Dry air and nose picking: This is the most common cause of punctate bleeding lesions on the nares and septum, often due to dry air causing irritation and subsequent picking or rubbing of the nose, leading to minor bleeding.

Hypertension: Uncontrolled high blood pressure can lead to small vessel rupture, resulting in punctate bleeding.
Allergic rhinitis: Inflammation and irritation from allergies can cause the nasal mucosa to become fragile and prone to bleeding.
Nasal trauma: Minor injuries to the nose, such as those from blowing the nose too hard or minor accidents, can cause punctate bleeding.
Vitamin deficiencies (e.g., Vitamin K or C deficiency): Deficiencies in certain vitamins can affect blood clotting and vessel integrity, leading to easy bruising and bleeding.

Nasal tumors or cancer: Although rare, tumors in the nasal cavity can cause bleeding and must be ruled out to avoid missing a potentially life-threatening condition.
Wegener's granulomatosis (Granulomatosis with Polyangiitis): A rare autoimmune disorder that can cause inflammation of the blood vessels, leading to bleeding and other systemic symptoms.
Leukemia: Certain types of leukemia can cause bleeding due to thrombocytopenia (low platelet count) or platelet dysfunction.
Coagulopathy (e.g., hemophilia, von Willebrand disease): Disorders that affect blood clotting can lead to easy bleeding and bruising, including punctate bleeding in the nose.

Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome): A genetic disorder characterized by the formation of abnormal blood vessels, which can lead to recurrent nosebleeds.
Pseudoxanthoma elasticum: A rare genetic disorder that affects the elastic fibers present in the skin, eyes, and cardiovascular system, potentially leading to bleeding due to vascular fragility.
Scurvy: A disease resulting from vitamin C deficiency, which can cause bleeding gums, joint pain, and poor wound healing, among other symptoms, including potentially punctate bleeding in the nose.