Unilateral Nosebleeds: Causes and Concerns

Unilateral profuse nasal bleeding?

Hello, Dr.
Chi.
I have a wound on my nose and visited a nearby ENT specialist.
The doctor confirmed that there is a wound and showed me the injured area, which appeared to be a small cut.
However, I have been experiencing a significant amount of bleeding, resembling a faucet running, along with some blood clots.
Recently, I noticed that the wound seems to have enlarged compared to what the doctor initially showed me.
I also experience occasional itching in my nose.
I try not to rub it, but sometimes when it itches more, I gently press or lightly touch it.
The wound has not healed, and I continue to have episodes of heavy nosebleeds.
This situation has been ongoing intermittently for about a week.
Occasionally, I notice a metallic taste of blood in my throat, but upon checking my nostrils, there is no visible bleeding.
Dr.
Chi, could you please advise if these symptoms indicate any specific condition?

Ms. Chen, 10~19 year old female. Ask Date: 2018/01/30

Dr. Ji Zhaoyun reply Otolaryngology

Hello, Ms.
Chen.
Based on your description, there are many causes of nosebleeds, with the most common being thinner nasal mucosa, often resulting from forceful nose blowing (which appears to be your current diagnosis at the clinic).
However, conditions such as nasopharyngeal or nasal cavity tumors (like nasopharyngeal carcinoma), sinusitis, fungal infections, allergic rhinitis, hypertension, coagulopathy, and nasal trauma can also lead to nosebleeds.
It is advisable to consult an otolaryngologist for further examination.
If oral medication is not effective, you may also consider treatments such as cauterization of the frequently bleeding nasal blood vessels using medication or laser therapy.
Wishing you peace and health.
This is purely an exchange of ideas; please follow the actual assessment of your physician.
Sincerely, Dr.
Chi Chao-Yun, Head of the Department of Otolaryngology, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2018/01/30

More Info

Unilateral nosebleeds, or epistaxis, can be a concerning symptom, especially when they are recurrent and accompanied by other signs such as itching, increased wound size, and the sensation of blood in the throat. Based on your description, it seems you have a small wound in your nose that has not healed properly and has been causing significant bleeding. Here are some potential causes and considerations regarding your symptoms:
1. Local Trauma or Injury: It sounds like you may have sustained a minor injury to the nasal mucosa, which can lead to bleeding. If the initial injury was not properly treated or if there is ongoing irritation (from scratching or other factors), it can result in a larger wound and persistent bleeding.

2. Infection: If the wound has become infected, it could lead to increased inflammation and bleeding. Signs of infection may include increased redness, swelling, and possibly discharge from the wound. If you notice any of these symptoms, it is essential to seek medical attention.

3. Nasal Polyps or Growths: Sometimes, abnormal growths in the nasal cavity, such as polyps, can cause recurrent bleeding. These growths can irritate the surrounding tissue and lead to bleeding, especially if they are traumatized.

4. Underlying Conditions: Certain medical conditions, such as blood clotting disorders, hypertension, or even systemic diseases, can predispose individuals to frequent nosebleeds. If you have a history of such conditions or if there are other symptoms present, it may be worth discussing with your healthcare provider.

5. Environmental Factors: Dry air, especially in winter months or in air-conditioned environments, can dry out the nasal mucosa, making it more susceptible to bleeding. If you live in a dry climate or have been exposed to dry air, consider using a humidifier or saline nasal sprays to keep the nasal passages moist.

6. Allergic Rhinitis: If you are experiencing itching in your nose, it may be related to allergies. Allergic rhinitis can cause inflammation and irritation in the nasal passages, leading to increased susceptibility to bleeding.

Given that your symptoms have persisted for about a week and the wound appears to be enlarging, it is crucial to follow up with an Ear, Nose, and Throat (ENT) specialist. They can perform a thorough examination, possibly including nasal endoscopy, to assess the extent of the injury and determine if there are any underlying issues that need to be addressed.

In the meantime, here are some self-care tips to help manage your symptoms:
- Avoid Picking or Scratching: This can exacerbate the injury and lead to further bleeding.

- Moisturize the Nasal Passages: Use saline nasal sprays or gels to keep the area moist.

- Stay Hydrated: Drinking plenty of fluids can help keep your mucous membranes hydrated.

- Avoid Irritants: Stay away from smoke, strong odors, and other irritants that can aggravate your nasal passages.

In conclusion, while unilateral nosebleeds can often be benign, your symptoms warrant further investigation to rule out any serious underlying conditions. It is essential to consult with a healthcare professional who can provide a comprehensive evaluation and appropriate treatment.

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