How To Treat Hole In Nose From Cocaine Use?

Hi I'm 21 and I fell into a binge with coke for about 8 months .well just this nov I had scabs and yes I picked them or blew them out, well here comes dec and here comes the scab! I blew the hole thing out!! And I look up there with a flash light and there is a hole , I freaked out I'm very depressed over it and always worring about it, it's not too big but one side is bigger then the other! Please help! I have stopped using also someone please tell me how I can help this close! Thanks!

Doctor Answers 33

Septal perforation due to cocaine use

It is common for cocaine use to cause septal perforation due to the lack of blood flow in the septum. This causes the nasal mucus membranes to die and as a result holes can appear. Reconstructive surgery can be performed but there is not a guarantee that it will be successful. Before entertaining the idea of surgery you first MUST be dedicated to stay off cocaine for the rest of your life. If you were to use cocaine post surgery you could not only recreate the same problem but worsen your condition further by causing the nose to collapse. To help ensure you stay off cocaine you may want to consider a rehabilitation program and then once you feel confident that you will not use in the future consider reconstructive surgery.

Septal perforation due to cocaine use

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It is common for cocaine use to cause septal perforation due to the lack of blood flow in the septum. This causes the nasal mucus membranes to die and as a result holes can appear. Reconstructive surgery can be performed but there is not a guarantee that it will be successful. Before entertaining the idea of surgery you first MUST be dedicated to stay off cocaine for the rest of your life. If you were to use cocaine post surgery you could not only recreate the same problem but worsen your condition further by causing the nose to collapse. To help ensure you stay off cocaine you may want to consider a rehabilitation program and then once you feel confident that you will not use in the future consider reconstructive surgery.

Options in Treating Cocaine Nose Holes

Cocaine has 2 medical uses; it alleviates pain and is a very potent shrinker of blood vessels. As a result it was commonly used in nose surgery to reduce surgical bleeding and pain. Unfortunately it is EXTREMELY addictive and among its victims were many famous people including doctors (Sigmund Freud (father of Pasychoanalysis), William Halstead (father of modern American Surgery) and Sherlock Holmes).

Prolonged application of cocaine causes spasm and stoppage of blood flow in the septum followed by death of the lining followed by creation of various size holes with communication from one side to the other often with whistling on deep breathing. There is NO point in attempting surgery on anyone who is actively still using either cocaine or Neosynephrin. It is highly likely to fail. In such patients, cufflink like rubber prosthesis can be inserted plugging the hole. In others, reconstruction is done by using long flaps of nasal floor and septal lining that are rotated across the hole and stitched in place.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.8 out of 5 stars 114 reviews

Options in Treating Cocaine Nose Holes

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Cocaine has 2 medical uses; it alleviates pain and is a very potent shrinker of blood vessels. As a result it was commonly used in nose surgery to reduce surgical bleeding and pain. Unfortunately it is EXTREMELY addictive and among its victims were many famous people including doctors (Sigmund Freud (father of Pasychoanalysis), William Halstead (father of modern American Surgery) and Sherlock Holmes).

Prolonged application of cocaine causes spasm and stoppage of blood flow in the septum followed by death of the lining followed by creation of various size holes with communication from one side to the other often with whistling on deep breathing. There is NO point in attempting surgery on anyone who is actively still using either cocaine or Neosynephrin. It is highly likely to fail. In such patients, cufflink like rubber prosthesis can be inserted plugging the hole. In others, reconstruction is done by using long flaps of nasal floor and septal lining that are rotated across the hole and stitched in place.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Hole in nose after cocaine use.

First of all you must stay off cocaine. Permanently. It is a potent vasoconstrictor that caused your nasal mucous membranes to die. Your body tried to heal from the alive edges, but more cocaine use killed more tissue (both sides) until the septal cartilage became exposed, dried out, and bacteria dissolved part of it (the part no longer protected by living mucous membranes). Hole results.

Reconstructive nasal surgery can be done, but this is not guaranteed and can fail as well. If even one use of cocaine happens, you might as well not have the surgery as you may cause an even bigger hole, collapse of the entire nose, and then you will really know what "freaked out" means.

I'd suggest professional drug rehab and prolonged and complete drug abstinence (tobacco as well, since nicotine is another major vasoconstrictor) for at least a year before even asking a rhinoplasty expert for surgical repair.

Surgical repair IS possible; the hole will NOT heal on its own (nothing you do or don't do will make a difference here except not making it worse with tobacco or more cocaine). So stay clean, don't pick any scabs that will form, and try to avoid blowing vigorously. Good luck!

Hole in nose after cocaine use.

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First of all you must stay off cocaine. Permanently. It is a potent vasoconstrictor that caused your nasal mucous membranes to die. Your body tried to heal from the alive edges, but more cocaine use killed more tissue (both sides) until the septal cartilage became exposed, dried out, and bacteria dissolved part of it (the part no longer protected by living mucous membranes). Hole results.

Reconstructive nasal surgery can be done, but this is not guaranteed and can fail as well. If even one use of cocaine happens, you might as well not have the surgery as you may cause an even bigger hole, collapse of the entire nose, and then you will really know what "freaked out" means.

I'd suggest professional drug rehab and prolonged and complete drug abstinence (tobacco as well, since nicotine is another major vasoconstrictor) for at least a year before even asking a rhinoplasty expert for surgical repair.

Surgical repair IS possible; the hole will NOT heal on its own (nothing you do or don't do will make a difference here except not making it worse with tobacco or more cocaine). So stay clean, don't pick any scabs that will form, and try to avoid blowing vigorously. Good luck!

Septal Perforation

Correcting a septal perforation is one of the most difficult procedure to perform and not all perforations can be closed.  You need to be seen by a doctor to examine you and see if the hole is small enough to fix.  In the mean time you want to avoid trauma like picking and of course cocaine and things like Afrin.  Also you will want to use nasal washes to keep the mucosa moist.

Septal Perforation

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Correcting a septal perforation is one of the most difficult procedure to perform and not all perforations can be closed.  You need to be seen by a doctor to examine you and see if the hole is small enough to fix.  In the mean time you want to avoid trauma like picking and of course cocaine and things like Afrin.  Also you will want to use nasal washes to keep the mucosa moist.

Hole in Nose

When dealing with a hole in the Septum I have found that using a Septal Button closes that hole the best. In my experience a patient can go on and have a normal life with minor daily care after this procedure.

Thank you for your question.

Gregory Roche, DO
Bloomfield Hills Facial Plastic Surgeon
4.0 out of 5 stars 12 reviews

Hole in Nose

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When dealing with a hole in the Septum I have found that using a Septal Button closes that hole the best. In my experience a patient can go on and have a normal life with minor daily care after this procedure.

Thank you for your question.

Gregory Roche, DO
Bloomfield Hills Facial Plastic Surgeon
4.0 out of 5 stars 12 reviews

Septal Perforation

Septal perforations can be surgically closed but you have to make sure that you do not go back to using Cocaine. The surgery is technically challenging and not all surgeons offer it. Do your research and then proceed. In the mean time try using as much Saline Nasal Spray as possible and also use Ayr Gel in the nostrils. 

Regards

Dr Janjua

Septal Perforation

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Septal perforations can be surgically closed but you have to make sure that you do not go back to using Cocaine. The surgery is technically challenging and not all surgeons offer it. Do your research and then proceed. In the mean time try using as much Saline Nasal Spray as possible and also use Ayr Gel in the nostrils. 

Regards

Dr Janjua

A hole in the septum (septal perforation) from cocaine use is difficult to repair

A septal perforation is a difficult and sometimes impossible problem to correct. You need to see an experienced surgeon who has specific experience treating this problem.

A hole in the septum (septal perforation) from cocaine use is difficult to repair

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A septal perforation is a difficult and sometimes impossible problem to correct. You need to see an experienced surgeon who has specific experience treating this problem.

Septal perforation repair

Hello and thanks for your answer. First, as others have suggested, I would suggest you seek help to make sure you are off the cocaine. Once free of this substance, a septal perforation repair can be done, often with a rhinoplasty to adjust the structural changes associated with effects of cocaine. If it crusting, causing obstruction, bleeding, or whistling then you are definitely a candidate. If the holes are larger than 3 cm however certain extreme measures such as transposition flap, free flaps, or intranasal tissue expanders can be entertained. A consultation with a rhinoplasty expert will help in your decision making. 

Septal perforation repair

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hello and thanks for your answer. First, as others have suggested, I would suggest you seek help to make sure you are off the cocaine. Once free of this substance, a septal perforation repair can be done, often with a rhinoplasty to adjust the structural changes associated with effects of cocaine. If it crusting, causing obstruction, bleeding, or whistling then you are definitely a candidate. If the holes are larger than 3 cm however certain extreme measures such as transposition flap, free flaps, or intranasal tissue expanders can be entertained. A consultation with a rhinoplasty expert will help in your decision making. 

Cocaine septal perforation

Cocaine causes small blood vessels in the lining of the nose to constrict and go into spasm. This can lead to the death of the mucosa and, eventually, the underlying cartilage. This may lead to a hole in the septum causing a communication between the two nostrils.

A hole in the nasal septum (septal perforation) following cocaine use is hard to treat. Firstly, patients must undertake to cease cocaine and cigarettes permanently (which is a difficult undertaking for the addicted patient).

Cocaine related nasal septal perforations commonly present with crusting, "whistling" during breathing and bleeding. If the hole gets large enough, the whistling disappears. If enough of the septum is destroyed by cocaine, the nose will collapse and there is no cartilage left to support the lower two thirds of the nose.

Reconstructive surgery for a cocaine nose is difficult. Small holes can be "plugged", either with synthetic materials of with local tissues which have been moved around ("local flaps"). If the nose has collapsed, then a rhinoplasty usually involving cartilage harvested from the rib cage is performed to rebuild the nose. This is a significant surgical undertaking.

Cocaine septal perforation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Cocaine causes small blood vessels in the lining of the nose to constrict and go into spasm. This can lead to the death of the mucosa and, eventually, the underlying cartilage. This may lead to a hole in the septum causing a communication between the two nostrils.

A hole in the nasal septum (septal perforation) following cocaine use is hard to treat. Firstly, patients must undertake to cease cocaine and cigarettes permanently (which is a difficult undertaking for the addicted patient).

Cocaine related nasal septal perforations commonly present with crusting, "whistling" during breathing and bleeding. If the hole gets large enough, the whistling disappears. If enough of the septum is destroyed by cocaine, the nose will collapse and there is no cartilage left to support the lower two thirds of the nose.

Reconstructive surgery for a cocaine nose is difficult. Small holes can be "plugged", either with synthetic materials of with local tissues which have been moved around ("local flaps"). If the nose has collapsed, then a rhinoplasty usually involving cartilage harvested from the rib cage is performed to rebuild the nose. This is a significant surgical undertaking.

Septal perforation

Septal perforation can occur after cocaine use.  The membranes lining the septum, as well as the cartilage in between, can be damaged and die, leaving a hole between the left and right sides of the nose.  Septal perforations become problematic if the support of the nose (especially bridge and tip) is compromised, if there is bleeding, infections, significant crusting, pain or if the hole is progressively enlarging.  In these cases, surgery can be performed in many cases to repair the hole.  In other cases, conservative care can limit symptoms and surgery might not be necessary.  Seek care from a qualified facial plastic or plastic surgeon who performs this kind of surgery.

Anthony P. Sclafani, MD
New York Facial Plastic Surgeon

Septal perforation

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Septal perforation can occur after cocaine use.  The membranes lining the septum, as well as the cartilage in between, can be damaged and die, leaving a hole between the left and right sides of the nose.  Septal perforations become problematic if the support of the nose (especially bridge and tip) is compromised, if there is bleeding, infections, significant crusting, pain or if the hole is progressively enlarging.  In these cases, surgery can be performed in many cases to repair the hole.  In other cases, conservative care can limit symptoms and surgery might not be necessary.  Seek care from a qualified facial plastic or plastic surgeon who performs this kind of surgery.

Anthony P. Sclafani, MD
New York Facial Plastic Surgeon

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.