Sunday, November 25, 2001
Steamboat Springs Your mother told you not to pick your nose.
Most nosebleeds are mere nuisances, but some are frightening and a few are even life-threatening. Due to Steamboat's typical cold, dry air, our risk of having a nosebleed is greater here than in locations that experience warm, moist air. It is not rare for me to see up to three patients a week in my office with some form of a nosebleed.
"Anterior" nosebleeds, the most common type, begin in the lower part of the septum, the dividing wall that separates the nose into a right and left passage. The septum has blood vessels, which can be injured by a blow to the nose or a sharp fingernail.
Dry air, cold air, allergies, aspirin, non-steroidal anti-inflammatory drugs or other drugs that interfere with clotting all can increase the risk of bleeding from blood vessels in the septum.
Less often, the nosebleed is "posterior," high or deep in the nose. This causes blood to flow from the nostrils and down the throat. Risk factors for this more serious type of nosebleed include older age, high blood pressure, arteriosclerosis or hardening of the arteries, and rarely, a tumor.
To stop an anterior nosebleed, try using these steps:
Stay calm. Agitation increases bleeding.
Pinch the soft parts of the nose around the nostrils together between your thumb and index finger for a full 10 minutes.
Spray Afrin or Neo-Synephrine in each nostril and press firmly on nostrils again.
Hold this position for 10 minutes.
Once the bleeding has stopped, don't blow your nose, strain, bend over or lift anything for 12 hours.
If the nosebleed persists for more than 20 minutes, call your doctor or go to the hospital emergency department. Rarely, packing inside the nose, cautery of a blood vessel or more extensive procedures may be required.
In cases of recurring nosebleeds, a doctor may use a lighted scope to view the inside of the nose to identify and possibly treat abnormal vessels, a crooked septum or a tumor.
To prevent a nosebleed, certainly keep sharp fingernails out of your nose. Don't blow your nose too vigorously. Keep your nasal mucus membranes moist with a humidifier, saline nasal spray and a lubricating cream such as Vaseline or Bacitracin applied in each nostril at bedtime.
Maryann Wall, M.D., F.A.C.S., of Northwest Colorado ENT and Facial Plastic Surgery, is board-certified in otolaryngology and facial plastic and reconstructive surgery.