Nosebleed (Epistaxis) Cauterization

What Is Epistaxis?

Epistaxis is the medical term for a nosebleed. Most nosebleeds originate from the front part of the nose, where delicate blood vessels are easily irritated or injured.

Common causes include:

• Dry air or nasal irritation
• Nose picking or trauma
• Allergies or infections
• Use of blood thinners
• High blood pressure

What Is Cauterization?

Cauterization is a treatment used to seal a blood vessel that is causing recurrent nosebleeds.

This may be performed using:

• A chemical agent (such as silver nitrate), or
• A small electrical device (electrocautery)

The goal is to stop bleeding and reduce the risk of future nosebleeds.

When Is Cauterization Recommended?

Your doctor may recommend cauterization if:

• Nosebleeds are frequent or severe
• Bleeding does not stop easily with pressure
• A specific bleeding site can be identified
• Conservative treatments (such as nasal sprays or humidification) have not been effective

How Is the Procedure Performed?

In the Office (Awake)

• The inside of the nose is numbed with a topical anesthetic
• The bleeding site is identified
• Chemical or electrical cautery is applied
• The procedure typically takes 5-10 minutes
• You may feel mild pressure or brief stinging

In the Operating Room (OR)

• Used for severe or difficult-to-control nosebleeds
• Performed under general anesthesia
• Specialized instruments are used to locate and treat bleeding areas
• May involve deeper areas of the nasal cavity
• The procedure typically takes 10-15 minutes

What to Expect After the Procedure

• Mild discomfort or nasal irritation for a few days
• Temporary crusting or slight bleeding
• Instructions to use saline sprays or ointments to keep the nose moist
• Avoid nose blowing, heavy lifting, and straining as directed

Benefits of Cauterization

• Stops recurrent nosebleeds
• Targets the specific source of bleeding
• Quick and effective treatment
• Often avoids more invasive procedures

Risks

Cauterization is generally very safe. Possible risks include:

• Mild pain or irritation
• Temporary crusting
• Recurrence of bleeding
• Rarely, a small hole in the nasal septum (septal perforation)

Post-Procedure Care Instructions

Pain Management

Pain is usually minimal and typically resolves within the first hour. If needed, you may take:

• Acetaminophen (Tylenol)
• Ibuprofen (Motrin)

Nasal Care

• Keep the inside of the nose moist using saline spray and/or ointment
• This helps prevent scab formation and reduces the risk of recurrent bleeding
• Use prescription or over-the-counter products as directed

Discoloration

• Temporary gray or brown discoloration of the skin may occur if silver nitrate was used
• This can be gently washed off with soap and water
• Discoloration typically resolves within 1–2 days

Activity Restrictions

Children (under 18):

• Avoid nose blowing for 12 hours
• Avoid strenuous activity for 4 hours

Adults:

• Avoid nose blowing for 1 week
• Avoid strenuous activity and bending (head below heart) for 1 week

Fever

Fever is uncommon and usually unrelated to the procedure. If present, it may be treated with acetaminophen or ibuprofen.

Bleeding After Cauterization

Mild bleeding can occur as the cauterized area heals and scabs separate. This should improve over about one week.

If Bleeding Occurs:

1. Perform a saline nasal rinse
2. Blow the nose to remove clots
3. Use 4 sprays of over-the-counter Afrin (or similar decongestant spray) in each nostril
4. Pinch the entire nose closed firmly for 20 minutes

When to Seek Emergency Care

If bleeding persists despite the above measures, go to the nearest emergency room for further evaluation and possible nasal packing.

Recommended Emergency Facilities:

• Patients age 16 and older: Centennial Medical Center Frisco
• Patients under 16: Children’s Medical Center Plano