Causes of Recurring Nosebleeds

Causes of Frequent Nosebleeds

The nasal lining consists of various moist tissues and mucous membranes, which contain numerous blood vessels located close to the surface. This lining is delicate and can be easily damaged; any scratches or trauma to it may lead to a nosebleed. Typically, recurrent nosebleeds are attributed to anterior epistaxis (front nosebleeds). While there are numerous causes for nosebleeds, most are not serious. Below are some of the reasons behind frequent nosebleeds:

Nose Picking

Nose picking can sometimes cause scratches or wounds to the sensitive nasal lining, leading to ruptures of blood vessels and nosebleeds. Additionally, forceful blowing of the nose may also trigger bleeding. In fact, individuals who have experienced a recent nosebleed are at a higher risk of having another, even with gentle blowing. It is also worth noting that children are more prone to nosebleeds than adults, primarily due to their tendency to pick their noses or insert foreign objects into them.

Cold Weather and Allergies

Exposure to cold air and allergies can result in swelling or irritation inside the nose, leading to nasal inflammation and congestion, which may dilate the blood vessels and increase the likelihood of nosebleeds.

Hot or Dry Climate

Seasonal changes in climate can significantly influence the occurrence of frequent nosebleeds, largely because the nose struggles to adapt to fluctuations in temperature and humidity. Hot or dry air is a common cause of nosebleeds; it can lead to cracks in the nasal lining, resulting in irritation and itching. Scratching these dry areas might trigger a nosebleed, especially in environments with continuous central heating.

Nasal Deformities

Certain nasal deformities or defects can also contribute to recurrent nosebleeds. Below are some of these conditions:

• Deviated Septum: A deviated septum can occur congenitally or following an injury, leading to misalignment of the thin wall dividing the nostrils. This condition results in uneven airflow through the nostrils, causing one side to become dry and increasing the risk of nosebleeds.
• Abnormal Blood Vessels: Conditions such as Hereditary Hemorrhagic Telangiectasia (Osler-Weber-Rendu Syndrome) may result in the presence of abnormal blood vessels in the nose, complicating the management of nosebleeds.

Chemical Irritants

Prolonged exposure to certain chemicals can irritate the nasal lining, potentially causing recurrent nosebleeds. Some of these irritants include:

• Cigarette smoke
• Sulfuric acid
• Ammonia
• Benzene

Medication Use

Some medications may cause nosebleeds as a side effect, especially those that inhibit blood clotting. It is crucial to read medication leaflets carefully and follow provided instructions. Below is a list of medications known to cause nosebleeds:

• Anticoagulants: These medications, such as aspirin, clopidogrel, and warfarin, prevent or reduce blood clotting.
• Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
• Antihistamines
• Decongestants
• Nasal Sprays: Continuous use of nasal sprays can irritate nasal tissues and dry out the nasal and sinus lining, leading to potential nosebleeds.

Dietary Supplements

Some dietary supplements may thin the blood, resulting in prolonged bleeding and difficulty stopping it once it starts. Examples of such supplements include:

• Ginger
• Ginkgo Biloba
• Garlic
• Chamomile
• Ginseng
• Vitamin E

Certain Health Disorders

Various health disorders can lead to frequent nosebleeds. These include:

• Thrombocytopenia: This condition involves a reduced platelet count, essential for blood clotting.
• High blood pressure
• Drug abuse
• Kidney failure
• Leukemia
• Seasonal allergies
• Congestive heart failure

Blood Clotting Disorders

Recurrent nosebleeds may also be a result of blood clotting disorders, often due to genetic factors. Some of these disorders include:

• Hemophilia: This genetic disorder impairs the blood’s ability to clot properly, potentially leading to internal or external bleeding, including frequent and hard-to-stop nosebleeds.
• Von Willebrand’s Disease: This disorder slows the clotting process, which can cause recurrent nosebleeds that may be challenging to manage.
• Hereditary Hemorrhagic Telangiectasia: This hereditary condition results in the formation of abnormal blood vessels in the nasal cavity, as previously mentioned.

Other Causes

Other potential causes of frequent nosebleeds include:

• Abnormal Tissue Growth: Unusual growths within the nasal cavity can lead to bleeding. While most of these growths, including polyps, are benign, they require evaluation.
• Tumors: Nasal or sinus tumors can cause recurrent nosebleeds and may be malignant or benign. These tumors are more prevalent among older adults or smokers, and persistent nasal obstruction or foul-smelling nasal discharge can indicate a possible tumor.
• Alcohol Consumption: Excessive drinking can affect platelet function and slow clotting. Additionally, alcohol dilates superficial blood vessels, making them more prone to injury and bleeding.

Prevention Tips for Frequent Nosebleeds

While not all nosebleeds can be avoided, several tips and guidelines can help minimize their frequency and severity. Here are some recommendations:

• Keep the nasal lining moist by applying a thin layer of petroleum jelly or another soothing ointment with a cotton swab three times daily. Utilizing a saline nasal spray can also help, especially during colder months when the air is dry.
• Trim children’s nails to reduce the likelihood of nose picking.
• Avoid inhaling chemical irritants by using appropriate protective equipment.
• Refrain from smoking and avoid environments with smokers.
• Always wear a seatbelt in a vehicle to protect the face from potential injuries in case of an accident.
• Use a proper helmet during contact sports to safeguard the face from injuries.
• Avoid nose picking and blowing the nose forcefully.
• After a nosebleed, avoid strenuous activities for at least a week to prevent recurrence.
• Manage allergies or infections effectively.
• Utilize humidifiers to alleviate dry air conditions.

When to Consult a Doctor

Consult a healthcare professional in the following instances of recurrent nosebleeds:

• Nosebleeds without a clear cause. The doctor may perform a physical examination, review medical history, and inquire about medications to identify possible causes. If the cause remains unclear, blood tests may be ordered to check for clotting disorders.
• Nosebleeds occurring multiple times a week. Frequent examples, such as four or more times a week, warrant medical evaluation to determine the underlying cause. Similarly, recurring nosebleeds two to three times a month may indicate a chronic health issue, such as allergies.
• Prolonged bleeding. Immediate medical attention is necessary if a nosebleed continues for over 20 minutes without stopping or cannot be managed through home remedies, especially if the bleeding is profuse or follows a facial injury, or if it leads to fainting or dizziness.
• Excessive blood flow to the throat. If blood continues to flow down the throat despite leaning forward, urgent medical assistance is required.