For relief of chronic nosebleeds, saltwater measures up against the world’s best drug treatments, a new study shows.
Around 1 in 5,000 people suffer from hereditary hemorrhagic telangiectasia, or HHT – a genetic disorder of the blood vessels that causes chronic nosebleeds in more than 90% of patients. People living with this condition can experience up to two nosebleeds per day.
And the new findings, published in the Journal of the American Medical Association, suggest relief could be as simple as a daily squirt of saline solution.
A team from the US and Canada tested three known drug treatments – bevacizumab, estriol and tranexamic acid – to see which was the most effective for chronic nosebleed sufferers.
Their study observed 121 adults who experience epistaxis, or blood draining from their nostrils, at least once per week. Each participant was treated with one of three drugs or a control saltwater solution, twice a day for a 12-week period.
During the test, patients reported their symptoms using a standardised test that calculated scores to reflect bleeding severity. And across the board, there was little difference between treatments.
“No drug treatment was significantly different from placebo for epistaxis duration,” the researchers write.
Those similar results for each treatment, including the control saline solution, may suggest that simply hydrating the nasal passages can improve symptoms of HHT. This isn’t surprising, say the researchers, because people are at higher risk of nosebleeds when their nose dries out.
“This research highlights that there could be a benefit even in the simplest of interventions,” explains Kevin Whitehead from the University of Utah in the US and lead author of the paper.
“No drug proved to be any better than the saline placebo, but the majority of patients improved over the course of treatment – even those using saline.”
Alongside the possibility of a placebo effect – that is, participants noticing a change in symptoms because they were expecting one – the paper also acknowledges the possibility that sprays weren’t taken up successfully because of scabs or crust around the nose.
Regardless, the team recommends sufferers give saltwater a try.
“We stress the importance of hydration,” says Whitehead. “We tell them that something as simple as a morning and night saline spray could offer them some benefit.”
Amy Middleton is a Melbourne-based journalist.