Damages of Cocaine on Nasal Health: Burning, Collapse, and Septum Perforation

Cocaine and the Nose: Why Is It Dangerous?

Cocaine, especially when snorted through the nose, causes serious damage to the delicate tissues in this area. Initially, damage occurs in the nasal mucosa — the lining of the nose. The most common complaints include burning sensation in the nose after cocaine use, bleeding, chronic dryness, and at an advanced stage, perforation of the nasal septum (the cartilage dividing the nostrils), leading to nasal collapse (cocaine nose collapse).

The main cause of this damage is cocaine’s vasoconstrictive effect — it narrows the blood vessels. With prolonged use, this effect prevents the nasal tissues from receiving sufficient blood flow. Over time, the mucosa thins, cartilage deteriorates, and a perforation can occur in the septum.

Symptoms and Problems Caused by Cocaine

Nasal Burning and Dryness

Early symptoms of cocaine use include a burning sensation, dryness, and irritation inside the nose. Although these may seem temporary, continuous use indicates more serious problems.

Nosebleeds

Due to thinning of the nasal mucosa and damaged vessels, frequent nosebleeds occur. Over time, this may indicate more severe structural damage. In some patients, bleeding may be so severe that hospital treatment is necessary.

Septum Perforation (Hole in the Nasal Septum)

Cocaine damages the vessels that nourish the nasal septum (the cartilage in the center of the nose). This can eventually lead to perforation (hole formation).

Symptoms of Septum Perforation:

• Whistling sound from the nose (while breathing)
• Chronic crusting and dryness
• Persistent nosebleeds (can be severe)
• Nasal congestion and foul odor
• Crusting and swelling of the mucosa, leading to blockage of sinus openings and recurrent sinusitis

Cocaine Nose Collapse (Nasal Collapse)

One of the most severe structural problems caused by cocaine is the collapse of the nasal bridge. This condition is commonly referred to as “cocaine nose collapse.”

Symptoms:

• Depression of the nasal bridge (“saddle deformity”)
• Visible changes in appearance
• Flattened or widened nose
• Deformity at the nasal tip
• Nasal obstruction and difficulty breathing

How Is It Diagnosed?

Diagnosis is based on the patient’s complaints and a detailed endoscopic nasal examination. If necessary, CT scan (computed tomography) may be used for a clear assessment of internal nasal structures. In some cases, biopsy may also be needed for differential diagnosis.

Are These Conditions Permanent? Can They Be Treated?

If nasal damage due to cocaine use is detected early, it can be managed with medical treatment. However, most patients seek help when the damage is advanced, making surgical treatment inevitable.

In cases like septum perforation and nasal collapse, the damaged tissues must be reconstructed. This is a surgical area that requires specialization and experience.

If there is no visible deformity and only an internal perforation is present, endoscopic closed technique can be used. But if there is also a deformity, rhinoplasty (nasal aesthetic surgery) may be planned as a combined procedure.

Specialized Surgical Approach in Nasal Reconstruction with Prof. Dr. Gediz Murat Serin

I am an ENT surgeon who has been treating complex nasal damage for many years. Especially in advanced cases such as cocaine-induced septum perforation and nasal collapse, I apply customized, multilayered flap techniques.

In this technique:

• Vascularized and viable tissue flaps are prepared from within the nose
• If necessary, cartilage grafts from other body areas like the rib are used for structural support
• The perforation in the septum is repaired both structurally and functionally
• Rhinoplasty can also be performed during the same session

This way, patients can regain both comfortable breathing and a natural nasal appearance.

Surgical Success Rate and Realistic Expectations

Nasal surgery, especially for septum perforation repair and nasal collapse reconstruction, requires extremely precise and detailed planning. According to the literature, the success rate of these surgeries varies between 70% and 90%, depending on the size of the perforation, nasal tissue condition, and patient’s medical history. However, no surgical procedure has a 100% success rate.

My approach in these cases is to create personalized plans that address both functional and aesthetic goals simultaneously. Every patient’s nasal anatomy, extent of damage, and prior treatment history are different. Therefore, the definition of success should be individualized for each surgery.

In some cases, the hole can be completely closed; in others, reducing its size is enough to relieve symptoms and improve comfort. Before surgery, I thoroughly inform my patients about all possibilities, clarify their expectations, and determine the most appropriate treatment path together.

Realistic information + correct technique = Success

In addition to surgical skill, the patient’s adherence to treatment, post-operative care, and supportive treatments during recovery all play a crucial role in achieving success. That’s why I treat the process holistically and share all steps transparently with my patients.

Conclusion: Permanent Damage Can Be Repaired

If you are experiencing symptoms like nasal burning after cocaine use, nasal collapse, or septum perforation, these damages can be treated with proper techniques. Seeking help without delay increases the chances of achieving successful functional and aesthetic outcomes.

To get expert advice and a personalized evaluation, you can contact our clinic.

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If you are experiencing issues like nasal burning, nose collapse, or septal perforation after cocaine use, permanent and reliable solutions are possible with Prof. Dr. Gediz Murat Serin’s specialized surgical techniques.