By Dr. Loretta Lanphier, ND, CN, HHP, CH

I doubt that many people spend a lot of time thinking abut their noses, but as with so many other features of our bodies, the nose is an amazing organ. It is on the front lines of defense when it comes to filtering the environment around us, and is a key player in the sense of smell as well. Because of its sensitive functions, the nose is densely populated with blood vessels, and as such is liable to bleed rather easily. Most nosebleeds are nothing more than a nuisance, but they can also be an indicator of underlying problems. Let’s go over the basics of nosebleed so that we can better understand this common medical condition.

What Is Nosebleed?

The official medical term for nosebleed is epistaxis, and it refers to any hemorrhaging of blood from the nasal area. The vast majority of nosebleeds are classified as anterior, which means the bleeding begins in the front of the nose, and blood generally is discharged through the nostrils. Anterior nosebleeds can occur at any age. Much less common, and more serious as well, are posterior nosebleeds, which begin near the rear of the nasal passages, and can flow down the throat and into the stomach. These are much more common in folks who are middle-aged and beyond. In rare cases, nosebleed can even cause hemorrhaging that travels through what is called the nasocrimal duct, causing blood to flow out of the eye.

Nosebleeds are very common, and almost everyone will experience at least one in their lifetime. Has there ever been a child who hasn’t developed a nosebleed from roughhousing at some point while growing up? Not likely, because the sensitive nature of the nose, its location, and its rich supply of blood vessels makes it a very easy target. An occasional nosebleed is nothing to worry about. It is only when nosebleeds are recurring or if they lead to excessive loss of blood that they are of greater concern.

What Causes Nosebleeds?

The nose is very sensitive to changes in temperature and humidity, and this is mainly because one of the reasons it is there is to filter the air and help adjust the body to extreme temperature and humidity differences. As such, the tiny blood vessels that help the nose do its job take the brunt of such environmental factors, Thus the nose is more likely to bleed when the weather is hot and dry. Alternatively, winter is also nosebleed season for some people due to the extreme temperature differences between cold outdoor air and the warm, dry air from the furnace indoors. All of these factors make nosebleeds more likely to occur.

The number one reason behind most nosebleeds is some kind of trauma to the nose. This may occur in the course of an accident, or from a punch in the nose, or from any blow to the nose or face. Most of the time nosebleeds from trauma are only temporary, and do not normally indicate any other medical conditions. However, if a fracture of the nose occurs, this can lead to posterior bleeding as well as hemorrhaging from the nose, which may lead to such conditions as anemia, nausea, or vomiting, especially if the blood loss is ongoing, and the victim is not aware of the hidden bleeding.

Besides trauma, most nosebleeds occur when the nose is picked or rubbed, and the delicate blood vessels in the area are aggravated. This is especially true in children, who are apt to rub their noses, often while sleeping. Once a nosebleed occurs, if the nose is stimulated in any way, it can easily begin to bleed again unless enough time has gone by to allow for complete healing.

Other common causes for nosebleeds include:

  • Hypertension: If your blood pressure is too high, you may experience recurring nosebleeds. This is one of the few indicators of high blood pressure that one can see or feel. If you have a problem with repetitive nosebleeds, especially if you are middle-aged or older, it is important to have your blood pressure checked.
  • Rhinitis: Chronic nose inflammation in the nasal passages can leave the nose irritated and inflamed, making it more likely to bleed. Rhinitis may be allergic or non allergic, and it may be triggered by a variety of factors, including nasal infections and various forms of allergies.
  • Allergies: Hay fever, pollen, or dust and other environmental irritants can leave your nose more susceptible to nosebleeds too. The tendency to suffer from such allergies often runs in families, and they are actually due to aggressive and chronic responses from the immune system that result in inflammation. That is why chronic nosebleeds often seem to run in families as well.
  • Medications: Certain drugs, both prescription and over-the-counter, can increase your risk for nosebleeds. Common offenders include blood thinners such as Coumadin or warfarin, aspirin, and anti-inflammatory drugs such as corticosteroids. If you are taking blood thinners or any substance that interferes with blood clotting, nosebleeds can be difficult to stop and may start up again with little provocation. If you have an existing problem with nosebleeds, be sure to let your health care provider know about this if he or she prescribes such drugs.
  • Alcohol abuse: One of the effects of chronic alcoholism can be nosebleeds. Alcoholic beverages have a dilating effect on the blood vessels of the body, causing an increase the amount of blood flowing through them. After prolonged use of alcohol, sensitive areas of the circulatory system can become permanently damaged and lead to leakage. The tiny and numerous blood vessels in the nasal passages is one such area.
  • Drug abuse: Any drug that is inhaled through the nose, such as cocaine or heroin, will eventually lead to a breakdown of the septum and lining of the nose, which commonly leads to chronic nosebleeds. In severe cases, the entire septum will develop a hole in it (deviated septum) and will no longer be able to function. Such intense irritation inevitably produces nosebleeds. If you suspect someone is hiding a drug problem, nosebleeds may be a clue that can help tip you off to their addiction.
  • Nasal oxygen: Sometimes folks who are given oxygen through a nasal tube may experience nosebleeds due the drying effect of the oxygen in combination with irritation from the tubes in the nose.
  • Hormonal changes: Some women experience nosebleeds during menopause, pregnancy, and during their menstrual cycle. This is due to fluctuating levels of hormones, mostly estrogen.

Nosebleeds may also be indicators of other illnesses that themselves may be serious in nature. Examples include:

  • Respiratory damage: If a person has sustained respiratory damage from inhaling smoke in a fire or chemical irritants, the lining of the nose may have been damaged as well, making it more susceptible to nosebleeds. If you have been exposed to such circumstances recently and are experiencing nosebleeds, it may be that you sustained more damage to your respiratory tract than you might be aware of.
  • Congestive Heart Failure (CHF): This illness is a condition that results in circulatory problems due to a heart that can no longer pump properly. In fact, one of the first signs that a person may be developing CHF is the presence of unexplained nosebleeds. If you have poor heart health and begin to get uncharacteristic nosebleeds, it would be a good idea to get evaluated for CHF.
  • Malnutrition: Chronic nosebleeds can also be a sign of malnutrition, especially a lack of iron (anemia).
  • Blood disorders: Nosebleeds can indicate blood conditions such as hemophilia (a blood clotting disorder) or any condition that results in lowered amounts of hemoglobin or red blood cells.
  • Leukemia: Any kind of abnormal bleeding can indicate leukemia, and nosebleeds fall under that category.
  • Tumors: Other malignancies may produce nosebleeds as well. These include tumors in the nose and throat region, as well as other parts of the body including the back, ribs, and hips.

How Can I Stop a Nosebleed?

Most minor nosebleeds are relatively easy to control, especially once you learn a simple technique. From a sitting position, pinch your nose with thumb and forefinger, and apply steady pressure for about five or ten minutes, while breathing through your mouth. This should usually do the trick. If this method does not work after 15 or 20 minutes, you may have more than a simple nosebleed on your hands, and it would be best to see your health care provider or an emergency room physician to help stop the bleeding and examine you for other possible causes.

Assuming you were able to stop the bleeding, there are some other precautions you should take to prevent the nosebleed from returning before complete healing has taken place:

  • Lay down and rest, but keep your head propped up at about a 45 degree angle for the first 24 hours.
  • Be careful not to do anything that is strenuous for a while, such as lifting heavy objects or straining at a bowel movement.
  • You may want to apply an ointment such as petroleum jelly or aloe vera to the inside of your nose to prevent drying and cracking that may cause the nosebleed to re-bleed.
  • The use of a humidifier is also recommended, especially if the air in your home or place of work is very dry. This may also help to prevent a reoccurrence of the nosebleed.

As far as diet and supplements go, some folks have had success at stopping nosebleeds through the use of vitamin C and other antioxidants. If you are recovering from a nosebleed, take more than your usual dose of vitamin C, and load up on dark fruits and vegetables, which are particularly high in antioxidants. These nutrients are good for everyone all the time, but they can be particularly useful while the body is seeking to heal and repair tissues.

If you are experiencing nosebleeds for which you have no explanation, I would suggest visiting a naturopath or doctor that takes a holistic approach to medicine. When your body is exhibiting any abnormal signs such as nosebleeds, there is always a reason for it. It may be something as simple as not enough humidity in your home, or as serious as a debilitating disease like cancer. But find someone who will take the time to help you find the cause, and not just throw a diagnosis and a prescription at you.

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