A nosebleed, also called epistaxis, is bleeding from the nose. Often, nosebleeds are caused by blowing the nose too hard, picking the nose, or being hit in the nose. Nosebleeds are more common in people with hay fever, because theswollen membranes inside the nose are fragile. While most nosebleeds are nota sign of serious medical problems, persistent bleeding--from the nose or from any other part of the body--should be investigated, as it could be an earlysign of cancer.

Nosebleeds most often come from the front of the septum, the wall of cartilage that separates the nostrils. The septum has a mass of blood vessels on either side called Kiesselbach's plexus that is easy to injure. Nosebleeds from areas farther inside the nose are less common and much harder to manage.

The first treatment for nosebleed is to pinch the nostrils together, bend forward at the waist and stay in that position for 5-10 minutes. Bleeding that continues is usually from the back of the nose and will flow down the throat.If that happens, emergency medical attention is needed.

For a nosebleed that won't stop, health care professionals may pack the nosewith cotton cloth and a rubber balloon, which may cause some discomfort. Having no place to flow, the blood should clot. Then a physician can find the source of the bleed and permanently repair it. If the packing has to remain in place for some time, antibiotics and pain medication will be necessary. Nose packing may so interfere with breathing that the patient will need supplemental oxygen.

Many bleeds are from small exposed blood vessels. They can be sealed with cautery (burning with electricity or chemicals). Larger vessels may not respondto cautery. The surgeon may have to tie them off.

Estrogen cream, the same preparation used to revitalize vaginal tissue, can toughen fragile blood vessels in the front of the septum and delay the need for cauterization. Plant-based medicines known as stiptics, which slow down andcan stop bleeding, may be taken internally or applied to the inside of the nose. Some of the plants used are achillea (yarrow), trillium, geranium, and shepherd's purse (Capsella bursa-pastoris).

To reduce the chance of getting a nosebleed, blow the nose gently and do notpick. Treatment of hay fever helps make the tissues inside the nose less fragile.

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