There are two types of nosebleeds:
The type of nosebleed that you have will depend on where the bleeding originates.
Anterior nosebleeds
If you have an anterior nosebleed, the bleeding comes from the lower septum (the wall between the two nose channels), just inside your nose. This part of the nose, which is sometimes known as Littles’ area, has a lot of delicate blood vessels inside it.
The blood vessels are supplied with blood from your carotid arteries (the two main arteries in your neck which supply the blood flow to your brain). These delicate blood vessels are easily damaged and if they are knocked they will begin bleeding.
Sometimes, the cause of anterior nosebleeds is unknown (idiopathic). However, the main causes include:
- picking your nose, particularly if you scratch the inside of your nose with a sharp fingernail,
- blowing your nose very hard,
- a minor injury to your nose,
- a deviated septum (a crooked nose, either present from birth or due to an injury),
- a cold or flu (influenza),
- sinusitis (an infectionan of the small, air-filled cavities inside your cheekbones and forehead),
- a blocked or stuffy nose that is often caused by an infection,
- a dry nose that is caused by dry air in a hot climate or heated indoor air,
- hayfever or other allergies,
- high altitude,
- excessive use of nasal decongestants,
- excessive use of the illegal drug, cocaine.
Children almost always have anterior nosebleeds and these are easily treated at home.
Posterior nosebleeds
A posterior nosebleed is where the bleeding is heavy and comes from further back, and higher up your nose. Posterior nosebleeds are more common in adults than in children and they may need medical attention.
During posterior nosebleeds, the bleeding originates from branches of the arteries which supply blood to your nasal cavity (the space inside your nose between the roof of your mouth and your brain).
This type of nosebleed can be more serious. If your nosebleed has resulted from a large blow to your head, or a fall, you should seek medical attention because you may have broken your nose.
Other possible causes of posterior nosebleeds include:
- recent nasal surgery,
- high blood pressure,
- hardened arteries (from fat, cholesterol, or other substances that build up in your arteries),
- a calcium deficiency,
- exposure to irritating chemicals,
- a tumour in the nasal cavity, and
- certain medicines, such as aspirin, medicines for arthritis, and anticoagulants (blood-thinning medicines), such as warfarin and heparin.
In some cases, nosebleeds can be a symptom of another condition such as:
- a blood clotting abnormality - for example haemophilia (an inherited condition that affects the blood’s ability to clot) or von Willebrand’s disease (an inherited disorder that causes bleeding and bruising) , or
- leukaemia (although this is rare and you are likely to have other symptoms as well).
