The inside of the nose has a rich blood supply. Certain areas, such as the front portion of your nasal septum (the wall that divides the inside of your nose in half) are especially rich in blood vessels. Sometimes these blood vessels can become dilated and very close to the surface. When the thin surface of the nasal lining is disrupted, such as with minor trauma or nose picking, one of these blood vessels can open up and a brisk nosebleed can result. Here in Colorado, with our low relative humidity, the nose can become quite dry, which makes the nasal lining fragile and prone to cracking open. The most common source (90% or more) of nosebleeds is as described above, in the front part of the nose. Though messy and at times frightening, these nosebleeds tend to be easier to control. A much less common source of nosebleeds is a blood vessel in the back of the nose. When this is the case, nosebleeds can be a lot harder to stop, and some even require hospitalization. People who take blood thinning medications, such as aspirin, Plavix, Warfarin and others, tend to have more severe nosebleeds that are more difficult to stop.
Severe nosebleeds are often managed in the Emergency Room by placing a pack in the nose. This will stop most nosebleeds. The pack is then removed typically 2-5 days later in our office. If a source of the bleeding can be identified after removing the pack, your ENT doctor may cauterize this area to help prevent another bad nosebleed.
For recurring, more minor nosebleeds, your ENT doctor will first thoroughly examine your nose to identify the likely source of the problem. Recommended treatments may include a regimen of moisturizers for the nose, avoidance of trauma to the nose such as with nose-picking, or cauterization of the offending blood vessel. Nasal cauterization is a simple procedure that can usually be performed in the office under topical anesthesia, with minimal discomfort.