Nosebleeds can be a scary occurrence, but are usually not dangerous. The medical term for nosebleed is epistaxis. They are fairly common in children, especially in dry climates or during the winter months when dry heat inside homes and buildings can cause drying, cracking, or crusting inside the nose. Many times, children outgrow the tendency for nosebleeds during their teenage years.
The front part of the nose contains many fragile blood vessels that can be easily damaged. Most nosebleeds in children occur in the front part of the nasal septum close to the nostrils.
What causes a nosebleed?
Nosebleeds are caused by many factors, but some of the most common causes include the following:
- Picking the nose
- Blowing the nose too hard
- Injury to the nose
- Air that is too dry
- Colds and allergies
- Foreign body in the nose
Many times no apparent cause for a nosebleed can be found.
First-aid for nosebleeds
- Calm your child and let him know you can help.
- Pinch the nostrils together for five to 10 minutes without checking to see if bleeding has stopped. Do not pinch the nasal bridge or "bony part".
- Have your child sit up and lean forward to avoid swallowing blood.
- Apply ice or a cold water compress to the bridge of the nose.
- If bleeding does not stop, try the above steps one more time.
- Do not place tissue or gauze in your child's nose.
When should I call my child's physician?
Specific treatment for nosebleeds that require more than minor treatment at home will be determined by your child's physician. In general, call your child's physician for nosebleeds if:
- You are unable to stop the nosebleed or if it recurs.
- Your child also has a nose injury that may indicate a more serious problem (such as a fractured nose or other trauma to the head).
- There is a large amount or rapid loss of blood.
- Your child feels faint, weak, ill, or has trouble breathing.
- Your child has bleeding from other parts of the body (such as in the stool, urine, or gums) or bruises easily.
- There is a foreign body stuck in your child's nose.
Prevention of nosebleeds
If your child has frequent nosebleeds, some general guidelines to help prevent nosebleeds from occurring include the following:
- Use a cool mist humidifier in your child's room at night if the air in your home is dry. Be sure to follow the manufacturer's advice for cleaning the humidifier so that germs and mold do not grow in it.
- Teach your child not to pick the nose or blow it too forcefully.
- Apply petroleum jelly (vaseline) inside the nostrils several times a day, especially at bedtime, to help keep the area moist.
- Use saline (salt water) drops or a saline nose spray, as directed by your child's physician.
- See your child's physician for treatment of allergies that may contribute to frequent nosebleeds.
Occasionally there are clotting problems that can contribute to nosebleeds. Your child's physician can help test for these rare disorders.
In instances of frequent or severe nose bleeds, your physician may recommend cauterization in the office or operating room. If Nasal Cautery is performed in the operating room, it is done under general anesthesia. The surgeon will use an instrument that will either pass electricity or apply a chemical to burn the area of the nosebleeds. This will cause the area to scab and scar. This allows the healing membranes to thicken which prevents further nosebleeds.
Please review Discharge Instructions: Nasal Cautery from The Children's Hospital of Philadelphia.
Reviewed by: Steven D. Handler, MD, MBE
Date: April 2009