What Is Cocaine Nose? Harmful Effects & Treatment Options

What Is Coke Nose?

Coke nose, also referred to as cocaine nose, is a term used to describe the range of nasal and sinus problems that develop from snorting cocaine. Cocaine, a powerful stimulant, constricts blood vessels and reduces blood flow to the delicate tissues inside the nasal passages. Over time, reduced blood flow and repeated irritation from snorting can seriously damage nasal tissues. The damage may be minor at first — such as occasional nosebleeds — but, if left untreated, it can progress and lead to permanent deformities, infections, and breathing difficulties.

Below are some of the most common ways cocaine use can damage the nose.

Deviated Septum

A deviated septum occurs when the thin wall (septum) between the nostrils shifts away from its normal midline position. Snorting cocaine weakens and irritates the septum’s tissues. This can lead to cartilage erosion or even perforation, causing the septum to lean more to one side. In severe cases, a deviated septum from cocaine use can cause significant breathing difficulties, chronic congestion, and a constant feeling of a blocked nasal passage.

Cocaine Nosebleed

Nosebleeds (epistaxis) are a common symptom of coke nose. Cocaine’s blood vessel-constricting properties and its acidic additives both irritate and dry out the nasal lining. Over time, the delicate tissue inside the nose can crack, bleed easily and develop sores. Repeated nosebleeds can further compromise nasal tissues by creating scabs and increasing the risk of infection.

Cocaine Nose Hole

One of the most dramatic signs of advanced nasal damage is the formation of a hole in the septum or other areas of the nasal cavity. Also known as a septal perforation, a cocaine nose hole develops because the tissue has been eroded and can no longer regenerate. This perforation can cause whistling sounds during breathing, chronic infections, and ongoing discomfort. Sometimes, the damage can spread beyond the septum into surrounding bone or cartilage.

Saddle Nose

Saddle nose deformity is a collapse of the nasal bridge that creates a sunken or flattened appearance. Prolonged cocaine use can weaken and destroy the structural support in the nose, causing the bridge to cave inward. A saddle nose can severely affect a person’s self-esteem and may require reconstructive surgery to restore both appearance and function.

Sinus Infections

Cocaine use can interfere with the normal function of the sinuses, leading to frequent or chronic sinus infections. The drug impairs the nose’s natural filtering and humidifying mechanisms, making it easier for bacteria to accumulate. When the nasal lining and septum are compromised, it becomes harder for the sinuses to drain properly. This trapped mucus can lead to sinusitis characterized by facial pressure, headache, nasal discharge, and congestion.

Palatal Perforation

Though less common, severe cocaine damage can extend from the nasal passage into the roof of the mouth (the palate). This process can create holes that connect the nasal cavity to the oral cavity. A palatal perforation can lead to difficulties with swallowing, speaking, and eating. It can also heighten the risk of serious infections in both the nose and the mouth.

Why Do Nasal Injuries Occur?

Cocaine triggers intense vasoconstriction (the narrowing of blood vessels). This reduced blood flow means the tissues within the nasal passages receive less oxygen and fewer nutrients. Over time, the starved tissues can die, leading to ulceration, perforations, and structural damage. Furthermore, cocaine often contains additives that can be abrasive or toxic. These adulterants can further irritate nasal tissues and accelerate damage.

Additionally, repeated trauma from snorting — particularly if someone is snorting cocaine multiple times a day — irritates the nasal lining, exacerbates dryness, and prevents healing. Scar tissue replaces the healthy tissue, and as more healthy tissue breaks down, it becomes even harder for the nose to maintain its structure and function.

Coke Nose Signs and Symptoms

Coke nose can manifest in a variety of symptoms that may intensify over time:

• Frequent Nosebleeds: These might start off as occasional but can become more frequent and harder to control.
• Chronic Nasal Congestion: Individuals may feel as though their nose is perpetually blocked.
• Crusting or Scabbing Inside the Nose: Constant irritation can lead to persistent scabs that, when removed, cause additional bleeding.
• Change in Nasal Appearance: This can include the development of a crooked septum or a flattened (saddle) nose.
• Whistling Sound When Breathing: This can happen if there is a perforation in the septum.
• Decreased Sense of Smell: Damage to the nasal lining can reduce one’s ability to smell properly.
• Facial Pain or Sinus Pressure: Chronic sinus infections can cause facial discomfort or headaches.
• Bad Breath or Foul Odor: Infections in the nose or palate can lead to unpleasant smells.

If you or someone you know exhibits these signs and has a history of cocaine use, it is important to seek professional help. Early intervention can prevent further damage.

Can Coke Nose Be Treated?

Treatment options for coke nose vary based on the level of damage:

• Quitting Cocaine Use: The single most crucial step is to stop using cocaine. Continuing use will only worsen existing damage and hinder any chance of healing. Substance use treatment programs, like those offered at The Recovery Village Cherry Hill at Cooper, can provide medical supervision and therapeutic support to address the underlying causes of cocaine addiction.
• Medical Evaluation: An ear, nose, and throat (ENT) specialist can conduct a thorough examination, order imaging tests and determine the extent of the damage. They can also identify infections or the presence of a nasal perforation.
• Medications: Antibiotics may be prescribed to clear sinus infections. Saline sprays, nasal lubricants and other topical treatments can help keep nasal passages moist and facilitate healing of irritated tissues.
• Surgery: In some cases, surgery may be required to repair a deviated septum, reconstruct the nasal bridge, or close a perforation. The specifics of reconstructive surgery depend on the amount of tissue remaining and the extent of the damage. Even with surgery, however, continued cocaine use can undermine healing.
• Long-Term Aftercare: Because coke nose is usually a result of chronic cocaine use, ongoing addiction recovery support is critical. Individual therapy, group counseling, and relapse prevention strategies can help maintain sobriety and protect against further nasal damage.

Seeking help early cannot be overstated. The nose and sinus area are delicate structures, and the longer the damage persists, the harder it may be to treat. If you suspect cocaine has caused nasal damage, consult both a medical professional for the physical effects and a treatment program for substance misuse.

The Recovery Village

If you’re seeking addiction treatment for yourself or a loved one, The Recovery Village Cherry Hill at Cooper is here to help. Our facility is conveniently located within the heart of New Jersey, under 20 minutes from Philadelphia. We have a full range of treatment options, including medical detox, inpatient care, partial hospitalization programming and intensive outpatient services. We offer a state-of-the-art inpatient facility and have specialized options for trauma, including EMDR and a specialty track for veterans and first responders. 

If you or a loved one are ready to begin the journey toward a substance-free life, we’re standing by to take your call. Reach out to our Recovery Advocates to learn more about our treatment programs and find a plan that works well for your specific needs and situation.