Epistaxis is common in children and most frequently results from trauma to the vascular area of the anterior septum called Kisselbach’s plexus. It is often triggered by dryness which can lead to itching which can cause trauma or irritation in this area. Another common cause is related to allergic rhinitis, which causes irritation and increased blood flow to the area.
Other causes for epistaxis include coagulopathy or foreign body. Very rarely, tumors and vascular lesions such as juvenile nasopharyngeal angiofibroma will present as severe epistaxis. Epistaxis is rare in children < 2 years, and should raise suspicions of trauma or systemic illness.