February 14th, 2018 by Sepehr Oliaei, MD

If you are reading this, then you or a loved one maybe one of millions of people suffering from various nasal ailments this winter. Dry, painful and occasionally bloody noses with lots of crusting have been a frequent complaint in the ENT clinics this winter  — and the weather is to blame.

Although 2016 was one of the planet’s warmest years on record, the Puget Sound region has been dealing with unusually cold and dry weather. Last January, the region had temperatures hovering around the 50s with substantially greater humidity and rainfall, which is what makes this year’s influx of patients with nasal complaints so remarkable in comparison to prior years.

So why does the nose get dry in this weather? The answer lies in the base function of your nose, which is to provide a relatively tight, warm and humid passageway for the air to get through to the lungs. In the process, the nose “lends” some of its own humidity and warmth to the air that passes through. Warm, moist air is more compatible and less irritating to your lungs and lower airways. Ever notice how you may get into a coughing fit if you take a deep breath through your mouth in cold weather?

However, this function of the nose comes at a cost. Overly dry air can take away too much of the moisture from the nose, causing lining of the nose (mucosa) to dry out, and the mucous in the nose to form dry crusts that stick to those dry surfaces. When these crusts are peeled away (by blowing or picking at the nose), they can cause small tears in the lining, which lead to nose bleeds of varying severity.

To make matters worse, many people tend to suffer from various viral upper respiratory illnesses this time of the year, which further damages the lining and causes it to crack and bleed easily. Antihistamines and decongestant use can further dry the nose and exacerbate the problem.

What can be done about it? Other than waiting for warmer temperatures and more rainfall in the spring, there are a few steps you can take to improve things:

  • In-room humidifiers at night while you sleep
  • Regular saline rinses to gently wash away pesky dried crusts from the nose
  • Be gentle and avoid forceful nose blowing or picking at the nose, as this can lead to nose bleeds
  • Use of petroleum jelly or water-soluble, over-the-counter saline gel products specifically made for dry nose problems
  • In cases of severe recurrent bleeding, in office and surgical procedure may be indicated to resolve the problem. (below is a video of an endoscopic procedure for control of severe recurrent bleeding episodes)

If you have frequent severe bleeding episodes, significant pain/pressure in the nose or face or frequent discharge of thick green/yellow mucous from the nose, you may be suffering from a more serious condition. Please discuss with your primary care provider or an ear, nose and throat specialist to further evaluate.

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