Introduction
Nosebleeds, known as epistaxis, can affect both adults and children. They can be embarrassing or stressful when they unexpectedly occur. A small, one-off nosebleed is often not significant, but when episodes are recurrent or if they always occur from one side of the nose, they need to be investigated.
Causes
A dry nose, hot weather, blood thinning medications and uncontrolled blood pressure are relatively common causes of epistaxis. In children, nose picking commonly causes bleeding. Rarely, tumours inside the nose can be a source of nose bleeds. These are easily ruled out with nasendoscopy (looking inside the nose with a small camera). Very rarely, epistaxis can be the first presentation of a bleeding disorder, but patients are usually aware of easy bruising or bleeding from other areas e.g. the gums when brushing teeth.
Diagnosis
Nasendoscopy allows both nasal cavities to be examined from front to back and in most cases will determine the cause of epistaxis and allow appropriate treatment to be initiated. In some cases, blood tests to rule out a generalised bleeding disorder may be requested.
Treatment
Commonly, prominent blood vessels on the nasal septum (partition between both nostrils) will be identified and can be cauterised with silver nitrate. Keeping the nose moist with salt water sprays or applying Vaseline to the nostrils often reduces the frequency of epistaxis. Sometimes, surgery is required to tie off one of the blood vessels further back in the nose. Some other causes of epistaxis, such as tumours, have individualised treatments, so a thorough examination with nasendoscopy should be performed followed by tailored treatment.
Dr Levin can demonstrate simple first aid measures to control your nose bleeds and limit their duration, as well as perform cautery in both children and adults. He can assist with both diagnosing and managing other causes of epistaxis after performing nasendoscopy in his rooms.