Fatigue, stress, heat… Several causes can explain a nosebleed. But how to stop it? Adult, child: advice with our doctor from the Medical Emergency Department of Paris.
Nosebleed (also called “epistaxis” medically) is a generally mild ENT disorderthat touches mainly children from 2 to 10 years old and the adults after 70. But it can affect anyone, at any age. This bleeding translates a lesion of the vascular network which irrigates the nasal mucosa, most often in an area called “vascular spot“. Generally “a bleeding stops after 5 minutes, as the platelets arrive very quickly” explains Dr. Sebastian Marciano, doctor at the Paris Medical Emergency Department. In the meantime, what do we do? Dr. Marciano advises:
- sit still and keep your head up (don’t tilt your head back otherwise the blood will flow into the throat).
- do a bi-digital compression (with two fingers) i.e. press on the top of the nose because that’s where all the ships are, for at least 2 minutes.
- gently blow your nose to evacuate the clots.
- if the bleeding continues, it is advisable to insert a hemostatic wick (type Coalgan) in the nostril to allow coagulation (see a doctor if you don’t have one at home).
- after 30 minutesif the bleeding does not stop or is very heavy, see a doctor or go to the emergency room.
- in case of dry nose, put on some cream Homeoplasmin at the entrance to the nose to hydrate the mucous membranes.
When to worry about a nosebleed?
A nosebleed should alert if:
- The bleeding is abundant
- The bleeding touch both nostrils
- The flow is backwards: blood clots are then observed in sputum
- Bleeding affects the general condition and causes significant pallor or fatigue
In most cases, epistaxis is benign : the bleeding is light (drop by drop) and unilateral. It also has no impact on the general condition of the person. “Often, bleeding is overratedin the sense that people who have it forget that the discharge does not contain only bloodemphasizes Doctor Handschuh. The nose begins to flow at the same time, which sometimes gives the impression of abundant flow.”
Causes: what are the reasons for a nosebleed?
Several causes can explain this hemorrhage in the nose, from the most benign (most often) to the most serious: “It is sufficient that the person is blowing their nose a little hard or it is hot so that it bleeds from the nose for half an hour, three-quarters of an hour, we are sometimes obliged to send them to the hospital to wick them more deeply because there is a risk of anemia” explains Dr. Marciano.
► Bleeding may occur after blowing your nose or sneezing a little hard during a cold or sinusitis for example.
► A sudden change in temperature, especially in children, for example when we go from the cold indoors to the warm outside.
► The air is dry. “We must also be careful that the air is not too dry because the dryness of the mucous membranes promotes bleeding”, explains Dr. Sebastian Marciano.
► A trauma (such as scratching) at the vascular spot, nasal trauma with or without fractureor even a violent effort.
► The presence of a foreign body (especially among young children)
► A vascular abnormality (coagulation defect, arterial hypertension). “Bleeding is not always the result of a mucosal problemadds Doctor Richard Handschuh, general practitioner.
► Certain medications (blood thinners, antiplatelet drugs (aspirin), decongestant nasal sprays) can cause nosebleeds.
► “The use of drugs or alcohol can also lead to bleeding. Although epistaxis is generally mild, people suffering from alcoholism will need to be more vigilant about this symptom, which in this case can reveal a liver problem“says Doctor Handschuh.
Can an allergy cause a nosebleed?
“When the bleeding is chronic, we can think of an allergy, continues Dr. Marciano. Allergy itself doesn’t make your nose bleed, it’s blowing your nose too much that makes it bleed.”
Can stress make your nose bleed?
A big stress rush can make your nose bleed. “We also see quite a few students get nosebleeds at the time of the baccalaureate points out Dr. Marciano. Because, “a rise in stress, tension vasodilates the blood vessels”.
What cancer can cause nosebleeds?
“When there is a tumor, there isnot hyper-vascularization, the arteries are weakened“ explains Dr. Marciano. cavum cancer (upper part of the pharynx) or cancer of the ENT sphere can cause bleeding, for example. “A heavy smoker or who inhales a lot of smoke has a higher risk of getting ENT cancer. If he’s bleeding a lot from his nose, it’s a sign of cancer. continues the doctor. A cabinet maker, a carpenter or someone who works in chemicals and has been bleeding from the nose for a week, we will also test for cancer.
When to consult a doctor ?
If the nosebleed is severe, if it recurs frequently and/or if it lasts a long time, it is necessary to consult a doctor quickly to precisely identify the cause, “if there are no polyps, an infection, more rarely an ENT cancer” explains Dr. Marciano. In rare cases, a nosebleed can reveal the presence of an underlying pathology. Cauterization of the vascular spot in the doctor’s office is sometimes considered in case of repeated bleeding, to reduce the risk of recurrence.
Thank you to Dr Sebastian Marciano from Paris Medical Emergencies and Richard Handschuh, general practitioner.