Nasal perforations are a serious complication from long-term cocaine use. Find out what to do to avoid developing the deformation.

Cocaine causes nasal perforation by reducing blood flow and numbing the inside of the nose. This condition, which is often called “cocaine nose hole,” manifests at the septum and generally requires medical attention.

When cocaine is applied topically (like in the sinuses when it is snorted), it causes blood vessels to constrict. Cocaine also acts as a numbing agent, so when the cells in the nose lose blood for too long, they send pain signals which are not “heard” by the brain. This side effect can lead to the continued use of the drug even when it is cutting off the nose’s blood supply.

Nasal perforation or septal perforation is when the membrane that divides the nostrils develops a hole between the nostrils. The membrane that divides the nostrils is soft, cartilaginous tissue and can be damaged easily. Once damaged, the tissue cannot repair on its own.

Article at a Glance:

Nasal perforations are a serious risk. Keep the following key points in mind when considering how cocaine can lead to nasal perforations:

  • Long-term cocaine use can create a hole in the bridge of the nose
  • Cocaine causes damage by cutting off blood flow and numbing the affected area
  • A perforated septum will not heal on its own
  • If you think you might be developing a perforated septum, contact a doctor immediately
  • Do not use medicated nasal sprays because they might make the perforation worse
  • Only use saline nasal rinse to treat a perforated septum

Signs of Coke Nose Damage

Damage to the nasal septum usually takes many years to develop. However, heavy cocaine abuse can accelerate damage to the nose. Some common symptoms associated with and leading to nasal perforation are:

  • Dryness
  • Increased congestion
  • Increased mucus (rhinorrhea)
  • Nose bleeds
  • Pain
  • Sensations of nasal obstruction
  • Sensitivity
  • Whistling while breathing

A person experiencing these symptoms, along with cocaine abuse, needs to see a physician immediately. A perforated septum happens quickly and the symptoms are easy to miss because they are similar to the symptoms of cocaine use.

Is Cocaine-induced Damage to the Nose Permanent?

Will a perforated septum heal on its own? Probably not. A small sore or ulcer that does not penetrate the septum can heal on its own. If cocaine nose damage created a hole through each side, it would need surgery to repair.

Nasal perforation is permanent, so it is critical to either stop cocaine use or seek help before the damage is done.

Can I Treat Nasal Perforation at Home?

You cannot fix nasal perforation, but you can treat some of the symptoms. Self-treating might slow down some of the damage and allow a person to get to a physician in time to prevent further damage.

Do not use medicated nasal sprays to help with mucus production. Many medicated nasal sprays dry out the sinuses and can make the damage worse. Use a saline nasal rinse to help with mucus and dryness.

If you think you have or are about to develop a nasal perforation, contact your physician immediately.

If you or a loved one live with a cocaine addiction, it’s time to seek help. Avoiding addressing cocaine addiction can lead to serious health issues, including nasal perforation. Contact The Recovery Village today to speak with a representative about how treatment can work for you. You deserve good health.

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    Editor – Thomas Christiansen
    With over a decade of content experience, Tom produces and edits research articles, news and blog posts produced for Advanced Recovery Systems. Read more
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    Medically Reviewed By – Dr. Conor Sheehy, PharmD, BCPS, CACP
    Dr. Sheehy completed his BS in Molecular Biology at the University of Idaho and went on to complete his Doctor of Pharmacy (PharmD) at the University of Washington in Seattle. Read more

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    Pedroza, Fernando. “A Review of 25-Year Experience of Nas[…]oration Repair.” Archives of Facial Plastic Surgery, 2007. Accessed May 14, 2019.

    Medscape. “Septal Perforation – Medical Aspect[…]gy, Epidemiology.” April 2019. Accessed May 14, 2019.

    Medical Disclaimer

    The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.