Dry air a common cause of nosebleeds, especially in children
Q: Our 7-year-old daughter has been getting a few nosebleeds each month. It started last fall, and the school nurse thinks it's from dry air. This has been scary for her, and I wonder what can be done to make them stop. Is this something to be concerned about?
A: Nosebleeds can be an alarming event for both the child who is having one and for the parent who is helping to deal with it. They begin suddenly, often without an obvious cause, and involve what seems like a lot of blood.
The medical term for a nosebleed is epistaxis. It occurs when one of the many blood vessels that supply oxygen and nutrients to the mucous membranes that line the nose and the nasal cavity becomes damaged and ruptures. These blood vessels are close to the surface in young children, which is part of the reason they have more nosebleeds than adults. Younger kids are also more apt to pick and rub their noses, which can cause blood vessels to break. Blowing your nose too vigorously, a physical blow to the nose or a foreign object in the nose can also result in a nosebleed. The nurse at your daughter's school is also correct about the role of dry air. Children who live in an arid climate are at increased risk of developing a nosebleed. The low humidity that comes with the onset of colder winter weather also plays a role. This is due to cold outdoor temperatures and the heated air indoors, either of which can quickly dry out the delicate membranes within the nose. This can cause them to crack, which can rupture a blood vessel.
To manage a nosebleed, have the child lean slightly forward, just enough so they won't swallow blood. As they breathe through their mouth, gently pinch the soft part of the nose closed, just above the nostrils, and maintain that direct pressure for the 10 minutes or so that it typically takes for bleeding to stop. A cold compress across the bridge of the nose can also be helpful.
Now that you are aware your daughter is prone to nosebleeds, you can take several steps to lessen the chances of a recurrence. Begin by explaining the mechanics of a nosebleed. This can make it less frightening and will help her understand why she should be gentle with her nose. This includes blowing her nose, which should be done with just the amount of force needed to clear the nasal passages. A cool-mist humidifier, particularly in her bedroom, will help keep nasal membranes moist. A small dab of a water-based ointment spread inside each nostril can also help the tissues remain lubricated.
The reassuring news is that nosebleeds are common in children between the ages of 2 and 10, and rarely are they dangerous. However, if a nosebleed won't stop, if there is a large volume of blood, if the bleeding is associated with an injury or if an object is lodged in the nose, call your health care provider right away.
• Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health. Send your questions to email@example.com.