Dear doctor;

My nose is too susceptible to bleeding. Whenever there is a minor contact with the upper hard part of my nose, I begin to bleed. I have been suffering with this problem since childhood. Is there a way to stop it forever?

Jean, 23.

Dear Jean,

The most common cause for nose bleeds is dryness of the inner covering of the nostrils (mucosa). The small blood vessels of this part are very delicate and even minor irritation as caused by dryness can lead to nose bleed. Exposure to cold can also cause this problem. Pricking of the nose due to dryness or a mannerism, adds on to the problem.

Recurrent inflammation of the nasal mucosa as happens with allergic rhinitis is yet another cause of nose bleeds. Reduced ability of blood to clot as in some congenital clotting disorders or due to blood thinning drugs may manifest as nose bleed with or without bleeding from another part of body. It may also occur due to deficiency of platelets whether congenital or due to other causes. High blood pressure raises pressure within blood vessels and can disrupt the small vessels of nose causing a nose bleed.

Polyps are benign growths in the nose that can cause intermittent bleeding. Rarely it can be due to a cancer of the nose. Systemic diseases like those of liver and or kidney can have nose bleed as one of the manifestations.

Best way to prevent nose bleed is to prevent dryness inside nose. Applying any lubricant like glycerine, petroleum jelly, oil, ghee, among others, with a clean finger inside the nose two to three times every day prevents dryness and keeps nose well lubricated thus minimising the irritation. By effort it is important to avoid nose pricking. As soon as the nose starts bleeding, it is advisable to pinch it hard with a thumb and forefinger. Thus, pressure exerted  on bleeding vessels stops the bleeding. Packing the nose with clean, sterile cotton also helps in stopping the nose bleeding.

However, if the nose bleed is recurrent, severe, does not stop with first aid measures, there is associated fever, one feels dizzy after it, there is vomiting or coughing of blood after it, it is advisable to consult in a medical setting, get all relevant medical investigations done to find an underlying cause and treat it.