When a child has recurring nosebleeds from only one nostril, this can be from leukemia, lymphoma or a cancer inside the sinus cavity.
It is important to recognize, however, that cancer is NOT the most likely cause of this symptom.
There is a big difference between “It CAN cause” and “What is the most likely cause.”
“Anterior nosebleeds come from the front of the nose and are characterized by a flow of blood out of one nostril when the child is sitting or standing,” says Jacqueline Winkelmann, MD, who’s been a hospital-based pediatrician at CHOC Children’s Hospital in Orange County, CA, and most recently Chief of Staff at CHOC Children’s at Mission Hospital.
Single Nostril Nosebleeds in Kids: Dry House or Cancer?
Dr. Winkelmann explains, “Anterior nosebleeds are common in dry climates and during the winter months when using heaters.”
If the nosebleed in your child has suddenly started up, a change to a new, and dry, climate might be the cause.
But what about cancer?
“While rare in children, paranasal tumors or nasopharyngeal angiofibroma can present with a nosebleed from a single nostril,” says Dr. Winkelmann.
“In fact, leukemia can present with a nosebleed since the clotting mechanism is usually affected due to low platelets.
“Lastly, lymphomas, usually of the non-Hodgkin’s type, can erode the nasal mucosa and cause nosebleeds.
“However, it is important to recognize that a nosebleed, or epistaxis, without any associated symptoms, such as bone pain, weight loss, fever, night sweats or weakness, will rarely indicate a malignancy.”
In fact, paranasal cancer (somewhere within the sinus cavity and surrounding tissue) is EXTREMELY rare. Furthermore, some tumors in this location are benign.
More specific symptoms to a paranasal tumor include a new bump near the nose and inner eye, excessive tearing from one eye, bleeding from an eye, reduced sense of smell and a sensation of stuffiness in the nose that doesn’t resolve.
These symptoms can also have many benign causes. Again, paranasal cancer is VERY rare!
Other than a dry house, another possible explanations for a nosebleed in one nostril is nose-picking.
Many times, a child will stick a finger up his or her nose and begin digging – while the parent is either standing right next to that child, or has an arm around the child – seemingly oblivious to the infraction.
If you ever discover nose-picking, you must immediately teach your child (even as young as two) that this is unacceptable, especially in public.
Not only is it unsightly to other people, but it can cause a nosebleed because the digging finger ruptures the very tiny blood vessels in the nasal cavity.
Dr. Winkelmann recommends keeping your child’s nails short to minimize rupture of the blood vessels when picking their nose. But again, the goal is to extinguish this behavior.
“Patients using nasal steroids, especially children who might be using them improperly and pointing them directly in the mucosal wall of the nose, are more likely to bleed,” adds Dr. Winkelmann.
Suspecting a Nosebleed Is Cancer
“If the nosebleeds are persistent or difficult to control, a full evaluation is warranted,” says Dr. Winkelmann.
“This might include a full history and thorough physical exam, including lighted scopes to better evaluate the nasal cavity.
“If there are concerning signs, other studies might be ordered by the primary care physician or ENT (ear, nose and throat) specialist. A CT scan and/or laboratory tests may help in the final diagnosis.”
Prevention of Harmless Nosebleeds
• “Apply a light coating of clear ointment (petroleum jelly, Vaseline, A and D ointment, Eucerin) with a cotton swab up to three times a day during dry months, including at bedtime,” says Dr. Winkelmann.
• “Keep children’s nails short and discourage nose-picking.”
• “Use a humidifier in dry climate (make sure it’s clean!).”
• “Use a saline nasal spray to keep membranes moist.”
In an anterior nosebleed, the patient will not taste blood going down the back of their throat, as is often the case with a posterior bleed.
“Other conditions might cause posterior bleeds, usually in older people,” says Dr. Winkelmann. “Posterior bleeds usually flow down the back of the throat and mouth, even when the patient is sitting or standing.”
This is commonly caused by aggressive nose-blowing and cleaning out one’s nose with a Q-tip or – nose-picking with a finger. Unfortunately, there are adults who will do this in public!