Epistaxis

Epistaxis (also known as nosebleeds) which can happen at any time, most often occurs when the air suddenly turns cold and dry, especially in the winter season. The source of the nosebleeds usually is in the very front of the nose on the septum where the air entering the nose is at its most dry state. The septum is a wall that divides the right and left nasal cavities. Note that epistaxis is a particular problem in individuals with a deviated septum (correctable by a surgical procedure known as septoplasty) due to turbulent nasal airflow which creates a further drying effect. Sinus infections and allergies may also exacerbate nosebleeds.

What do I do if I have a nosebleed?

Pinch your nose firmly NOT over the bone, but just below it as shown below. One should keep the nose pinched for at least 10 minutes as that is how long it takes to create a scab. Should this measure fail, using a nasal decongestant such as Afrin or Zicam may help before pinching the nose for another 10 minutes.

What do I do after a nosebleed?

There are some conservative measures one can try first before going to see a physician.

NO nose-blowing for at least 2 weeks (blowing the nose just rips the scab off causing it to bleed again). It is OK to dab at the nose or gently pinch the nose to milk out secretions.
NO nose-picking which may also rip scab off resulting in bleeding.
Sneeze out the mouth (do NOT sneeze out your nose).
Keep a humidifier going in the bedroom with the door closed to raise the ambient humidity.
Gently apply a saline gel (ie, NasoGel or equivalent) around the inside entrance of your nose with a q-tip 3 times per day.
Use a saline nasal spray every 2 hours to keep things moist in the nose.
Use a nasal emollient like ponaris (akin to chapstick for dry cracked lips, but for the nose).
Use a nasal decongestant (ie, Afrin, Zicam) for no more than 3 days. Do NOT use for more than 3 days due to risk of addiction (rhinnitis medicamentosa).

What options can Drs. Phillips or Chang provide for epistaxis?

Silver nitrate cauterization. May need to be repeated up to 3 times spaced 2 weeks apart.
Nasal packing.
Prescription medications including CME Nasal Spray (an oil-based spray that is akin to chapstick for the nose).
Surgical treatment (septoplasty, surgical cauterization, etc).
Studies (CT/MRI scans, nasal endoscopy, etc to look for more sinister causes of nosebleeds).

For more information, please contact our office to make an appointment.

Any information provided on this Web site should not be considered medical advice or a substitute for a consultation with a physician. If you have a medical problem, contact your local physician for diagnosis and treatment.