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DEAR MAYO CLINIC: My 12-year-old daughter gets nosebleeds often, especially during the winter, and usually at night. They don't last long, but they disrupt her sleep and can be frightening. Why are some people more prone to nosebleeds than others? Are there ways to prevent them?
ANSWER: Nosebleeds are a common problem. A number of lifestyle and medical factors increase a person's risk for nosebleeds. Although they can be bothersome and upsetting, nosebleeds are rarely a sign of a more serious condition.
Nosebleeds happen when the blood vessels in the lining of the nose become damaged. Dry air is often part of the problem. When the nasal membranes dry out, they become more vulnerable to bleeding. That's why nosebleeds happen more often during the winter when the air is particularly dry.
To combat dry air, put a cool-water humidifier in your daughter's bedroom at night. It will infuse moisture into the air and reduce her risk of nosebleeds while she's sleeping. Do not use a warm-water humidifier. This can promote the growth and distribution of mold, which may lead to other health concerns.
Another way to keep her nose from drying out is to coat the inside with petroleum jelly before she goes to bed. This is most easily done by placing a small amount of the jelly on a cotton swab, or on your finger, and gently rubbing it in each nostril. Use a product that does not have any scent, perfume or other additives, as they may irritate the nasal lining.
Another common cause of nosebleeds is nose picking. The picking may nick the small, sensitive blood vessels within the nose. They bleed and a scab forms. The scab can make a child feel as if there's something in the nose. Then he or she picks at it again, and the cycle starts over.
Nose picking can become an unconscious habit for some children. If your daughter picks her nose, encourage her to become more aware of it. Help her find something else to do with her hands to keep them occupied when she becomes bored, tired or stressed.
In some cases, nosebleeds are due to allergies. Allergy symptoms may appear during the wintertime when allergens build up indoors. If nosebleeds are the only symptom of an allergy, using saline to rinse out each nostril before bedtime can help clear out allergens and lower the risk of a nosebleed.
If saline is not effective, your daughter's doctor may prescribe a nasal steroid to reduce inflammation and irritation within the nose. When nosebleeds occur along with other allergy symptoms, such as watery eyes, a runny nose or a scratchy throat, taking an allergy medication may be more useful in order to combat all the symptoms at once.
A less common cause of nosebleeds in children is nasal polyps -- soft, noncancerous growths on the lining of the nasal passages. In addition to nosebleeds, nasal polyps may cause symptoms such as a persistent runny nose, chronic stuffiness, and decrease in a person's sense of smell or taste. If you suspect nasal polyps, make an appointment to have your daughter evaluated.
You should also take your daughter to see her primary care physician if her nosebleeds are more frequent than once a week, if they last longer than 45 minutes, or if they involve a significant amount of blood. Rarely, chronic nosebleeds can be due to a bleeding disorder.
When your daughter gets a nosebleed, ask her to sit quietly. Put a tissue over her nose to catch the blood. Do not put anything up her nose. Comfort her if she's frightened. Sit with her. Sing a song. Rub her back. Reassure her that she will be OK. Most nosebleeds stop within a few minutes and don't require any other treatment. -- Esther Krych, M.D., Community Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minn.
(Medical Edge from Mayo Clinic is an educational resource and doesn't replace regular medical care. To submit a question, write to: firstname.lastname@example.org. For health information, visit www.mayoclinic.com.)