Ask the Doctors

Dear Doctor: We just moved from Miami to northern Michigan, and even though my daily routine hasn't changed and I'm not on any new medications, I have begun to get a nosebleed every few weeks. Should I be worried?'

Dear Reader: If you had reported the onset of nosebleeds on a daily or even biweekly basis, then we would be having a different discussion. But you have recently moved from a climate that is warm and moist to one that, in winter, is cold and dry, and this can cause quite a bit of stress to delicate nasal tissues. Add in the effects of the heaters and furnaces that are pumping hot, dry air into homes and offices, and you've set the stage for the occasional nosebleed.

Why? A look at the inner workings of the nose will help explain.

Our noses have two main jobs. They not only serve as airways that filter, moisten, and either warm or cool the air we breathe, they are also our scent organs. Behind the visible portion of the nose that draws in air lies a wonderfully complex series of chambers and canals known as the sinus cavities. These are covered with a specialized lining called the mucosa, which includes numerous mucus glands that keep all the inner surfaces moist.

When cold or dry air causes the nasal membranes to dry out enough that they crack, the result is a nosebleed. This is most common in areas where winters are cold or summers are hot and dry. Because nasal membranes gradually become less robust over time, older adults can be more susceptible to nosebleeds than those who are younger. Individuals on blood-thinning drugs are also at greater risk.

Fortunately, there are a few steps you can take to lessen your chance of another nosebleed. First, try a little tenderness. When you need to blow your nose to clear it of mucus, do so gently. Instead of abruptly trumpeting full force into a tissue, use the minimum amount of gradual pressure needed to clear your nasal passages.

Using a humidifier, particularly in the bedroom as you sleep, gives your mucus membrane a boost. Just be sure to stay vigilant about keeping the humidifier clean, as moist air is basically a welcome mat for fungus. A dab of a water-based ointment inside each nostril will also help to keep things lubricated.

If you do get another nosebleed, don't panic. Lean forward (if you lean back, you wind up swallowing blood) and lightly pinch your nostrils together near the bridge of your nose. This puts pressure on the vessel that's bleeding and the flow should stop. Give it five minutes and then gently release.

If your nose is still bleeding, pinch again and go for another five minutes. In most cases, bleeding will stop within 10 to 15 minutes. If you nose is still bleeding after 20 minutes, it's time to see a doctor.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

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