Nose sprays and nose bleeds

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The most common limiting side effect of nasal steroid sprays (flonase, nasonex, etc.) is nose bleeds.  Since doctors have to use obscure names we call this epistaxis.  Most epistaxis arises from a specific location in the nose called Kiesselbach’s plexus, where several blood vessels in the septum come together.

Obviously, this area could easily be irritated by using a nasal steroid spray.  If you aim the spray nozzle slightly inward, it directs the spray right toward this point. That’s why, when using a nasal steroid spray, you should always aim slightly outward. Try using your right hand for the left side of the nose and vice versa. Often, this simple trick will allow someone who has had difficulty with epistaxis from nasal steroid sprays to use the medications without complication.

Dr. O

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