The sight of blood oozing out from your nostrils can be discomforting especially if you are out in public. Epistaxis (also called nose bleeds) is one of the most common complications of the ENT ( ear, throat and nose) region. Often, nose bleeds are not life-threatening and can stop on their own. It has been portrayed as a disease for children but it typically affects people of all ages. In this article, we will discuss everything you need to know about nose bleeding.

What is epistaxis?

Put simply, epistaxis (also called nosebleeds) is bleeding from the blood vessels in the nose. There are two types of epistaxis depending on where they occur: anterior epistaxis and posterior epistaxis.

What is anterior epistaxis?

This is the most common type of epistaxis and doesn’t call for alarm. Here, the blood flows from the front of the nose and flows from one nostril. It typically occurs in children younger than 10 and can be easily managed at home.

What is posterior epistaxis?

This is a more severe type of nosebleed that originates from an artery in the back of the nose. It is less common and usually occurs in adults older than 50 and happens more when they suffer from hypertension. Blood usually flows from both nostrils.

What are the causes of epistaxis?

Nose bleeds can be caused by a variety of factors. The common causes include:

  • Dry weather
  • Nose picking in children
  • Foreign object in the nose
  • Blunt trauma such as receiving a punch to the face.
  • Nasal and sinus infections
  • Hormonal changes during pregnancy 
  • Alcohol abuse
  • Inhalation of cocaine and other drugs
  • Inflammatory diseases
  • Cancer
  • Cold weather
  • Blowing your nose with too much force
  • Blood-thinning drugs like warfarin and aspirin
  • Hereditary haemorrhagic telangiectasia

How To Stop Epistaxis

When a person suffers from nose bleeds, the priority is to stop the bleeding. These steps can help to stop a nosebleed.

  • Don’t panic
  • Sit down and lean forward and never backwards. Leaning backwards can cause blood to flow to the throat and cause choking or to the stomach and cause discomfort. 
  • Breathe through the mouth and pinch the bottom soft part of the nose.
  • Place a piece of fabric to catch any blood that may drain out.
  • After 10 minutes, release the pressure.
  • If the bleeding hasn’t stopped, apply pressure for another 10 minutes.
  • After the bleeding stops, avoid strenuous activity for some days.
  • If bleeding persists, visit the doctor.

How to treat epistaxis?

Treatment of epistaxis depends on the severity of the condition and other underlying medical conditions.

  • Removal of foreign objects in the nose if this is the cause of bleeding.
  • Surgery to fix a broken nose if this is the cause of the nose bleed.

Nasal packing:

This involves inserting a nasal pack which contains an inflatable balloon into the nose. 

This balloon can be inflated with a syringe to apply direct pressure to the side of the nose bleed. 

Once inserted into the nose, enough air is added such that the amount of pressure exerted by the balloon is more than the pressure of the bleeding vessel. Depending on the severity of the bleeding, the nasal pack is kept in place from one to as long as five days.


In this operation, the leaking blood vessel is sealed by using either a chemical (silver nitrate) or thermal energy (electrocautery). 

How to prevent epistaxis?

For people who frequently suffer from nosebleeds, the following tips can help to prevent recurrence:

  • Avoid nose picking or blowing the nose too hard.
  • If you suffer from high blood pressure, make sure the pressure is as controlled as possible.
  • Avoid activities that suddenly increase blood pressure. E.g rigorous exercise
  • Avoid over-the-counter medications like ibuprofen, Motril and Advil.
  • Use nasal sprays to keep the nostrils moist.
  • Keep a humidifier in your home to add moisture to the environment.
  • Wear protective headgear during sports to prevent the risk of injury to the face or nose. 


1. Celik, T. et al. A new evidence of end-organ damage in the patients with arterial hypertension: Epistaxis?. Int. J. Cardiol. 141, 105–107. ( 2010).

2. Lebrin, F., Srun, S., Raymond, K. et al. Thalidomide stimulates vessel maturation and reduces epistaxis in individuals with hereditary hemorrhagic telangiectasia. Nat Med 16. 420-428 (2010).

3. Ording, A., Veres, K., Farkas, D. et al. Risk of cancer in patients with epistaxis and haemoptysis. Risk of cancer in patients with epistaxis and haemoptysis. Br J Cancer 118, 913–919 (2018).

4.Pope, L. E. & Hobbs, C. G. Epistaxis: An update on current management.                                                  Epistaxis: An update on current management. Postgrad. Med. J.  81, 309–314. (2005)

 5. Walker, T. W., Macfarlane, T. V. & McGarry, G. W.The epidemiology and chronobiology of epistaxis: An investigation of Scottish hospital admissions 1995–2004.  Clin. Otolaryngol. 32, 33 (2007).


  1. Hi there! I came across this post and it reminds me of my former roommate who used to always talk about similar topics. I’ll definitely pass this on to him. Thank you for sharing!

  2. Hi there! This post could not be written any better! Looking at this post reminds me of my previous roommate! He always kept preaching about this. I most certainly will forward this post to him.

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