Epistaxis causes

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Editor in Chief: Liudvikas Jagminas, M.D., FACEP [1] Phone: 401-729-2419

Etiology

The cause of nosebleeds can generally be divided into two categories, local and systemic factors.

Local factors

• Anatomical deformities, such as septal spurs or Osler-Weber-Rendu Syndrome
• Chemical inhalant
• Inflammatory reaction (eg. acute respiratory tract infections, chronic sinusitis, allergic rhinitis and environmental irritants)
• Foreign bodies
• Intranasal tumors (Nasopharyngeal carcinoma in adult, and nasopharyngeal angiofibroma in adolescent males)
• Nasal prong O₂ which tends to dry the nasal mucosa
• Nasal sprays, particularly prolonged or improper use of nasal steroids
• Surgery (such as septoplasty and endoscopic sinus surgery)
• Trauma (usually a sharp blow to the face)
• Nose-picking
• Low relative humidity of air breathed occurring especially during winter seasons.

Systemic factors

• Drugs - Aspirin, Fexofenadine/Allegra/Telfast, warfarin, ibuprofen, clopidogrel, isotretinoin, desmopressin and others
• Alcohol (due to vasodilation)
• Allergies
• Blood dyscrasias
• Heart failure (due to an increase in venous pressure)
• Hematological malignancy
• Hypertension
• Infectious diseases
• Malnutrition (especially anemia)
• Narcotics
• Vascular disorders
• Nose-picking (especially in children)
• Muscle tightness as caused by scoliosis (the tightened muscles cause blood vessels to become constricted, resulting in nosebleeds from the same side as the tightened muscles).