Nosebleed: is it dangerous, how to stop it?

Nosebleeds happen to everyone, at any age. If it is most of the time without gravity, a nosebleed that persists or is too recurrent should lead to consulting a doctor. The nosebleed is called theepistaxis in the medical environment. What are the reasons what can explain a nose bleed? When to worry? Is it dangerous to bleed from the nose? How to stop nose bleeds? What cancer causes nosebleeds?

Definition: what is a nosebleed?

Nosebleed (also called epistaxis medically) is a generally mild ENT disorder, which mainly affects children from 2 to 10 years old and adults after 70 years. 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.

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.

► 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 the child, for example when one passes from the cold inside to the hot outside.

► A trauma (such as scratching) at the vascular spot, nasal trauma with or without a fracture, or even violent exertion.

► The presence of a foreign body (especially in 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 (anticoagulants, antiplatelet agents (aspirin), decongestant nasal spray) can cause nosebleeds: “It is enough for the person to blow their nose a little hard or for it to be hot for them to bleed from the nose for half an hour, three-quarters of an hour, we are sometimes obliged to send them to the hospital for the wick more deeply because there is a risk of anemia” explains Dr. Marciano.

► “The use of drugs or alcohol can also lead to bleeding. If the epistaxis is generally benign, people suffering from alcoholism will have to be more vigilant in the face of this symptom, which in this case can reveal a liver problem.“, specifies Doctor Handschuh.

► 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.

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 a lot of students bleeding from the nose 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 check for cancer.

In most of the 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.”

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 case of mild bleeding, it is necessary:

• sit still and keep your head up (do not especially tilt the head back otherwise the blood will flow into the throat).
• bi-digital compression that is to say press not on the nostrils but on the top of the nose because that is where all the vessels 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 (Coalgan type) into the nostril to allow coagulation.
• after 30 minutes, if the bleeding does not stop or is very heavy, see a doctor or go to the emergency room.
• in case of dryness of the nose, put a type cream Homeoplasmin at the entrance to the nose to hydrate the mucous membranes.

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.