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Nosebleeds (Epistaxis)

Epistaxis means a nosebleed. When children have recurrent nosebleeds, it is important for them to be seen by a pediatric otolaryngologist (ENT) to understand the root cause of the nosebleeds, as well as rule out any other possible conditions.

Causes of Epistaxis

Nosebleeds are usually due to commonly occurring conditions in childhood, including:

If a child has frequent number of nosebleeds, particularly those that are hard to stop, he or she should be evaluated by a pediatric ENT. While your pediatrician may have guidance for you on how to control your child’s nosebleeds, it is critical to rule out any possible underlying causes for chronic nosebleeds. Our expert pediatric ENTs at the Johns Hopkins Division of Pediatric Otolaryngology are specially trained to examine and evaluate children with epistaxis.


Diagnosing pediatric epistaxis requires the experience to understand when more advanced imaging is necessary to rule out any structural problems within the nose, when to test for allergies, and even when to suspect a disorder of the clotting mechanism. We only treat children, so we have the necessary techniques and child-friendly atmosphere to thoroughly evaluate and diagnose our patients.

Your child’s evaluation will include:

  • A complete medical history and a thorough physical examination, using special lighted scopes if needed.
  • Different diagnostic studies may be ordered, including imaging studies, lab tests and detailed physical examinations. These may include:
    • CT scan
    • Allergy tests


Treatment for epistaxis may include the use of humidifiers, saline nasal spray and nasal ointments. Your pediatric ENT may recommend cautery in the clinic or in the operating room. Cautery should stop the cause of the bleeds. If nasal masses are causing the chronic nosebleeds, your physician will recommend they be surgically removed. If bleeding disorders are suspected, consultation with pediatric hematology experts and specialized laboratory tests will be arranged.

For more information about nosebleeds please review our handout.

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