Nosebleeds can be caused by trauma to the inside or outside of the nose. Other conditions that predispose a person to nosebleeds are exposure to warm, dry air for a prolonged period of time, nasal and sinus infections, allergies, an object inside of the nose, vigorous nose blowing or picking, a deviated or perforated nasal septum, and nasal surgery. Less commonly, an underlying disease process or taking certain medications may cause a nosebleed or make it more difficult to control. Blood-thinning medications such as Warfarin, Coumadin, Eliquis, Xarelto, or Plavix (clopidogrel bisulfate), non-steroidal anti-inflammatory drugs (NSAIDs), or aspirin increase the risk of nosebleeds. Topical nasal medications, such as corticosteroids, may sometimes lead to nosebleeds. Liver disease, chronic alcohol abuse, kidney disease, platelet disorders, and inherited blood clotting disorders can also interfere with blood clotting and predispose to nosebleeds. Vascular malformations in the nose and nasal tumors are rare causes of nosebleeds. High blood pressure may contribute to bleeding.
Anterior nosebleeds originate from the front of the nose. A minor nosebleed that has stopped may require no treatment at all. Frequently, the body will for a clot at the site of the bleeding that stops any further bleeding. If the source of bleeding is from a blood vessel that is easily seen, your provider may cauterize it (or seal the blood vessel) with a chemical called silver nitrate. In more complicated cases, nasal packing may be required to stop the bleeding. Nasal packing applies direct pressure inside the nostril to promote clotting and stop the bleeding. The packing is left in place approximately 5 days. Because these packings block the drainage pathways of the sinuses, antibiotics are prescribed to prevent infection. Posterior nosebleeds are much less common. The bleeding usually originates from an artery in the back part of the nose. In order to control the bleeding, a posterior nasal packing may be inserted by your physician and left in place for approximately 5 days. If this does not control the bleeding, additional procedures may be required.