As of Friday, January 3, 2014
DEAR DOCTOR K: My son suffers from occasional nosebleeds. What's the best way to stop a nosebleed?
DEAR READER: Many people suffer from nosebleeds. I tend to get them this time of year when the air is cold and dry, as it irritates the normally warm, moist surfaces inside the nose.
Most nosebleeds occur when a blood vessel in the nose's soft cartilage leaks. If your son is like most people, his nosebleeds probably stop quickly. Sometimes, though, if the nosebleed is more severe, he may need medical attention.
A recent research study looked at treatment options for serious nosebleeds. It found that simpler and gentler options work just as well as more invasive efforts. They also have fewer negative side effects and cost less.
More invasive options include using electricity or heat to burn a bleeding blood vessel, surgery to tie off the bleeding blood vessel, or injecting a plug of material into the artery to block its flow.
My colleague Dr. Mary Pickett at Harvard Medical School has reviewed medical studies of nosebleed treatments. She tells me that a low-tech option -- a good, strong pinch in the right place -- will often do the trick. Specifically, she recommends the following technique to treat a nosebleed at home:
-- Nod your head forward. This prevents the flow of blood from going down the back of your throat.
-- Place your thumb on one side of your nose and your forefinger on the other side, up near the bridge. Slowly slide them down to the sudden "drop-off" where the bones give way to cartilage.
-- Pinch your thumb and forefinger together, and hold.
-- Pinch with enough pressure to press both sides of your nose firmly against the septum -- the cartilage in the middle of your nose. The tissue on either side of the nose puts pressure on the bleeding blood vessel, which is usually on the septum.
-- If the bleeding slows or stops, you are pinching in the right place. If not, start over, and pinch lower or higher.
-- Hold the pinch for a minimum of five minutes before you release. You may need to repeat this again for another five-minute session.
You can watch a video of my Harvard Medical School colleague Dr. Howard LeWine demonstrating this technique on my website, AskDoctorK.com.
One final thought, prompted by a patient I saw not long ago. The patient was in his mid-40s and had never had nosebleeds in the past. But he had suffered from three of them in the past week, and they didn't always stop with the technique I've just recommended. I diagnosed a blood condition (low platelets) that, fortunately, was treated and cured. This is rare, and blood tests are rarely necessary in people with nosebleeds. But even common problems can sometimes have more serious causes.
Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.