Telangiectases in the nose, along with the nosebleeds they cause, are the most common symptom of HHT. About 90% of people with HHT have recurring nosebleeds by the time they reach middle age. The average age at which nosebleeds begin is 12, but they can begin as early as infancy, or as late as adulthood. Nosebleeds can be as infrequent as a couple per year or can occur daily. When a nosebleed occurs, it can last anywhere from a few seconds, up to several hours in some cases. The amount of blood lost may be a few drops, or enough to cause anemia (low blood count). As with most things that are variable in human beings (i.e. height and shoe size), the majority of people with HHT are in between the two extremes in terms of nosebleed frequency and severity.
Telangiectases of the skin, on the hands, face and mouth are also found in about 95% of all people with HHT. These often do not become apparent until the ages 30 to 40. They appear as small red to purplish spots. In some individuals with HHT they become quite prominent by late adulthood, in others they are subtle. The telangiectases on the skin and in the mouth can also bleed, but are less likely to bleed than those in the nose. Both telangiectases of the skin and nose have a tendency to become more numerous with increasing age. But with this too, there are many variations and exceptions!