Nosebleeds In Teenagers (Epistaxis): Causes, Treatment And When To See A Doctor

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Nosebleeds, also called epistaxis, may look scary but are mostly harmless. The nose has blood vessels close to the external surface, and therefore they get injured easily (1). It is not uncommon to see nosebleeds in teenagers. Usually, these happen in winters or too dry climates. Read this post to know the types, causes, treatment, prevention, signs you need to see a doctor, and tips on stopping nose bleeding in teenagers.

What Are The Types Of Nosebleeds?

There are two types of nosebleeds (2):

• Anterior nosebleeds are the most common and account for 90% of nosebleeds. The bleeding originates from the front part of the nose. It could be due to allergies, nose picking, or dry air.

• Posterior nosebleeds come from deep parts and may be difficult to manage. High blood pressure, airway obstruction, or trauma are some of the reasons for these bleeds.

Causes Of Nosebleeds In Teenagers

There are common and less common causes of nosebleeds in teenagers. The common reasons are often related to anterior nosebleeds.

1. Dry air: During dry climate or winter, the nasal passages may dry out, leaving the blood vessels fragile and prone to rupture. A ruptured blood vessel leads to nosebleeds (3).

2. Medicines: Nosebleed could be one of the side effects of allergy, cold medications, or using nasal sprays. (4).

3. Infections: Chronic inflammation, infections, and sinusitisⁱXAn infection in which the tissues that line the sinus get swollen or inflamed (hollow, air-filled spaces in the skull). may also make the nasal tissue susceptible to bleeding (5).

4. Injury: Picking the nose with fingernails or blowing too hard may damage the inside of the nose, thereby causing bleeding.

Some of the severe causes that may lead to both anterior and posterior nosebleeds are:

5. Hypertension: Although rare, high blood pressure could be one of the reasons for nose bleeding (6).

6. Accident or trauma: If a foreign body gets into the nose or if your nose is injured in an accident, then it may cause a nosebleed.

7. Drug abuse: Frequent nosebleeds, along with other symptoms such as weight loss, dilated pupilsⁱXA condition characterized by the dark part of the eye (pupils) being larger than usual. , and change in lifestyle, might be due to drug or alcohol consumption (7).
   

   

   Image: IStock

8. Blood-related diseases: Nose bleeding can be a symptom of bleeding disorders and conditions or cancer such as leukemia (8) (9).

9. Deviated septum: The tissue separating the nostrils gets deviated, leading to frequent nose bleeding (10). It is a less common condition.

Quick fact

Abnormal tissue growth, such as polyp, in the nose can also cause chronic nosebleeds in teens (19).

How To Stop Nosebleeds In Teenagers?

Here are some dos and don’ts that your child may follow to stop nose bleeding (11) (12):

Dos

• Sit up straight or stand upright.

• Lean forward and breathe through the mouth.

• Pinch nose slightly above nostrils for about 15 minutes. The pressure can stop the bleeding.

• Place an ice pack on the nose.
  

  

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• Use a topical vasoconstrictorⁱXAn external agent or drug that helps constrict blood vessels. .

Aaron LaRoche recounts his teenage struggles with nosebleeds and how he effectively managed them, “As a kid, I couldn’t stay out of my nose. From cramming things into them to seeing how far a finger could go, something about the olfactory bulb drew me. I had a lot of nosebleeds growing up. I’ve gathered some of my favorite ways to stop them – Tilting your head forward. This is a classic. I didn’t realize this was even a possibility till my teens when a friend showed me on an arid day. Pinching the nose between your fingers usually takes five to ten minutes to stop the bleeding. Also, decongestant sprays can clean and moisten the area and return it to a smooth nasal passage (i).”

Don’ts

• Do not lie down or do not tilt the head upside down or backward. This way, blood may go into the windpipe, resulting in choking or coughing.

• Do not put pressure on the nose after bleeding has stopped.

Point to consider

Once your teen has stopped bleeding, ask them to sneeze through the mouth as it can help reduce pressure in the nose and prevent recurrent bleeding (20).

• Do not stuff the nose with tissues, and do not blow nose when it is bleeding.

• Do not poke or pick at the clot formed within the nostril after bleeding.

The teen should avoid putting a finger or blow nose for the next two to three days. It is good to avoid strenuous activity like outdoor sports and lifting heavy weights. Reduce the intake of hot beverages for 24 hours after bleeding.

When To See A Doctor?

According to the National Institutes of Health, approximately 60% of individuals have encountered a nosebleed at some point. However, only 10% are adverse enough to warrant medical attention. Nonetheless, see a doctor, specifically an ENT specialist, if the adolescent has frequent nosebleeds and during the following circumstances (13):

• Nosebleeding is frequent and the condition does not resolve

• Bleeding often lasts for more than ten minutes

• Nosebleed due to an injury

• Unable to breathe
  

  

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• A foreign object got into the nose

• Blood volume is too large

• Feeling too weak or dizzy

• Blood in gums, urine, or stool

Based on the diagnosis and symptoms, the doctor may suggest treatment options.

Treatment For Nosebleeds In Teenagers

If the nosebleed is due to some underlying condition, treatment for that problem will address nosebleeding too. In other cases, the most common management methods for nosebleeds in teens are (14) (15):

• Nasal packing: The doctor may use nasal sponges or ribbon gauzeⁱXA sterile, soft, and highly absorbent dressing material used to absorb blood from wounds. to stop bleeding and accelerate clotting.

• Cauterization: It is a medical procedure in which the doctor may use electric current, laser, or silver nitrate to burn the blood vessel that is bleeding.

• Medications: Based on the cause (such as high blood pressure), some teenagers may be prescribed medicines to control bleeding and pain.
  

  

  Image: IStock

• Surgical repair: In the case of a deviated septum or broken nose, a surgical procedure may be required. One method is arterial ligation, in which the blood vessel is tied to prevent bleeding.

The treatment of nosebleeds is carried out with the oversight of a doctor. As the adolescent grows, there is likely to be a complete resolution of nosebleeding with the help of treatment.

How To Prevent Nosebleeds In Teenagers?

Here are some tips to help prevent nosebleeds from happening (13).

1. Wear protective gear (such as helmets) when playing to avoid injury to the nose.
   

   

   Image: Shutterstock

2. In the case of nasal irritation, cold or allergies, do not blow the nose forcefully. Do it gently so that the blood vessels don’t rupture.

3. Don’t pick the nose too often.

4. Use a humidifier in the room in case of dry air. At the same time, make sure to clean it from time to time as molds and germs may grow in it.

Quick tip

Applying a petroleum-based ointment, such as vaseline, to the dry and cracked nostrils twice daily for a week may also help prevent nosebleeds (21).

5. Applying sprays, drops, or saline gels in the nostrils may help. Doctors may prescribe antibiotic ointment that can be applied in the nostrils.

6. Avoid inappropriate or careless use of drugs.

7. Avoid hot and spicy foods.

Infographic: How To Stop Nosebleeds In Teenagers?

Nosebleeds in teens are common and can be due to various factors, including dry air, infections, or an injury. In most cases, nosebleeds can be treated at home, as explained in the infographic below. However, if the bleeding persists or is accompanied by other symptoms, seek medical attention.

Illustration: Momjunction Design Team

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Obtain valuable knowledge on how to effectively address and avoid nosebleeds in children. Get concise and user-friendly tips to safeguard your child’s well-being and maintain their optimal health.

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