Persistent Nosebleeds: How To Get Better

Suffering from nosebleeds in Singapore can be quite frightening because you don’t know if they will stop on their own. You also won’t know how long each episode will last! As an experienced ENT doctor in Singapore, many children and adults with recurrent nosebleeds come to see us. Recurrent nosebleeds can lead to heavy blood loss and anaemia (low blood count). In turn, this may make some people literally feel faint and light-headed. In fact, some people suffer a vasovagal attack and blackout if their nose bleeds!

WHERE DOES MY NOSE KEEP BLEEDING FROM?

For most patients, nosebleeds usually originate from delicate blood vessels at the front of the nasal septum. Did you know that the septum is the central bone dividing your left and right nasal passages?When they sneeze, sniff, blow or dig their noses, these friable blood vessels easily rupture and bleed. It’s tricky to stop children from picking their noses!

DO MY NASAL ALLERGIES INCREASE THE RISK OF NOSEBLEEDS?

Suffering from hayfever and nasal allergy problems may worsen nosebleeds as it makes the nasal lining dry and itchy. So it is important to treat nasal allergy problems too. Learn more about nasal allergy problems and ways to manage your nasal allergies, to stop your nosebleeds from recurring! Remember, when your nose is inflamed and irritated, there is a high chance of nosebleeds. So you should consider allergy testing to find out what is irritating your nose repeatedly. It may well be poorly-controlled allergic rhinitis to house dust mite that is the main problem! House dust mite allergy is the Number One cause of nasal allergies, allergic asthma and eczema.

COULD MY REGULAR MEDICATIONS CAUSE NOSEBLEEDS?

Some patients may have serious underlying conditions which affect the ability of their blood to clot. This means that they may suffer from nosebleeds which take much longer to stop on their own. Other patients may be taking regular blood-thinning medications such as aspirin, plavix or warfarin. These medications are usually prescribed for to prevent or treat heart or stroke conditions. Therefore nosebleeds can commonly occur with even the slightest trauma. Even digging your nose can lead to heavy bleeding if you are already taking such medications!

WHEN DO I NEED TO SEE ENT FOR A CHECKUP?

If your nose keeps bleeding, then you need to see ENT to undergo nasal endoscopy (“nose scope”). You need to make sure that the nosebleeds aren’t related to a tumour growing inside the nose. Nose cancer or Nasopharyngeal Cancer (NPC) in the 8th most common cancer in Singapore so you should go for regular screening, especially if you have a relative with NPC like your parent or sibling. There are now some extremely good screening blood tests using antibody protein markers which can lay your fears to rest if the results come back negative.

But what can you do to stop nosebleeds at the front of the nose?

Here are some of Dr Annabelle’s tips to stop or prevent nosebleeds:

1. Protect the delicate skin just inside your nostrils by applying a thin layer of Vaseline as a buffer against dry or cold air. This comes in useful if you are a frequent flier due to the drier atmosphere inside the airplane cabin.
2. Try not to blow your nose as this can potentially injure the fragile blood vessels which run close to the skin surface inside your nose. You’ll be surprised at just how much force is generated by blowing your nose!
3. Don’t dig or pick your nose because this may lead to a traumatic nosebleed and your fingers may also be a source of infection.
4. If your nose does start to bleed, don’t panic! Pinch the soft part of your nose firmly between your thumb and index finger for at least 15 minutes without letting go and try to breathe calmly through your mouth.
5. Consider getting those blood vessels at the front of your nose sealed off with the simple, safe and painfree procedure of Silver Nitrate cautery which is usually done in clinic by your top ENT specialist in Singapore. It takes just a few seconds (picture below)!

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