Local causes of epistaxis

Local causes of epistaxis:

• chronic sinusitis
• irritants (cigarette smoke)
• medications (e.g. topical corticosteroids)
• rhinitis
• trauma:
  • nose picking
  • foreign body
  • fracture of the nasal bones, skull or sinuses
  • nasal surgery
• nasal vessel degeneration
• septal deviation and perforation
• vascular malformation (e.g. telangiectasia)
• neoplastic:
  • polyp of the septum
  • carcinoma of the nose or sinuses usually causes a sero-sanguinous discharge rather than frank epistaxis
  • epistaxis, often unilateral, is a common presentation of a nasopharyngeal carcinoma
  • an angiofibroma is an uncommon cause of epistaxis in young boys
  • Wegener's granulomatosis

Reference

1. Tunkel DE, Anne S, Payne SC, et al. Clinical practice guideline: nosebleed (epistaxis). Otolaryngol Head Neck Surg. 2020 Jan;162(suppl 1):S1-38.