Summary

• A common condition with a bimodal age distribution, occurring more frequently in the young and the old.
• 90% arise at Little's area of the anterior septum, the location of the Kiesselbach plexus.
• Precipitating factors include dry weather and other causes of nasal mucosal inflammation or hyperaemia, such as allergy, viral rhinitis, bacterial rhinosinusitis, dust, or chemicals. Although rare, neoplasm may also cause nosebleed.
• Topical anaesthesia and vasoconstriction are essential for initial treatment of active bleeding. If initial measures fail, almost all episodes may be controlled with anterior or anterior-posterior packing techniques.
• Bleeding may be refractory in the presence of coagulopathy.