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Nose Bleeds


Have a bleeding nose is called “epistaxis”. Epistaxis is very common and is more prevalent around winter months when the air is dry and the humidity content is low.


Epistaxis is caused by a blood vessel breaking in the nose causing bleeding. The epistaxis can be either minor, or very troublesome. Epistaxis is classified anatomically as either anterior (front of the nose) or posterior (back of the nose). The vast majority of epistaxis is anterior and this form of epistaxis is thankfully not as severe as posterior epistaxis.

Anterior epistaxis

Anterior epistaxis is caused by a blood vessel at the front of the nose breaking open and causing bleeding. This bleeding is almost always self limiting. The causes of anterior epistaxis include:

  • Picking your nose
  • Having a cold
  • Trauma (breaking you nose)
  • Blood thinners (aspirin)

The sign that you have anterior epistaxis is that you have some blood on your upper lip. This may occur in the middle of the night or after you have picked your nose. If you do get some bleeding from your nose squeeze the tip of your nose as hard as your can with your head forward and mouth open. This will stop the vast majority of anterior epistaxis.

Following an event of epistaxis, Dr Robinson may find a blood vessel in your nose which requires cautery to get rid of the vessel. Another important thing to do after you have had an episode of anterior epistaxis is to ensure that you keep your nose moist with a product such as Vaseline so that the lining of the nose doesn’t crack again.

Posterior epistaxis

Posterior epistaxis can be a major bleeding event. Posterior epistaxis usually happens in the context of one or more of the following conditions:

  • Hypertension
  • Anticoagulation (Blood Thinners)
  • High cholesterol
  • Age over 65

Posterior epistaxis usually starts with bleeding noticed in the mouth. The bleeding doesn’t subside of its own accord and requires packing usually in a hospital. Once the bleeding has been stopped and the blood loss replaced, Dr Robinson will usually perform a procedure called a sphenopalatine artery ligation. This procedure is done through the nostril with no incision on the face and has a high success of stopping the posterior epistaxis.