I Know It Wont Close, but Will It Get Bigger?

I have a hole in my nose from cocaine use two yrs ago. The hole hasnt caused problems that i noticed but can it keep gerting bigger

Doctor Answers 4

Septal perforation changing size

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Septal perforations range in size and symptoms.  Typically, posterior septal perforations can be left alone that are asymptomatic while the more anterior the perforation the more likely it will become symptomatic.  If a perforation is stable in size (especially if the patients is using nasal saline, gel and other nasal emollient) then observation is fine.  If the perforation continues to grow in size or becomes symptomatic, repair can be considered.

Chicago Facial Plastic Surgeon
4.8 out of 5 stars 181 reviews

Hole in Septum

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Unfortunately, it is unlikely to close on its own. However, many small perforations don't cause any symptoms. 



Hope this helps,


Dr. Michael in Miami

Does a septal perforation enlarge over time?

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A septal perforation from cocaine use should not enlarge once you've stopped using cocaine or any inhaled drugs. If your nose is kept moist and trauma (fingers, Q-tips) is kept to a minimum that should also help stabilize the damage. If the perforation is bothering you it can be remedied with either a plastic "button" to plug the hole or surgery to repair the hole permanently with your own tissue. I hope this information is helpful.

Stephen Weber MD, FACS

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Septal Perforation Related to Cocaine Use

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A septal perforation can occur with nasal cocaine use because of the mechanical trauma involved in "snorting", and the vasoconstrictive properties of cocaine (it is the only local anesthetic that is also a vasoconstrictor).  Assuming that the nasal cocaine has ceased and there is no further mechanical trauma to the septum, the perforation should stabilize and not grow bigger.  A resumption of cocaine abuse will restart the cycle of trauma and vasoconstriction and could eventually lead to nasal collapse ( a saddle nose deformity).

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 104 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.