Nosebleed

This article has been prepared by Dr. Ali.

Overview
Nosebleeds are common and usually arise from the front part of the nasal septum, known as Kiesselbach’s plexus. This area contains delicate vessels that can easily rupture due to dryness, trauma, or nose picking. Most bleeds are mild and self-limiting but may recur if the underlying cause isn’t corrected.

Common Causes

• Dry nasal mucosa (especially in heated or air-conditioned environments)
• Digital trauma (nose picking)
• Local irritation from sprays, allergies, or infections
• Prominent surface vessels on the septum
• Hypertension or use of blood-thinning medication may contribute to prolonged bleeding

Typical Presentation

• Bleeding from one nostril, usually from the front
• Blood dripping when leaning forward
• Occasional clot or metallic taste in the mouth

Initial Management

1. Sit upright and lean slightly forward.
2. Firmly pinch the soft part of the nose (just below the bony bridge) for 10–15 minutes without releasing pressure.
3. Apply a cold compress to the bridge of the nose.
4. Once bleeding stops, avoid sniffing, blowing, or touching the nose for several hours.

Further Assessment
A thorough examination should include inspection of the septum, evaluation for crusting, mucosal dryness, and prominent vessels. Blood tests may be indicated in recurrent or prolonged bleeding to assess platelets and coagulation status, especially if liver function abnormalities are present.

Preventive Care

• Keep the nasal mucosa moist with saline sprays or a thin layer of petroleum-based ointment.
• Avoid nose picking or forceful blowing.
• Maintain adequate room humidity.
• Manage underlying contributing factors such as high blood pressure or use of anticoagulants.
• If prominent vessels are identified, chemical or electrical cautery may be performed under local anaesthesia.

Ongoing Care
Recurrent anterior bleeds may benefit from gentle cauterisation, nasal moisturising routines, and addressing environmental dryness. Patients with liver-related clotting changes may require adjustment of medication or additional investigation under supervision.

Dr. Ali has prepared this article.
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