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Epidemiology and etiology of epistaxis in children

Anna H Messner, MD
Section Editors
Glenn C Isaacson, MD, FAAP
Jonathan I Singer, MD
Deputy Editor
James F Wiley, II, MD, MPH


Epistaxis is common in children. Childhood nosebleeds are rarely severe and seldom require hospital admission [1]. Nonetheless, frequent minor nosebleeds can be both bothersome and alarming for parents and children.

The epidemiology and etiology of epistaxis in children will be reviewed here. The evaluation and management of epistaxis in children are discussed separately. (See "Evaluation of epistaxis in children" and "Management of epistaxis in children".)


There is limited evidence regarding the prevalence of nosebleeds in children. One 1979 study found that 30 percent of children younger than 5 years and 56 percent of children aged 6 to 10 years had had at least one nosebleed [2]. The incidence of epistaxis declines in adulthood, but approximately one-half of all adults with epistaxis had nosebleeds during childhood [3]. Epistaxis is rare in children younger than 2 years (approximately 1 per 10,000) and should prompt consideration of trauma (intentional or unintentional) or serious illness (eg, thrombocytopenia) [4-6]. Some pediatric healthcare providers believe that when a young baby bleeds from the nose, or is reported to have had a nosebleed, that child abuse must be considered [7,8].

Epistaxis that occurs in children younger than 10 years usually is mild and originates in the anterior nose, whereas epistaxis that occurs in individuals older than 50 years is more likely to be severe and to originate posteriorly [9].

Data from the National Hospital Ambulatory Medical Care Survey indicate that epistaxis accounted for <1 percent of all emergency department visits between 1992 and 2001 [10]. Overall, there were approximately two emergency department visits for epistaxis per 1000 population annually. The age-related frequency was bimodal with one peak in individuals younger than 10 years (4 per 1000 population) and a second peak in those 70 to 79 years.

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Literature review current through: Nov 2017. | This topic last updated: May 15, 2017.
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