathermy’. This treatment is performed by ENT doctors using a small telescope inside the nose. The telescope allows us to find the blood vessel that is bleeding and then use diathermy to stop the bleeding. Diathermy can also be a very successful treatment for nosebleeds and is usually performed under local anaesthetic.
Summary
Nosebleeds can affect all ages. In most cases the cause of the bleeding is unknown. Most bleeds are relatively minor and can be treated easily. Some patients with severe bleeding may need admission to hospital. If the bleeding does not stop, or if you are on medication such as warfarin, then you may need to be seen by an ear, nose and throat specialist.
We can often stop the bleeding by cauterising the blood vessels inside the nose. In some patients with very severe bleeding an operation may be required. We will be able to explain the treatment required for your nosebleed.
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Weavering,
Maidstone,
ME14 5FT
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Borough Green,
Sevenoaks,
TN15 8BB
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42 High St,
Tunbridge Wells,
TN1 1XF
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