In the United States, 1 of every 7 people will develop a nosebleed at some time. Nosebleeds tend to occur during winter months and in dry, colder climates. They can occur at any age, but are most common in children aged 2-10 years and adultsÊaged 50-80 years. For reasons as yet unknown, nosebleeds most commonly occur in the morning hours.
Anterior nosebleeds make up over 90% of all nosebleeds. The bleeding usually comes from a blood vessel at the very front part of the nose. Anterior nosebleeds are usually easy to control, either by measures that can be done at home or by a doctor.
Posterior nosebleeds are much less common. They tend to occur more often in the elderly. The bleeding usually comes from an artery in the back part of the nose. These are more complicated and usually require admission to the hospital and management by an otolaryngologistÑan ear, nose, and throat specialist.
Most nosebleeds do not have an easily identifiable cause. Most commonly, trauma to the nose triggers a nosebleed. This can be from trauma to the outside of the nose, such as a blow to the face, or trauma inside the nose, such as nose picking or repeated irritation from a cold.
Less commonly, an underlying disease process may contribute to the bleeding, such as an inability of the blood to clot. This most often is due to blood-thinning medications such as warfarin (Coumadin) or aspirin or from liver disease. Abnormal blood vessels or cancers in the nose are rare causes of nosebleeds. High blood pressure may contribute to bleeding but almost never is the only reason for a nosebleed.
Laboratory tests usually are not needed. For severe nosebleeds, a blood count may be checked. If there is a suspicion that the blood is not clotting properly, for example, in people who take certain types of blood thinners, tests can be performed to evaluate these factors.
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