Nosebleed cautery (Nasal cautery for epistaxis)

A quick procedure to seal a small bleeding blood vessel inside the nose, usually with a silver nitrate stick, to reduce repeated nosebleeds.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

It is a quick procedure to seal a small bleeding vessel inside the nose, usually with a silver nitrate stick after a numbing spray.
It can reduce repeated nosebleeds, but they can come back and cautery sometimes needs repeating.
Only one side of the nasal septum is usually cauterised at a time, to protect the wall between the nostrils.
Recurrent or heavy nosebleeds, or those on blood thinners, should be properly assessed rather than just cauterised.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeMinor procedure to seal a nasal blood vessel

AnaestheticLocal anaesthetic spray to numb the nose

How long it takesA few minutes

Hospital stayOutpatient — no hospital stay

Time off workUsually none

When you'll see resultsOften reduces bleeding straight away; the small scab takes a week or two to settle

On the NHS?Commonly done on the NHS; also available privately

A general guide. Your specialist will give you advice for your situation.

Best fit

Can stop or reduce repeated nosebleeds from a visible bleeding point

Pause if

There is no visible bleeding point to seal, so cautery cannot be aimed accurately.

Main recovery point

The numbing spray wears off over the next hour or so. You can usually go home and carry on as normal, avoiding nose-blowing and heavy exertion at first.

Good aftercare

Clear, written aftercare advice and first-aid steps for if bleeding restarts.

Straight after

The numbing spray wears off over the next hour or so. You can usually go home and carry on as normal, avoiding...

First few days

A small scab is healing inside the nose. Avoid picking your nose, blowing it hard, hot drinks, alcohol, hot baths...

First 1–2 weeks

The scab settles and any soreness or crusting eases. A prescribed cream is often used to help healing. Any skin...

Beyond 2 weeks

The treated area is usually healed. If nosebleeds keep coming back, go back to be reassessed rather than waiting.

Medical line illustration of nasal septum turbinate airway for Nosebleed cautery. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is nosebleed cautery?

Nosebleed cautery is a quick procedure to seal a small blood vessel inside the nose that keeps bleeding. Most nosebleeds come from an area just inside the nostril where small vessels sit close to the surface and are easily damaged.

The most common method uses a stick tipped with silver nitrate, a chemical that seals the vessel when held against it for a few seconds. A local anaesthetic spray numbs the inside of the nose first. Heat (electrocautery) is sometimes used instead, usually in hospital.

It is used for repeated or troublesome nosebleeds once a clear bleeding point can be seen. It is not a treatment for a nosebleed that is happening heavily right now — that needs first aid and sometimes packing first — and it does not address other causes such as blood-thinning medicines or, rarely, more serious conditions.

Cautery often helps, but nosebleeds can come back, and sometimes the procedure needs repeating. Simple measures and good aftercare matter just as much as the cautery itself.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Silver nitrate (chemical) cautery

A stick tipped with silver nitrate is held against the bleeding point for a few seconds to seal it. This is the most common method and is often done in clinic.

Electrocautery (heat)

Heat is used to seal the vessel, usually in a hospital setting and sometimes for bleeding that silver nitrate has not controlled.

Cautery for children

Nosebleeds are common in children and are often managed with creams and simple measures first; if cautery is needed, it is done gently with a numbing spray, with a parent or carer present.

Cautery after first aid or packing

When a heavy nosebleed has been controlled with first aid or nasal packing, the bleeding point may be cauterised afterwards once it can be seen clearly.

Cautery vs other approaches

	Cautery	Creams / first aid
When used	Visible bleeding point	Mild or frequent bleeds
Needs a clinic visit	Yes	Often no
Discomfort	Brief stinging	Minimal
Nosebleeds can recur	Yes	Yes

These are often used together — for example a cream after cautery. Your clinician will advise what suits your nose.

Preparing for your procedure

Expect the clinician to examine inside your nose to find the bleeding point.
Tell them about all medicines, especially blood thinners or aspirin, and any bleeding problems.
Mention if you have a peanut allergy, as one commonly used aftercare cream (Naseptin) contains peanut oil and an alternative would be used.
Tell them about high blood pressure or any condition that affects bleeding.
You do not usually need to fast or stop normal activities beforehand.
For children, a parent or carer should attend and help reassure them.
Ask what aftercare you will need and whether the procedure may need repeating.

What happens

The clinician first looks inside your nose to find the bleeding point. A local anaesthetic spray is used to numb the inside of the nose, and sometimes a decongestant to reduce bleeding and improve the view.

When the bleeding point is found, it is sealed. With silver nitrate, the tip of the stick is held against the spot for a few seconds. This can sting a little, but most people do not find it troublesome, and it is over quickly. Usually only one side of the central wall (septum) is treated at a time, to protect it.

A small scab forms where the vessel has been sealed. You can normally go home straight away and carry on with your day, following the aftercare advice you are given.

Is this procedure right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

There is no visible bleeding point to seal, so cautery cannot be aimed accurately.
A nosebleed is bleeding heavily right now — this needs first aid and sometimes packing first, not immediate cautery.
The lining is very fragile or already cauterised recently on the same side, raising the risk of a hole in the septum.
The bleeding is likely from a cause that needs different treatment, such as a clotting problem or, rarely, a growth in the nose.

Delay or rearrange if…

Bleeding is heavy or uncontrolled and needs stabilising first.
The same side of the septum was cauterised very recently.
Blood-thinning medicines or a bleeding disorder need reviewing first.
There is an active infection of the nasal lining.
An underlying cause needs assessing before repeated cautery.

Alternatives to discuss

First aid (leaning forward and pinching the soft part of the nose) for an active bleed.
Moisturising or antiseptic creams and advice on humidity and not picking the nose.
Nasal packing for heavier bleeding that cautery has not controlled.
Reviewing blood-thinning medicines and treating high blood pressure.
Further investigation, such as a nasal telescope examination or referral, for recurrent or one-sided bleeding.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

Local anaesthetic spray

A spray numbs the inside of the nose, often with a decongestant to reduce bleeding and improve the view. No injection or general anaesthetic is usually needed.

Benefits

Can stop or reduce repeated nosebleeds from a visible bleeding point
Quick, done in clinic, and usually needs only a numbing spray
No cuts and no general anaesthetic
Lets you return to normal activities the same day
Can be repeated if a nosebleed comes back

Risks & complications

More common

Brief stinging during the procedure
A small scab inside the nose that should be left to heal
Mild crusting, soreness or a blocked feeling for a few days
Nosebleeds sometimes coming back, needing repeat treatment

Less common

Temporary dark staining of the skin just below the nostril from silver nitrate, which fades over a few weeks
A further nosebleed from the treated area while it heals
Mild infection of the lining of the nose

Rare but serious

A hole in the wall between the nostrils (septal perforation), more likely if both sides are cauterised at once
More significant bleeding needing further treatment

The main reason cautery is done on one side of the septum at a time is to avoid making a hole through the wall between the nostrils. Tell your clinician about blood thinners and any peanut allergy. If you have frequent or heavy nosebleeds, ask whether the cause has been properly looked into rather than just treating the bleeding point.

Published figures to discuss

Nosebleed cautery is a low-risk procedure, and reliable figures for how often it permanently stops bleeding are limited because nosebleeds vary in cause and severity. Recurrence is common enough that repeat treatment is sometimes needed, and serious problems such as a hole in the septum are uncommon, particularly when only one side is treated at a time. This guide therefore describes risks in plain terms rather than as fixed percentages.

Figure	Reported range	How to interpret it	Source / confidence
Bleeding coming back	Common enough that repeat treatment is sometimes needed	Recurrence depends on the cause of the nosebleed, blood-thinning medicines, nose picking, dryness and whether a clear bleeding point was seen.	NHS — Nosebleednhs.ukSource-linked context
Crusting, soreness or temporary discharge	Common in the first 1-2 weeks	Good aftercare, moisturising/antiseptic cream where advised, and avoiding picking reduce this.	Guide sourcesClinical context
Septal perforation (a hole in the middle wall of the nose)	Uncommon	Risk is higher if both sides of the septum are cauterised, if cautery is repeated too soon, or if the lining is already damaged.	NHS — Nosebleednhs.ukSource-linked context
A serious complication	Rare	Heavy bleeding that will not stop needs urgent care and may need packing or specialist treatment rather than more clinic cautery.	NHS — Nosebleednhs.ukSource-linked context

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is usually no real recovery time after nosebleed cautery — most people carry on with their day. The treated spot forms a small scab that settles over a week or two, and gentle aftercare helps it heal without bleeding again.

Straight after

The numbing spray wears off over the next hour or so. You can usually go home and carry on as normal, avoiding nose-blowing and heavy exertion at first.

First few days

A small scab is healing inside the nose. Avoid picking your nose, blowing it hard, hot drinks, alcohol, hot baths and heavy exercise, which can restart bleeding.

First 1–2 weeks

The scab settles and any soreness or crusting eases. A prescribed cream is often used to help healing. Any skin staining below the nostril starts to fade.

Beyond 2 weeks

The treated area is usually healed. If nosebleeds keep coming back, go back to be reassessed rather than waiting.

What's normal — and not a worry

A small scab and mild crusting inside the nose
A slightly blocked or sore feeling for a few days
Faint dark staining of the skin below the nostril that fades over weeks
The occasional small spot of blood while the area heals

Aftercare

Do not pick your nose or remove the scab — let it heal naturally.
Avoid blowing your nose hard for the first days.
Avoid hot drinks, alcohol, hot baths or showers and heavy exercise for the first day or two, as these can restart bleeding.
Use any prescribed cream (such as Naseptin, or Vaseline if you have a peanut allergy) as directed.
Sneeze with your mouth open to reduce pressure in the nose.
If a nosebleed restarts, lean forward and pinch the soft part of your nose for 10 to 15 minutes.
Go back to your clinician if nosebleeds keep happening or are heavy.

Before your procedure

Prescribed cream collected (or Vaseline if peanut-allergic)
Know the first-aid steps if a nosebleed restarts
Plan to avoid hot drinks, alcohol and heavy exercise for a day or two
Avoid picking or blowing the nose
A note of when to go back if bleeding continues
The clinic's contact number saved

Scars and how they heal

There are no cuts and no external scars. A small scab forms inside the nose where the vessel was sealed and settles over a week or two. Silver nitrate can sometimes leave faint dark staining of the skin just below the nostril, which usually fades over a few weeks.

⚠ Get urgent help if…

A nosebleed that will not stop after 15 to 20 minutes of pinching the soft part of the nose — seek urgent help
Heavy bleeding, or bleeding pouring down the back of your throat
Feeling faint, dizzy or short of breath with bleeding
Repeated heavy nosebleeds despite treatment
Spreading redness, swelling or pus around the nose (possible infection)
A persistent blocked nose, whistling when you breathe, or a sense of a hole in the septum after cautery

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result is fewer or no nosebleeds from the treated spot, with the small scab healing without further bleeding. Many people notice an improvement straight away.

Cautery treats the bleeding point you can see, but it cannot promise that nosebleeds will never return — new vessels or other spots can bleed, and underlying factors such as blood-thinning medicines, dryness or high blood pressure still matter. If bleeding keeps coming back, the cause should be looked into rather than simply repeating the cautery.

How long it lasts

Cautery often gives lasting relief from a particular bleeding point, but nosebleeds can return from the same or a different spot, especially if the lining is dry, you take blood thinners, or you pick or blow your nose hard. Repeat cautery is sometimes needed, and persistent bleeds deserve a proper assessment.

Related tests, treatments or support

Cautery is often combined with simple measures such as a moisturising or antiseptic cream, advice on humidity and avoiding nose-picking, and review of blood-thinning medicines or blood pressure, because these address why the nose is bleeding rather than just the bleeding point.

Follow-up & long-term care

Many people need no routine follow-up after a single cautery. If nosebleeds keep happening, are heavy, or affect only one side persistently, go back to be reassessed — further investigation or a different treatment may be needed. Always return promptly if a nosebleed will not stop.

Repeat, follow-on and what comes next

Nosebleeds can come back from the same or a different spot, and cautery may need repeating.
If repeated cautery does not help, the cause should be investigated rather than simply treating again.
Persistent one-sided bleeding deserves a closer look, including a nasal telescope examination.
Some people need a different treatment, such as packing or specialist assessment, if cautery is not enough.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

Clear, written aftercare advice and first-aid steps for if bleeding restarts.
A suitable aftercare cream, with an alternative for people with a peanut allergy.
Advice to return if nosebleeds keep happening or are heavy, rather than just repeating cautery.
A plan for further investigation if bleeding is recurrent or affects only one side.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Whether it is done by a GP, in an emergency department, or by an ENT specialist
The clinician's time and the clinic facility
Whether one or more sessions of cautery are needed
Any examination with a nasal telescope to find the bleeding point
Prescribed aftercare creams
Further investigation if nosebleeds are recurrent or have an underlying cause

Make sure your written quote includes

The clinician's and facility fees
Whether a nasal examination or telescope is included
Aftercare creams and advice
Whether repeat cautery is included if bleeding returns
What happens, and what it costs, if further investigation is needed
A clear plan and contact if bleeding will not stop

On the NHS? Nosebleed cautery is commonly available on the NHS, including in emergency departments and ENT clinics; it can also be done privately for convenience or choice.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Choosing a specialist safely

Check the specialist is on the GMC Specialist Register for this area.
Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good specialist will welcome every one of these.

Can you see a clear bleeding point that cautery will help?
Could my medicines, including blood thinners, be making nosebleeds worse?
What aftercare should I use, and do I need to avoid anything because of allergies?
How likely is it that the nosebleeds will come back or that I'll need it repeating?
Should the cause of my nosebleeds be investigated further?
What should I do, and who do I contact, if a nosebleed won't stop?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the specialist who carries out my procedure, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this procedure not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Does nosebleed cautery hurt?

A numbing spray is used first, so it is usually well tolerated. Silver nitrate can sting a little, but most people do not find it troublesome and it is over in a few seconds.

Will it stop my nosebleeds for good?

It often helps, but it cannot promise nosebleeds will never come back. New or different spots can bleed, and things like dry air or blood-thinning medicines still matter. Sometimes cautery needs repeating.

Why is only one side of the nose treated?

Cautery is usually done on one side of the central wall (septum) at a time. Treating both sides at once raises the risk of making a hole through the wall, so clinicians avoid it.

What is the dark mark under my nostril?

Silver nitrate can leave faint dark staining of the skin just below the nostril. It is harmless and usually fades over a few weeks.

What should I do if it bleeds again?

Lean forward and pinch the soft part of your nose for 10 to 15 minutes. If it will not stop after about 20 minutes, or is heavy, seek urgent medical help.

Is it available on the NHS?

Yes, nosebleed cautery is commonly done on the NHS, including in emergency departments and ENT clinics. It is also available privately.

Find a verified specialist for nosebleed cautery

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

No verified consultants list this procedure yet — browse the full directory.

See all specialists for nosebleed cautery →

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Nosebleed ENT UK — patient information NICE CKS — Epistaxis (nosebleeds) Royal Berkshire NHS — Epistaxis: advice after cautery University Hospitals Sussex NHS — Nosebleed (epistaxis)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.