Nose bleeds (epistaxis) are a common complaint both in the young and old. Most are idiopathic (i.e. no identifiable cause can be found rather than no known cause) although there are a number of predisposing factors.

These include hypertension, blood thinning drugs (e.g. warfarin, clopidogrel). Obviously trauma and nose picking (usually subconscious!!) will inevitably lead to nose bleeds.

During a nose bleed it is best to lean forwards (to avoid the blood going down your throat/you swallowing it) and pinch the soft part of your nose continually for at least five minutes. It is important that you pinch your nose continually rather than pinching on and off. Most nose bleeds will stop by doing this. If not you should seek medical attention.

In between nose bleeds they can be treated with certain nose ointments or by cauterising the affected blood vessel. Cautery is usually done with a chemical agent that burns these small vessels. This can be done with or without local anaesthesia in a clinic. Nose bleeds that remain refractory to all the above measures can be controlled by surgery whereby a major feeding vessel at the back of your nose is clipped - sphenopalatine artery ligation. This is done with a rigid telescope to accurately see what is being done, so there are no cuts or scars on the face or around the nose.

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