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Allergic Rhinitis for Children and Teenagers

Qn: My paediatrician said that my 4-year-old daughter has very sensitive nose and nose bleeding may occur especially after flu. However, recently her nose started bleeding frequently. This week, she had been bleeding twice a day. It is a really alarming and frightening sight and it hurts me to see her losing so much blood. What should I do?

Ans: Firstly, your daughter has allergic rhinitis. Whether you noticed or not, children usually have extremely itchy noses and they often rub or pick their noses. With each cold, your daughter's nose may have been very itchy and she was probably rubbing it. The repeated trauma will cause the nose to bleed. Secondly, nosebleed or epsitaxis is extremely common in children whether or not there is concomitant allergic rhinitis. This is because they have very prominent blood vessels in an area of the nose called the Little's area. In colder climates and low humidity, many children bleed spontaneously frequently.

Your daughter needs to be treated for her allergic rhinitis, properly and adequately. She will require an antihistamine and possibly an inhalational steroid for the duration of a few weeks depending on his condition. If her improvement is minimal in spite of the treatment, she needs to be reviewed by the ENT surgeon. During this review, the surgeon will use a small scope to look into her nose and the Little's area. If a source of bleeding is identified, the blood vessel can be cauterised to curb further bleeding.