Why do people suffer from epistaxis (nosebleeds) more during the Winter?

Let us review some of the basic anatomy of the nose before we can understand why nosebleeds occur.  The nose itself is a conduit for the breathing as the air enters our body and reaches deep down into the lungs.  The membranes of the inside of the nose are designed to provide moisture, heat, and filtering functions before the outside air reaches our lungs.  Sincewe breath gallons of air on a daily basis, there is a lot of turnaround that needs to happen in our nasal membranes on a regular basis.

In order for the membranes to be able to keep up with this demand, the nasal passages have a very rich supply of blood vessels.  This supply is much richer than most other organs in our body.  In fact, there are three main arteries that supply either side of the nasal passages.  Additionally, the blood vessels of the nasal membranes happen to be much more superficial than most other places accessible to the outside world.  Therefore, any slight scraping or dryness can lead to exposed blood vessels.

During the winter, the air around us is much colder and much more dry.  Basically, as the temperature around us drops, the moisture in the environment drops as well.  In addition, most of us are exposed to central heating, which is a dry heating mode (as compared to the old style fireplaces that used to be the main heating elements in most houses).

The combination of cold weather and dry heat is very damaging to the nasal membrane.  Frequently, the membranes cannot stand up to their demand, and they start having superficial cracks.  These can lead to nosebleeds of capillary, vein, or artery origin.

The best way to improve the hygiene of the nose in order to prevent any unnecessary bleeding is to give it extra moisture.  Over-the-counter saline sprays can be used periodically throughout the day to keep the moisture up in the nose.  Rhinaris® is the only over-the-counter nasal spray that in addition to saline contains an emollient designed to further soothe the dry nasal membranes.  You can also put a small amount of Vaseline on a Q-Tip and gently rub on the inside of the nostrils to provide extra moisture to the membranes couple of times a day.  Make sure you keep up oral intake of liquid in order to keep up the hydration of the body as a general principle.

Another important element is to provide environmental humidification.  Using a cold mist humidifier can replace the missing moisture in environment around you.  The optimal place for use of the humidifier is in your bedroom in a location near the head of the bed.  This will make sure that the air that you breathe all night is optimally moisturized, and you will avoid a dry nose as you wake up in the morning.  I recommend that you have the humidifier working in your bedroom all nights, every night.  Ideally, in climates similar to New York, this should be done from November until April.


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Posted in: Nose

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