What are the causes of nosebleeds (epistaxis)?
Epistaxis can be caused by a number of different factors. In children, it is most often caused by chronic nose picking or the use of steroid nasal sprays. In adults, it is usually caused by nasal steroids sprays, nasal septal deviations (from old nasal fractures), the use of appliances for obstructive sleep apnea (CPAP and BiPAP masks), and certain disease states that lead to excessive bleeding, such as hereditary hemorrhagic telangiectasia (HHT). In the elderly, it is often associated with the additional problems of medication use, such as Coumadin and other “blood thinners”, and excessive nasal dryness. At any age, any of the above factors may have a role in causing or contributing to nosebleeds.
