
Unraveling the Mystery of Cocaine Nose
Table of Contents
How Does Cocaine Damage the Nose?
It might sound comical but ‘cocaine nose’ or ‘coke nose’ is no laughing matter. It means that the constant snorting of cocaine has caused structural damage to your nose, which is not just unsightly but can affect your ability to breathe properly.
When you snort cocaine, blood vessels in the nose constrict. Blood vessels circulate blood, oxygen and other nutrients to your tissues so they’re vital for keeping your heart healthy and your organs functioning. If the blood vessels have to constrict too often they can’t do their job properly. This leads to structural damage of the nose: the so-called cocaine nose.
Signs that your nose is becoming damaged from cocaine include headache and fever (due to sinusitis), a crusty nose and difficulty inhaling through the nose. All these symptoms can occur before you notice any physical damage to your nose, so take them as warning signs.
Short-term Effects of Snorting Cocaine
Cocaine is a quick hit, with the highs appearing almost instantly and the lows following in anything from a few minutes to an hour. This is one of the reasons it’s so addictive: you’re forever chasing that high again.
When you snort cocaine you might feel a burning sensation in your nose and nosebleeds are common. This is because the blood vessels in the sensitive lining of the nose are damaged. Damage to the nasal tissues can also result in loss of smell.
Other short-term physical effects of snorting cocaine include a racing heart rate, shaking, twitching muscles, increased temperature, loose teeth and dilated pupils. Psychological short-term side effects include paranoia, anxiety and feelings of restlessness.
Cocaine is one of the most addictive drugs out there and it can hook you after just one use. There is no manageable form of cocaine use and if you are taking it in any quantity, you need help.
Smarmore Castle is a family-run drug addiction rehab clinic in the Irish countryside. We understand the pull cocaine has, and the difficulty in recognising and accepting that you have a problem. We don’t judge. We help.

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How Does Long-term Cocaine Use Affect the Nose?
Cocaine leaves its mark in more ways than one. Even if you seek the right help and kick your cocaine addiction, your nose may always be damaged, and due to its prominence on your face, this can cause stress and mental anguish.
Surgery is available but it can’t always make good a cocaine-ravaged nose.
Cocaine Nose Holes (Nasal Perforation)
As blood vessels in the lining of the nose are close to the skin, these are easily damaged when you snort cocaine. Eventually, the lining breaks down and creates holes in the skin that get bigger with repeated use.
A 38-year-old cocaine user was shocked when a soft drink he was enjoying ran out of a pinhole in his nose. Two months later this hole was the diameter of his little finger and he was plugging it with bubblegum.
The good news is blood vessels can repair themselves if the damage isn’t too advanced.
Perforated Septum
The wall of cartilage and bone that separates the two nostrils is called the septum. It’s flexible and allows you to breathe easily. Snorting cocaine causes holes in the septum and repeated use can result in the holes becoming so big and/or multiple that the septum collapses completely.
In a study of long-term cocaine users, 99.2% had a perforated septum, which means it is virtually impossible to avoid if you are a persistent cocaine abuser.
This leaves your nose as an entire open cavity. It can become dry and crusty and can impact your ability to breathe. Surgery is the only option but it is not always successful.
Deviated Septum From Cocaine Use
Repeatedly snorting cocaine, especially if you use one nostril over another, can result in the septum shifting and collapsing so it is no longer straight. This means the septum falls into one nasal cavity, restricting its size so it becomes difficult to breathe. Your nose will become congested and you may get headaches, high blood pressure and interrupted sleep.
As a deviated septum is outwardly noticeable – your nose is wonky – it can be distressing as not only does it look unusual, it can betray the fact that you are a frequent cocaine user. For this reason, it can cause stress, anxiety and depression.
Saddle Nose
A saddle nose is when the nose collapses in, so it loses its height and is dipped (a bit like a saddle on a horse). Like a deviated septum it is an obvious facial deformity and can destroy your confidence. If you have a saddle nose, you might as well wear a sign saying, ‘I’ve taken a lot of cocaine’.
Saddle nose is often a result of a perforated septum. If the septum is no longer strong enough to support the nose, it will collapse.
Cocaine Sinus Infections
Sinus infections are usually one of the first signs (after nosebleeds) that the nose is becoming traumatised from snorting cocaine. This is the time to get help. Not later when the damage is irreversible.
If you are struggling to stop taking cocaine you need help. At Smarmore Castle we can explore the reasons behind your cocaine addiction, get you clean and support you as you begin the rest of your life drug-free.

Hard Palate Damage
The hard palate is the bony part of the roof of the mouth. It separates the mouth from the nose so any tongue movement or eating of food stays in the mouth and doesn’t interfere with the nose in any way.
Long-term cocaine use can damage the hard palate and even erode it completely. A damaged hard palate restricts your ability to eat properly as food and drink entering the mouth escape out the nose. It also results in nosebleeds and damage to other parts of the nose including the septum.
How to Soothe An Irritated Nose From Cocaine Use
If your nose is becoming irritated from cocaine use, the best thing you can do is seek help to stop taking cocaine. If you notice signs of damage and you continue to snort cocaine, you risk damaging and destroying your nose within months.
Rubbing Vaseline (petroleum jelly) or Vitamin E cream around the skin of your nostrils can reduce inflammation and prevent dry skin, and using a nasal rinse, which you can buy from pharmacists and chemists, may help unclog your nose.
Practical tips that can help protect your nose for longer include alternating the nostril you snort cocaine with and ensuring the surface you’re snorting from is clean.
Remember, you can’t be sure the cocaine you’re taking is actually cocaine. Tests on a random sample of coke found 40% included no cocaine at all. You could be snorting baking soda, sugar, talc, flour, heroin or anything. These can all damage your nose.
Treatment to soothe an irritated nose from cocaine use is a temporary solution. You need help now. Want to see if you’re addicted to cocaine? Try our quiz.
How Can You Recover From Cocaine Addiction?
Recovery from cocaine addiction involves undergoing detox to remove the drug from your system and managing the unpleasant withdrawal symptoms which include depression, paranoia and insomnia.
The next, and longest, stage of the recovery is staying clean. This requires you to alter your behaviour and make different choices that don’t involve taking drugs. This is where therapy comes in. It helps you unpick the reasons behind your addiction and arms you with strategies to deal with future triggers and avoid relapsing.
If you have some form of therapy or counselling, you will have better outcomes than if you don’t. Therapy is matched to your needs and your personality to ensure it suits you and you will engage with it. Smarmore Castle offers a range of therapy including one-to-one, group, family, aqua therapy, drumming therapy and equine therapy.
With the right therapy, you can focus on building a life worth living without cocaine. And the support doesn’t stop when you complete the treatment. We offer weekly aftercare groups for the next year to ensure you stay on track.
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Taking the first step in seeking help can be very difficult, our team is here to help you.
Seek Professional Help
Cocaine is highly addictive and extremely tolerable which means you can get hooked after one or two uses, and you need increasing amounts to achieve the same high. For this reason, it is hard to get clean and stay clean, without professional addiction treatment.
Your first port of call should be your GP as they can signpost you to local organisations in your area that may be able to help. They can also prescribe medication to manage some of your withdrawal symptoms.
This is a great starting point but it won’t help you understand why you became addicted in the first place and how you can avoid relapsing. You need intensive addiction treatment at a rehab centre such as Smarmore Castle where you will receive experienced, bespoke, safe care.
If you find the right support, you’ll get treated once, and for good.
If you are taking cocaine you risk destroying your health and your life. Contact Smarmore Castle today on 0141 214 5111 for free non-judgmental advice and take the first step to becoming addiction free.
Frequently Asked Questions
Can Nose Damage From Cocaine Be Treated?
Sometimes, depending on the severity. Surgery is normally the only treatment but this is not always successful.
What Is a Perforated Septum?
This is when the septum – the wall of cartilage that separates your nostrils – gets holes in it. If the holes multiply or get bigger your septum can collapse.
References
- Villa P D, (1999), Midfacial Complications of Prolonged Cocaine Snort, Canadian Dental Association
- Nitro L, Pipolo C, Fadda G L, et al, (2022), Distribution of Cocaine-Induced Midline Destructive Lesions: Systematic Review and Classification, Eur Arch Otorhinolaryngol, 279 (7), 3257-3267
- Di Rienzo Businco L, Lauriello M, Marsico C, et al, (2008), Psychological Aspects and Treatment of Patients With Nasal Septal Perforation Due to Cocaine Inhalation, Acta Otorhinolaryngol Ital, 28 (5), 247-251
- Alghamdi F S, Albogami D, Alsurayhi A S, et al, (2022), Nasal Septal Deviation: A Comprehensive Narrative, Cureus: 14 (11)
- Van Der Poel N A, Schot L J, Menger D J, (2013), Local Complications of Intranasal Cocaine Abuse: Diagnostic and Therapeutic Guidelines, Ned Tijdschr Geneeskd, 157 (24)
- Di Cosola M, Ambrosino M, Limongelli L, et al, (2021), Cocaine-Induced Midline Destructive Lesions (CIMDL): A Real Challenge in Diagnosis, Int J Environ Public Health: 18 (15), 7831
- Trimarchi M, Bondi S, Della Torre E, et al, (2017), Palate Perforation Differentiates Cocaine-Induced Midline Destructive Lesions from Granulomatosis with Polyangiitis, Acta Otorhinolaryngol Ital, 37 (4), 281-285
- Australian National University (2022), Coke Light: Drug Tests Show 40% of ‘Cocaine’ Had No Cocaine
- Morton W A, (1999), Cocaine and Psychiatric Symptoms, Prim Care Companion J Clin Psychiatry: 1 (4), 109-113
- Jhanjee S, (2014), Evidence Based Psychosocial Interventions in Substance Use, Indian J Psychol Med: 36 (2), 112-118
- McGovern M P, Carroll K M, (2013), Evidence-Based Practices for Substance Use Disorders, Psychiatr Clin, North Am: 26 (4), 991-1010
- Dimeff L A, Linehan M M, (2008), Dialectical Behavior Therapy for Substance Abusers, Addict Sci Clin Pract: 4 (2) 39-47
- How to Access Rehab With Health Insurance
For those experiencing existing mental health conditions in Ireland, there are private medical insurers who can help you cover treatment. As addiction experts, we know that receiving the appropriate care and support when you have a mental health disorder is pivotal to attaining long-lasting recovery. Below, we will go through the various health insurance options to help you understand your options when it comes to seeking private residential care for substance abuse. Please note that there is no guarantee that you can be covered for all addiction problems as policies are always assessed on a case-by-case basis. Find Out More
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Our treatment programme starts at 4 weeks and is flexible in length, giving you the opportunity to extend for a longer period if you need it.
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All patients are reviewed by a consultant psychiatrist in the first week and we can diagnose and provide treatment for a number of co-occurring mental health conditions.
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We can also arrange a ‘sober transport’ service with a trusted driver, from anywhere in Ireland or Northern Ireland, at an additional cost.