Tiny hole in septum skin on right nostril roughly 1mm. Just looks like missing mucosa membrane. Advice?

Hello,
Did you have a septo-rhinoplasty done and if so, how long ago? If the hole is not full thickness to the other side, then it is probably not an issue. Best to check with your doctor.

Treatment of nasal septal perforations can vary depending the size and cause of the perforation. Very small or very large perforations can be asymptomatic (meaning they don't necessarily cause any problems) and may not require any intervention. We always recommend maintaining good nasal hygiene including nasal saline spray and vaseline to keep the nose clean and the perforation free of crusting. Some perforations do cause symptoms such as nosebleeds, crusting, whistling sound when breathing through the nose, foul smell. Such perforations may require intervention, such as nasal surgery or placement of a septal button. Of course it is also important to figure out why you have the perforation to begin with and, if necessary, treat the underlying cause. I would recommend consultation with a Facial Plastic Surgeon to evaluate the nose and examine the perforation. Hope this helps!

You need to be seen in follow up.  Chances are that everything is fine, and the mucosa will heal.  If it is a true septal perforation, it likely does not have to be repaired unless it is large, or if it whistles when you breathe.  Best of luck to you!

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  An intranasal speculum exam will be able to tell more about your possible septal perforation.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Thank you for the questions Shelly. Is the perforation something that your surgeon told you about or something that you can see? A 1mm perforation (micro-perforation) is very small would be difficulty to visualize yourself.  If this in the front of your septum it may cause crusting, bleeding, or whistling. If it is in the back, a septal perforation will usually not cause any functional issues. 
A single event or recurrent trauma can lead to a septal perforation. The tip of a nasal spray bottle, picking scabs, blowing forcefully, cocaine abuse, decongestant abuse, or surgery are all traumatic causes of a perforation. It may or may not heal, but conservative measures (ointment) and avoiding future trauma can only help. At minimum, the skin (mucosa) should be healthier. This is only general advice and your care should be directed by your surgeon and the diagnosis confirmed. 
There are surgical measures to repair a hole if necessary, but you should see someone that has experience in this procedure and is comfortable with these repairs. A risk of surgical repair is enlargement of the perforation and incomplete closure is possible. I hope this helps. Take care. 

Thanks for your question. It is very difficult to see a septal perforation with using the proper instruments and lighting. It would be unlikely for you to develop a septal perforation without any risk factors like prior surgery, drug abuse, or certain medical conditions. I would recommend seeing a Facial plastic surgeon or Otolaryngologist for further evaluation. If you do have a hole, and it is only 1mm in size, it is unlikely to cause any significant issues. Good luck!