Will a perforated septum get worse if left alone?

Surgery can help improve the sensation of breathing but trying nasal emollients first is the best option.  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.

Dear whatsgoingonIt depends, if you perforation was subsequent to a single invasive event, like surgery, it is unlikely to progress. If its due to multiple medical insults, such as cocaine use, it is more likely to progress.You should see a well trained ENT or plastic surgeon to have your septum assessed.

The quick answer to this is maybe.  It depends on the cause of the hole in the nasal septum.  The most common causes include prior trauma, surgery, nose picking, aggressive medication use or drug use.  There are some other less common causes too.  Symptoms can vary also from none to horrible congestion or nosebleeds.  This should have an evaluation to determine if a biopsy is necessary and assess compounding factors.  Sometimes, regular follow-up is an option.  Surgery is an option too and can also be a challenging consideration, so work with someone who has a lot of experience with this condition.