What tests are needed for frequent nosebleeds?

Recurrent nosebleeds should be evaluated by a healthcare professional promptly. Common diagnostic tests include nasal endoscopy, complete blood count (CBC), coagulation function tests, allergy testing, and blood pressure measurement. These examinations help identify the underlying cause of bleeding and guide subsequent management. Detailed analysis is as follows:

1. Nasal Endoscopy

Nasal endoscopy allows clear visualization of the internal nasal structures, helping to detect conditions such as deviated nasal septum, nasal mucosal erosion, dilated nasal blood vessels, or nasal foreign bodies. Recurrent bleeding often occurs when the anterior nasal mucosa is fragile or blood vessels are exposed. Endoscopy can precisely locate the bleeding site and determine whether there is an underlying structural abnormality.

2. Complete Blood Count (CBC)

CBC evaluates red blood cells, white blood cells, and platelets to identify potential hematologic disorders. Reduced platelet count or impaired platelet function can compromise blood clotting and lead to frequent nosebleeds. This test helps screen for conditions such as leukemia or immune thrombocytopenic purpura.

3. Coagulation Function Tests

These tests include prothrombin time (PT) and activated partial thromboplastin time (aPTT), which assess the blood's ability to clot. Deficiencies or dysfunction in clotting factors may disrupt the coagulation process, resulting in recurrent epistaxis. Such tests aid in diagnosing coagulation disorders like hemophilia.

4. Allergy Testing

Allergic reactions can cause nasal mucosal congestion, swelling, and itching, leading patients to frequently rub their noses, which may damage the mucosa and trigger bleeding. Allergy testing identifies sensitivities to allergens such as pollen or dust mites, helping determine whether allergic rhinitis contributes to the nosebleeds.

5. Blood Pressure Measurement

In individuals with hypertension, fluctuations in blood pressure can cause nasal blood vessels to rupture due to increased pressure, especially among elderly patients. Measuring blood pressure helps determine if elevated levels are responsible for the nosebleeds and guides further treatment.

To prevent nosebleeds, avoid picking the nose forcefully and keep fingernails trimmed and smooth to prevent mucosal injury. In dry conditions, apply medical-grade petroleum jelly inside the nostrils to maintain moisture and reduce the risk of mucosal damage. During an episode of nosebleed, lean forward slightly and pinch the soft part of the nose firmly to achieve compression hemostasis—avoid tilting the head backward, which may cause blood to flow into the throat. If any abnormalities are detected during evaluation, follow medical advice and actively treat the underlying condition.