Nosebleeds in Teens: Causes, First Aid, and When to See a Doctor

Epistaxis affects ~60% of adolescents. Most are anterior (Kiesselbach’s plexus) and benign.

Common Triggers

• Dry air (heated indoor winter).
• Nose picking, trauma.
• Allergic rhinitis (rubbing, inflammation).
• Topical nasal steroids (improper technique).
• Deviated septum, foreign body.

First Aid

1. Sit upright, lean slightly forward (prevents swallowing blood).
2. Pinch soft part of nose (not bony bridge) firmly for 10–15 minutes uninterrupted.
3. Apply ice to bridge/cheeks.
4. Avoid nose blowing, picking, straining for 24 hrs.

See a Doctor If

• Bleeding >20 minutes despite pressure.
• Heavy volume (cup or more).
• Post-trauma (punch, fall) with deformity.
• Recurrent frequent episodes (>1/week).
• On anticoagulants, bleeding disorder, or chemotherapy.
• Associated bruising, petechiae, fatigue (rule out leukemia).

Medical Treatments

• Cautery (silver nitrate) for visible vessel.
• Nasal packing (absorbable or non-absorbable).
• Endoscopic ligation for refractory posterior bleeds.