Nosebleeds (epistaxis) in children can be a stressful event, both for the parent and the child. They can occur at any age but are most common in children between the ages of 2-10 years old and adults from ages 50-80. Fortunately, most nosebleeds in children are self-limiting and benign, and can typically be managed at home. Frequent or heavy nosebleeds or those associated with a blow to the head or a fall however, can indicate a need to consult with an ENT doctor for a thorough examination of the nose.
The most common cause of nosebleeds in children is from minor trauma, typically from nose picking. Other common conditions leading to nosebleeds include direct trauma to the nose, upper respiratory infections, nasal foreign bodies, allergic rhinitis, exposure to warm, dry air and nasal medications. Less common causes of nosebleeds in children include vascular malformations, leukemia, nasal tumors, and various blood clotting abnormalities.
Managing Nosebleeds at Home
Infrequent, non-severe nosebleeds can usually be managed at home. It is important to stay calm while handling the bleeding because an agitated patient may bleed more than one who is calm. Nasal decongestant sprays, such as "Afrin" can be sprayed into the nose, or a small cotton ball can be saturated with the decongestant spray. This cotton ball should be placed in the front portion of the nose and the nostrils can be gently pinched for 5 minutes, while the patient leans forward to prevent blood from going down the throat. After several minutes, the cotton can be gently removed to prevent dislodging the clot that may have formed. If bleeding persists, seek medical attention.
Professional Care for Nosebleeds
If frequent nosebleeds are a problem, it is important to consult an otolaryngologist who will carefully examine the nose prior to making a treatment recommendation. A common treatment for nosebleeds is cautery. Cautery is a technique in which the blood vessel is treated with an electric current or silver nitrate. Although some older children can tolerate cautery as an office procedure, sometimes general anesthesia is required depending upon the size and location of the blood vessel(s). More info.