I have a nosebleed once every two months. My nose appears crooked, and I get stuffy with a crust that I pick. I have had issues with post nasal drip for a few years. I have attached images for your reference. Please guide me.
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The basal view of your nose does not show much of a deformity (attachments removed to protect the patient's identity). However, I can say that the tip is broad. The nostrils are narrow. Does it cause a lot of crusting? We need to check the nasal valve area. Is there any issue with why you try to pick the nose? Have you tried nasal douching and lubricants? Do you smoke? Please send front, top, and lateral views of the nose to guide you accordingly.
I do not use any lubricants on it. I have attached some more pictures. Please let me know if I should send another view. I do get some dry mucus in the nose if that is what you mean by crusting. I pick the nose out of habit. I do not smoke, but I used to briefly, and I have not smoked now for over eight years. Kindly help me.
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The pictures are clear and decisive (attachments removed to protect the patient's identity). I dont need any more external pictures. My observations and views are that the nose is pretty decent externally. The alar-columellar show is good. But for a mild C-shaped deviation of the external dorsum, the nose seems fine. The tip is also not as bulbous as it appeared in the basal view. So, cosmetically it is all good. Bleeds are common from nasal cavities. They can occur due to dryness, smoking, infections, rhinitis, DNS (deviated nasal septum). The foremost cause is dryness. All other causes that I listed cause dryness. Dry mucus can further get dried and become like a paper-thin crust attached to the mucosa of the nostril at a small area. When you have DNS, the nose has more air currents on the lower airway side than the other, causing the mucus to dry up faster and the crusts to dislodge often. When this happens, the area where the crust was attached starts bleeding and gets controlled slowly. After any bleed initially, a clot and then a scab form, and the same can again dislodge due to the heavy air currents. So the cycle continues. When you smoke, dryness increases. More soot gets deposited on that.
When there are allergies and rhinitis (or flu or cold, for that matter), excess mucus is produced, which also has the propensity to dry up sooner when there are some anatomical deformities. All the above factors can cause you to pick the nose, and then it becomes a habit gradually. I would rule out crooked nose deformity in you. But from the insides, whether the septum has deviated in a C or S-shaped way, we cannot say unless we do a CT (computed tomography) scan and nasal endoscopy. If you indeed have the deformity, then we can think of a surgical way to correct those. However, I must say that in such cases, your symptoms will not be merely a few bleeds every few months. You will have constant or recurrent nasal obstruction and headaches. Facial pressure and sinus pains may also accompany. Nevertheless, it is wise to get the CT (of paranasal sinuses and nose) and an endoscopy of the nose to rule out any such internal deformity.
Try saline nasal spray. They moist the area and prevent dryness. Find out all reasons why the nose could go dry in your room, locality, or area where you reside. Lubricants like Framycetin or Paraffin can help you keep the nasal cavity's insides moist and lubricated and prevent crust formation.
Please get back if you have further queries.
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