Nosebleeds, also called epistaxis, commonly occur in children for a number of reasons. Bleeding usually comes from the front part of the nose where a plexus of blood vessels sit. The nasal lining is also very thin here and the vessels can break open easily and bleed. Dryness of the lining of the nose and trauma (from picking or from being hit in the nose) can also cause bleeding. Rarely bleeding can come from the blood vessels in the very back of the nose instead.
In most cases, physical examination by your doctor or ENT surgeon will reveal blood vessels close to the surface of the nose in the front of the nasal septum. If nasal bleeding occurs very frequently or if bleeding is more difficult to control than normal, your doctor may recommend lab work to check for disorders of bleeding or of blood clotting. Your ENT surgeon may also recommend a flexible nasopharyngoscopy if the bleeding that occurs is not typical.
The majority of nosebleeds can be prevented with moisturizing the nose. Typically application of ointment like Vaseline or antibiotic ointment, or of coconut oil, by Q-Tip to the nose daily will help to prevent bleeding. Use of a nasal saline spray or gel may also help to moisturize the nose. Use of a home humidifier or in-room humidifier may also be helpful, especially during winter months.
Avoiding trauma to the nose is also helpful in preventing nosebleeds. Avoid picking or rubbing the nose, especially in children who are prone to frequent nosebleeds.
To stop an active nosebleed, have your child sit upright and lean slightly forward. Hold firm steady pressure by pinching the nostrils together on the soft part of the nose below the bone. Do this for at least five minutes without stopping to check if the bleeding has stopped. After five minutes, check for continued bleeding, and if still present, apply pressure for another five minutes. If bleeding continues after this, you should seek immediate medical attention.
If bleeding is frequent or recurrent, your ENT surgeon may recommend a nasal cautery procedure to seal the blood vessels closed. This procedure takes only a few minutes and can be done in the office in older children and requires a brief anesthesia in younger children.
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