Nosebleed: Types, Causes, and Treatment

Nosebleeds are common occurrences, affecting one out of every seven people at some point in their life, according to the American Academy of Otolaryngology. They are typically caused by the rupture of small, fragile blood vessels, either at the front (anterior) or back (posterior) part of the nose.

Causes of Anterior Nosebleeds

Most nosebleeds occur within the lower end of the nose in the lower septum—the wall separating the two airways of the nose that ends in the nostrils. These blood vessels lie close to the surface, making them susceptible to injury.

A clue that a nosebleed is anterior is that blood will flow out of one nostril when the affected person is sitting or standing. Anterior nosebleeds usually don't require medical attention unless the bleeding can't be stopped or it happens in a very young child.

The most common causes of anterior nosebleeds include:

• Trauma
• Nose picking
• Dryness inside of the nose
• High altitudes
• Colds
• Allergies
• Certain medications

Smoking can dry out the nose, so quitting can be a part of treating recurrent nosebleeds (among many other health benefits.)

Treatment of Anterior Nosebleeds

Here are some tips for treating anterior nosebleeds: 

• Try to remain calm and not panic.
• Sit up straight.
• You can spray a decongestant in the nose — one that is or contains oxymetazoline (Zicam, Afrin).
• Pinch the nostrils together using your thumb and index finger firmly for five minutes. Repeat for 10 more minutes if bleeding is still occurring.
• You can place a cold compress or an ice pack across the bridge of your nose.

When Urgent Medical Attention Is Required

Anterior nosebleeds don't typically require emergency medical treatment. You should get immediate attention if:

• The blood loss is heavy
• You get nosebleeds often
• The injury/trauma is severe
• It's the result of a head injury
• It's in a baby, child, elderly person, or sick person
• It's doesn't stop after 10 to 20 minutes of direct pressure
• You feel like it's cause for concern

Causes of Posterior Nosebleeds

Posterior nosebleeds can be very serious and do require urgent medical attention.

Upper posterior septum nosebleeds are rare. When they do occur, bleeding begins high within the nose and blood flows down the back of the mouth and throat even when the person is sitting up or standing.

Posterior septum nosebleeds have a variety of causes. They're more common in: 

• People with high blood pressure
• People with nose injuries
• Older people

Treatment of Posterior Nosebleeds

Treatment is initially the same as for anterior nosebleeds.

Additionally, your healthcare provider may pack the nose with gauze (do not try packing yourself) or an inflatable latex balloon if the bleeding does not stop.

They may also cauterize the bleeding blood vessel. This involves an electrical or heated device to burn the ruptured blood vessel to stop the bleeding. The healthcare provider uses a local anesthetic before he or she begins this procedure.

Other Causes

Besides nose picking, dryness, trauma, and forceful nose blowing, there are other less common causes of nosebleeds (some of which can predispose a person to frequent nosebleeds) like: 

• Certain blood-thinning medications (for example, aspirin)
• Certain drugs (for example, cocaine)
• Osler-Weber-Rendu syndrome — a hereditary disease where a growth like a birthmark is located in the nose
• Tumors in the nose (both cancerous and noncancerous)
• A disease of the arteries such as atherosclerosis
• Bleeding disorders or medical conditions that may cause low platelets, which help the blood clot (for example, leukemia)
• Nasal tumors, cancerous and noncancerous

Sometimes too, minor nosebleeds just happen, and you never know the reason.