Nasal cautery is a treatment for nose bleeds where a silver nitrate coated stick is used to seal of the blood vessels that are causing the nose bleeds

This works by the generation of heat when the silver nitrate makes contact with water and this seals the blood vessels

How is it done?

A topical local anaesthetic is applied on cotton wool and placed in the nasal cavity for about 15 minutes.  After removing the cotton wool the vessel to be cauterised is identified.  A silver nitrate stick is applied to the area around the vessel until it has sealed. This works by generating heat on contact with moisture.

The procedure is not usually that painful but may "sting" a little.

It is not advisable to have both sides of the septum cauterised at the same time as this may result in a hole in the septum

What to expect afterwards?

After the procedure there may be some dark grey discharge from the cauterized site. There is a risk that this can discolour the skin and it is best to apply some cotton wool in the nose for a couple of hours after the procedure to minimise the risk of this happening. Further bleeding may happen over the first few days.

Antibiotic cream is prescribed after the procedure to be used for 5 days.  The area cauterised may scab and it is essential not to pick at this as this is likley to cause futher  bleeding. 

It is best to avoid contact sports, hot baths and not to fly for the following 10 days ( the dry air in the airplane may cause more scabbing which if it comes away may result in bleeding).

Whilst nasal cautery works well it is not a permanent cure and the nose bleeds can recur.

What can go wrong?

Aggressive and repeated cautery on both sides of the septum at the same time may result in a septal perforation