Winter Nosebleeds (Epistaxis)
| Murray Grossan, MD.
About the author: Dr. Grossan is an otolaryngologist and head and neck surgeon with the Tower Ear, Nose and Throat Clinic at Cedars-Sinai Medical Center in Los Angeles and the founder of the Web based Grossan Sinus & Health Institute (http://www.grossaninstitute.com). He is author of Free Yourself from Sinus and Allergy Problems Permanently.
Winter is coming with nasal dryness and bloody noses. Let’s avoid them this year.
People live in the desert and don’t get dry nose and epistaxis (nosebleed) Why do we get them in Wisconsin? Chicago?
Because in the desert the body is adapted to the dry condition, just as we adapt to humid conditions.
But in Chicago we have extreme changes of temperature, plus rapid changes from very cold to very hot and dry. The poor nose can’t keep up.
If you do get a nosebleed, here are some suggestions that I give to my patients:
How to stop a nose bleed.
- A Don’t panic. The more the panic the higher the blood pressure the more the bleeding.
- B Forget about the dress, its already bloody and anxiety and trying to keep further blood from it raises the blood pressure and more bleeding
- C Apply outer pressure from the outside. Use your finger to press the soft part of your nose to the midline.
- Ice to lip, and back of neck is good. Sit up.
- Pressure from the inside is good – gauze, tissue, applied inside and slight pressure from the outside helps
- If you have nose drops such as Neosynephrine or Afrin, put this on cotton and apply it into the nose over where you think the bleeding is coming from
- Stay calm. Stay off the phone. Anyone you call will tell you horror stories about their Aunt’s terrible nose bleed and make you nervous.
- Sitting up is better than lying down. If you lay down you raise the pressure to the nose.
- If bleeding persists, go to the ER.
- If bleeding is controlled, stay quiet all day. Don’t go skateboarding.
Remember it is very rare for anyone to bleed to death from a nosebleed. Neither I nor my 4 associates have had such a case, though we have had hundreds of bad nosebleeds.
To prevent nosebleeds, in winter keep a pan of water in the room. Have plants in the room that take a lot of water. If you are traveling, hang wet towels in the bedroom.
NeilMed NasoGel is useful. This introduces a product that moisturizes at two levels – the nasal level and the cellular level. This special moisture allows natural products that defend the body against dryness and infection to come to your aid. Comes in two variations, drip free gel spray and gel tube. It is over the counter, no prescription is needed.
It is water soluble, so no problem with it lodging permanently in the lungs like water insoluble products.
If you are susceptible to nosebleeds, regular use of the gel twice a day helps prevents epistaxis. Recommended to use after the bleeding has stopped.
Bactroban ointment is primarily an antibiotic that requires a prescription and doesn’t have a nasal tip, so there is waste. Helps clear up infections associated with nosebleeds and may be prescribed by your doctor after the bleeding has stopped.
Neosporin ointment is also useful, but more persons are showing sensitivity to this product, and it is not designed for nasal use.
NeilMed NasoGel is specifically designed for nasal use.
In addition to Winter Dryness there are dozens of other causes of epistaxis that physicians must consider. These include hypertension, effects of drugs and herbs – including Ginko Biloba.
Persons on Coumadin and other blood thinners should be diligent about keeping the bedroom moist and the nose moist too. Stick to pans of water or plants with lots of water rather than a vaporizor. Vaporizer may moisten the air too much and bring on an increase in mites as well as destroy the wallpaper.
Vitamin C and bioflavinoids all help strengthen the blood vessels as does Rutin.
Nosebleed with sinus infection may speak for a certain kind of bacteria that requires an antibiotic or just may be from the nose being so raw.
Recreational nasal drugs significantly cause nosebleeds. Cocaine will cause the blood vessels to clamp shut, cuts off circulation and leads to ulceration and nasal bleeding.
Certain industrial products lead to thinning of the membranes and subsequent epistaxis. Various paint solvents and thinners are some of these. Skydrol is one I am familiar with because it is used as a solvent inside of airplanes during manufacture. If you experience burning when exposed to chemicals, consider washing the nose by lavage after exposure to remove the products.
Use of the various Cortisone sprays – Nasarel, Flonase, etc over time may cause thinning of the membranes and lead to epistaxis. I have my patients alternate with the Breathe.ease XL Nasal Moisturizer gel to “restore” the membranes so they can continue with the spray that works for them.
What if you have seen the doctor, been treated and still are having nose bleed? Probably you need an antibiotic to clear the infection that is usually associated with a nasal bleeding. But also check: are you taking an herb that leads to bleeding like Gincko Biloba or Ephedra?
In one of my difficult epistaxis patients, I and my nurse had repeatedly asked him if he was taking ANY medication. Finally on the third visit his wife volunteered that he was taking Gingo! He shouted, “But that’s not a medicine, that’s an herb”
With extreme dryness, hard crusts may form that lead to nose picking and a resultant epistaxis. Copious use of Breathe.ease Nasal Spray helps clear this up – this liquid not only softens the crusts, but helps restore the cilia that defend the nose.
Allergy does not cause nose bleed unless you blow your nose too hard.
Winter or summer, certain medications can lead to nosebleed – such as aspirin products. Some antihistamines can dry the nose excessively and there are numerous drugs for heart and other conditions that have a nasal drying effect. Before stopping the medication, see if you can maintain moisture adequately, especially water in the bedroom.
There are still nosebleeds that require a doctor’s inspection and evaluation so if these simple measures don’t work, see your doctor.
There is an area called Hesselbach’s Triangle on the nasal septum, near the front, where blood vessels can expand and become fragile. If a single vessel is the culprit, the doctor may wish to anesthetize the area and then cauterize it with an acid or electric current. Since it is anesthetized, it won’t hurt.
The important thing is to rest, relax and help your poor nose to heal.