February 21st, 2017 by admin in Nose Clinic Comments Off on Epistaxis

A bleeding nose is a very common condition. The prevalence of epistaxis in random samples of the population has been found to be about 10 to 12%.

Spontaneous bleeding from the lateral wall of the nose is rare, accounting for 5% or less of all cases of epistaxis. The age distribution shows a biphasic curve, with one peak between 15 and 25 years and another between 45 and 65 years.

There is little difference in the prevalence of epistaxis between sexes. Most nosebleeds in children are relatively minor but repeated bleeds cause significant parental concern and often initiate a medical consultation.

Causes of Epistaxis


  • Spontaneous
  • Trauma
  • Surgery
  • Allergic Rhinitis


  • Hypertension
  • Drug use (anticoagulant, steroid sprays)
  • Blood pressure (leukemia)
  • Hereditary telangiectasia

Causes of epistaxis vary between children and adults. In the Paediatric age group most nosebleeds are anterior, caused by disruption of a large vein or veins at the front end of the nasal septum. Often the initiating factor is rubbing the nose or nose picking. Repeated rubbing of the nose is often a sign of allergic rhinitis and, by analogy, epistaxis is often a feature of this condition.

In adults the major cause of epistaxis is hypertension with resultant arterial bleeding. Other causes of epistaxis in adults include inflammation, allergic rhinitis, tumours and the use of intranasal steroid sprays.

Most nosebleeds are minor and settle with little medical intervention. Many of the conditions that in the past have responded to nasal cautery under local anaesthesia respond just as well to conservative management with broad-spectrum antibiotic/steroid ointments. If patients suffer recurrent, severe or atypical nose bleeds, or if their nose bleeds are associated with any nasal or facial fracture, they should be referred to a specialist sooner rather than later.

If you or your child is experiencing nosebleeds, please contact Havas ENT Clinics and we can ascertain the best course of action.