Dear Doctor,
I just read your response to the college students letter. It's about
two thirty in the morning, and I just woke up with a bad nosebleed. I
got into kind of a panic and now I'm afraid to go back to sleep, so here
I am. My problem is; I get frequent nosebleeds, and the 'blow your nose
then pinch it off for five minutes method' doesn't seem to work. When I
let go of my nose and my nostrils open up, it just pulls the new scab
away and it starts bleeding again. Maybe I'm doing it wrong, but this
method seems a bit harsh, in addition to being disgustingly messy
(seeing all that blood tends to make me a bit panicky). I am also
starting to see that my nosebleeds often coincide with drinking. I know
that heavy drinking can aggravate the problem, but I am not a heavy
drinker. I'm talking about one or two beers and that night or the next
day I'm bleeding again. I suppose I should stop being a baby and go see
a doctor. Any input you could give me would be appreciated.
Thanks
Reply: --------------------------
In most instances, nosebleeds originate from the septum near the front of your nose (+/- 90% of the time). Just beneath the lining of the septum near the front of the nose is a broad plexus of tiny blood vessels. Typically these anterior nosebleeds result from a combination of factors which usually include dryness of the septal membrane and minor traumas caused by rubbing or "picking" the nose or vigorous nose blowing. Nosebleeds occur more frequently when there is inflammation of the membranes such as that which occurs with colds, sinus infections, or allergy because inflammation results in dilatation of blood vessels. Nosebleeds tend to occur more commonly in cold and dry climates, most notably winter months or at high altitude (eg mountains). The best prevention of nosebleeds is humidification - this includes general humidification of the local environment as well as moisturization of the actual nasal membranes with regular use of nasal saline sprays or saline gels which are available over the counter - and avoidance of traumatizing the nose. When nosebleeds do occur, keep the head elevated, blow any clots out of the nose and apply firm pressure to the front of the nose by pinching. Additionally ice over the bridge of the nose and/or the use of Afrin or Neo-synephrine nasal spray may be helpful for more resistant nose bleeds. Frequent nosebleeds that fail to respond to basic measures such as these require an evaluation by a physician.
--
Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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