Introduction
Nosebleeds (lat. : epistaxis) in children can often be observed. When blood suddenly drips from the nose and apparently won’t stop, the fear and consternation is not only great for the affected children.
In most cases, however, the worry is unfounded and the nosebleed seems to be much more dramatic than it actually is. Even without external intervention, the blood flow usually stops of its own accord. Medical intervention is only necessary in a few cases.
Instead, simple measures, depending on possible causes, can prevent your child’s nosebleed. Unfortunately, even today, there are often large gaps in knowledge regarding suitable first aid measures. Our nose is supplied by many small blood vessels.
In the area of the anterior nasal septum, these vessels form numerous connections with each other, so that a dense network, the so-called “Locus Kiesselbachi”, is formed. Since the fine blood vessels are located close to the surface of the thin septum, they can be damaged relatively easily and thus cause the typical nosebleed. Other blood vessels, on the other hand, very rarely cause bleeding from the nose (“posterior nosebleed”).
Causes
There are numerous causes of suddenly occurring nosebleeds. In the vast majority of cases, children have drilled or scratched their nose in the area of the inner nasal mucosa, which can then lead to bleeding from the nose. In healthy children, the blood clotting starts after a few minutes and thus the bleeding usually stops very quickly.
In other cases, a blow to the nose or a fall may have caused a blood vessel in the nose to burst and start bleeding. Furthermore, there are still some causes of nosebleeds that are not immediately obvious at first sight. For example, chronic dryness of the nose can cause the so-called locus kiesselbachi to burst open and start bleeding heavily.
Blood count changes that result in a reduction of important blood platelets can also lead to nosebleeds that are very difficult to stop. Blood clotting is prolonged due to the reduced number of platelets, the bleeding is usually stronger and difficult to stop. For this reason, young children with recurrent nosebleeds should always be considered as having a serious disease of the blood system.
Much more harmless than the cause and relatively common is the increase in pressure in the blood vessels in the nose and mucous membrane. Thus, a strong and heavy nose blowing can always lead to a nosebleed. Even if the child is currently experiencing a severe cold, it is possible that frequent nose-blowing can irritate the mucous membranes to such an extent that a nosebleed can quickly occur.
In many cases, unfortunately, no clear explanation can be found for nosebleeds. However, the following causes can often play a role:The nasal mucous membranes are particularly strained in the case of colds and sniffles. Children in particular suffer from recurring colds, as they can easily be infected by their playmates.
Frequent nose blowing and strong nose blowing can temporarily damage the blood vessels within our olfactory organ. Injured or burst veins can lead to nosebleeds. The shock is often great when the child’s handkerchief suddenly turns red!
Injured vessels in the nasal mucosa usually heal quickly on their own. Frequent and heavy blowing and nose blowing, not least because of the constant increase in pressure in the nasal area, cause blood vessels to become more porous and can tear more easily. Nasal ointments or nasal oils are very helpful for a long cold.
They are applied to the front part of the nose and care for the nasal mucous membranes. As a result, the mucous membranes become smoother, the blood vessels do not become porous so quickly and start bleeding, and the dryness of the entire nasal cavity is reduced. Special care should be taken when using decongestant nasal sprays: If your child’s nose is blocked, decongestant nasal drops ensure rapid breathing due to their vasoconstrictive effect.
Used over a long period of time, however, they dry out the sensitive nasal mucosa and can cause nosebleeds. Nosebleeds and Nasic® Nasal Spray for children. In winter, the warm heating air dries out our mucous membranes.
Small children in particular, who spend almost all their time in heated rooms during the cold season, are at risk. The dried out nasal mucous membrane also damages the vessels lying just below the surface, which can lead to nosebleeds.More information can be found here: Nosebleeds in infantsAfter a fall on the face, your child’s nose can be affected. Often the force of the impact alone is enough to cause a nosebleed.
In the case of a bony injury, such as a fracture of the nasal bone, strong nosebleeds, swelling and “bruises” (lat. : haematomas) can be observed in addition to sometimes severe nosebleeds. Often, however, a simple contusion of the nasal bone is sufficient to cause bleeding.
It can happen that a fall can cause a severe nosebleed, which may also have to be treated with a so-called tamponade. A tamponade is a compression of the vessels by gauze material that is inserted into the nose to stop the bleeding. If this does not succeed, the nose should also be examined more closely to find out exactly which parts of the nose have been damaged.
Nosebleeds can be particularly severe if there are tears in the nasal mucosa, which is well supplied with blood. Sports accidents or small fights can also lead to nosebleeds in children. Occasionally, parents take their children to the pediatrician because small objects, such as Lego bricks or peas, have accidentally got into the nose while playing.
There they can cause injuries or cracks and thus nosebleeds. If a nosebleed suddenly occurs, especially when playing with such objects, you should therefore always keep this possibility in mind. Furthermore, small children in particular often pick their noses.
Through this manipulation, the children can inadvertently cause minimal mucous membrane injuries, which lead to nosebleeds. If children suffer from a nosebleed at night without being noticed, the next morning the fright is great: bloodstained pillows or a bloody face are not uncommon. But once again: It almost always looks worse than it is!
Because warm heating air dries out the mucous membranes of the children in their sleep. In very many cases, the child has scratched its nose or drilled into it with its finger. Nosebleeds at night can be treated in the same way as nosebleeds during the day with cooling compresses in the neck.
Furthermore, the nostrils should be squeezed together. It is also important to wake up the child and get it into its seat. Nosebleeds in a lying position always carry the risk of blood running into the throat and stomach and causing nausea or that the child inhales the blood.
Especially in the cold season, this can cause nightly nosebleeds. The phenomenon can also be observed occasionally in the context of an infection of the upper respiratory tract. However, if your child very often suffers from recurring, heavy nosebleeds at night, you should consult your pediatrician.
This can also be caused by defects of the nasal septum or coagulation disorders. If the cause is harmless, nasal ointments can be applied to the front part of the nose to make the skin smoother and prevent it from drying out. When small children get excited, nosebleeds also occur from time to time.
The background to this is that when they get excited, both the child’s pulse and blood pressure can rise, with the result that blood vessels in the nose that have already been damaged can burst open and start bleeding. The most important measure, apart from cooling the neck, is to calm the child. By calmly coaxing the child, the blood pressure is lowered and blood clotting in the nose can take place more quickly.
Further measures are usually no longer necessary. You can find more information here: Nosebleeds under stressIn the vast majority of cases, children’s nosebleeds have a harmless explanation. However, in the case of recurring events that are difficult to stop, a cause outside of the nose should be considered under certain circumstances.
In very rare cases, a congenital defect of the blood platelets (lat. : thrombocytes) or blood coagulation chain can also trigger a nosebleed in children. Various extremely rare syndromes (e.g. Rendu-Osler disease) should continue to be taken into account in the event of recurrent, severe episodes.
If boys in particular suffer from severe nosebleeds from the age of 10, a benign tumor of the nasopharynx (lat. : juvenile nasopharyngeal fibroma) may be present very rarely. In addition to the described nosebleeds, affected children often suffer from difficult nasal breathing, headaches and persistent rhinitis.
Unfortunately, nosebleeds can also have a very serious, but fortunately rather rare cause. It should be examined and ruled out especially if nosebleeds occur repeatedly in small children. Leukemia (blood cancer) is a malignant disease of the blood-forming system.An infestation ensures that certain blood cells, which have not yet fully developed and are not ready for use, are flushed out into the bloodstream.
However, since the cells are not yet mature, they cannot take over the work like healthy blood cells. If platelets are also affected, the number of platelets decreases, which means that blood clotting takes longer and bleeding occurs very quickly. In addition to bleeding gums and blood in the urine, children suffering from leukemia are also often conspicuous by a recurring nosebleed.
The diagnosis is made by means of blood tests or bone marrow puncture. Leukemias are relatively common in young children, but are usually easy to treat. Chemotherapy, radiation and, if necessary, a bone marrow transplant are used depending on the type of disease.
The prognosis of treatment can be good, depending on the type of leukemia and stage of the disease. You can find more information on this topic here: Leukemia in childrenIn many cases, a nosebleed occurs for no apparent reason. High blood pressure is extremely rare in children and is usually ruled out as the cause.
Even if children do not manipulate their nose and no fall can be remembered, the most common cause of nosebleeds is a porous venous plexus in the frontal turbinate of the nose. Often, nosebleeds disappear very quickly and no longer occur. The exact cause then usually remains in the dark.
