Nosebleeds (epistaxis) range from minor anterior bleeding to severe posterior haemorrhage requiring urgent intervention. Prof Lubbe offers expert assessment and treatment for both acute and recurrent nosebleeds.
Types of Nosebleed
Anterior Nosebleeds
The most common type — arising from the front of the nasal septum (Kiesselbach’s plexus). These usually respond to simple first aid measures and cauterisation.
Posterior Nosebleeds
Less common but more severe — arising from deeper in the nose. These may require nasal packing or arterial ligation under endoscopic control.
Causes
- Dry air and low humidity
- Nasal trauma
- Blood pressure elevation
- Blood thinning medication (warfarin, aspirin, clopidogrel)
- Hereditary Haemorrhagic Telangiectasia (HHT)
- Nasal tumours
Treatment Options
- Silver nitrate or bipolar cauterisation of bleeding point
- Endoscopic arterial ligation (sphenopalatine or anterior ethmoid artery)
- Nasal packing (anterior or posterior)
- Laser treatment for HHT telangiectasias
- Bevacizumab (Avastin) for HHT-related bleeding
First Aid for Nosebleeds
Sit upright and lean slightly forward. Pinch the soft part of the nose firmly for 10–15 minutes without releasing. Apply ice to the bridge of the nose. Do not tilt the head back.