Nosebleeds (epistaxis)
Bleeding from the nose, from short-lived bleeds at home to recurrent or heavy bleeds that need specialist assessment.
Most nosebleeds come from a cluster of small vessels at the front of the septum and stop with first aid: sit upright, lean slightly forward, and pinch the soft part of the nose firmly for 10 to 15 minutes without checking. A bleed that has not stopped after 20 minutes needs A&E.
Common causes
- Dry air, nose picking and forceful nose blowing
- Colds, allergies and nasal steroid sprays aimed at the septum rather than out toward the cheek
- Blood-thinning medication and high blood pressure
- Persistent one-sided bleeding, or a family history suggesting HHT, each needing assessment in its own right
In-clinic treatment
Assessment includes examination of the inside of the nose with a small endoscope, a blood pressure check and a medication review. Most recurrent bleeds are treated in clinic with cautery under local anaesthetic, one side at a time, plus a written prevention plan. Heavier or posterior bleeds that do not settle can need a day-case operation to tie off the supplying artery at the back of the nose.
When to be seen
Repeated bleeds that disrupt sleep or daily life, a heavy bleed that needed hospital care, bleeding on anticoagulants, persistent one-sided bleeding, or bleeds alongside anaemia all warrant specialist review.
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This page is general information and not a substitute for individual medical advice.