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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Exp 50 years

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What Course Of Treatment Should Be Done For The Pigmentary Demarcation Lines Over The Face And Nosebleeds?

I have had nose bleeds every day for a couple of years due to picking my nose one day and irritating a vessel that caused this. I have seen the ENT several times to cauterize it with no luck. Two weeks ago I tried again to see ENT and this time he cauterized it, waited a bit and it still bleed, he cauterized it again while I was sitting there because he said it was more superior. It did bleed again for a few days after that but it acted differently, meaning if I got in the shower, it didn t bleed like it used to or if I was in a dependant position it would not bleed now. It has been around three weeks and the bleeding has subsided, hopefully, I don t even blow on that side of the nose, it seems to be working. I will check with him again in a week to see what it looks like from the inside. The problem though I have been having for five years (which is how long this has been going on) is that I have a demarcation line near the malar area between the eyes and the cheekbone. I have used all kinds of creams including hydroquinone and triluma, which really isn t doing much. Could these two be related the nose bleeds and this swelling of demarcation line (it is darkened too) I wonder if it is a combination of swelling and melasma. I am going to talk to a plastic surgeon to see if it wouldn t help to have lower eyelid surgery to help it
Thu, 16 Apr 2020
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General Surgeon 's  Response
Hi,

Noted both your problems namely the recurrent nosebleeds and black demarkation lines over face.
The cause of the recurrent nosebleeds looks to be obvious as your ENT Surgeon could cauterize it.
I would advise you the following in such a situation:
Get the tests of blood for CBC, bleeding time, clotting time, prothrombine time and any other as may be advised.
CT scan with angiography of the sinuses to if there is any abnormal blood vessels in this area as a probable cause of recurrent nosebleeds.
Now there are specific surgeries for stopping nosebleeds like blocking the nasopalatine artery. Any ENT Surgeon specialized or experienced in such surgery can help for the probable permanent cure.
But more important than this is to stop your habit of picking the nose.
For the black lines on the face, the Dermatologist will tell a probable cause and you may need the tests for thyroid, liver and hormones and the treatment for local cure as well as for the original cause.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. T. Chandrakant, ENT and General Surgeon
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What Course Of Treatment Should Be Done For The Pigmentary Demarcation Lines Over The Face And Nosebleeds?

Hi, Noted both your problems namely the recurrent nosebleeds and black demarkation lines over face. The cause of the recurrent nosebleeds looks to be obvious as your ENT Surgeon could cauterize it. I would advise you the following in such a situation: Get the tests of blood for CBC, bleeding time, clotting time, prothrombine time and any other as may be advised. CT scan with angiography of the sinuses to if there is any abnormal blood vessels in this area as a probable cause of recurrent nosebleeds. Now there are specific surgeries for stopping nosebleeds like blocking the nasopalatine artery. Any ENT Surgeon specialized or experienced in such surgery can help for the probable permanent cure. But more important than this is to stop your habit of picking the nose. For the black lines on the face, the Dermatologist will tell a probable cause and you may need the tests for thyroid, liver and hormones and the treatment for local cure as well as for the original cause. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T. Chandrakant, ENT and General Surgeon