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Cocaine Nose: Potential Damage & Irreversible Nasal Destruction

Chronic users of cocaine often experience a significant decline in their nose health. They may start to notice frequent inflammation and bad nosebleeds.[1] 

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They may eventually start to cause permanent damage to their septum.[2] Cocaine use can also hurt a person’s sense of smell, sometimes permanently.[3] 

There are ways to reduce the risk of harm, but the risk will always be present if you continue to snort cocaine.

Cocaine Nose: Long-Term Abuse & Damage Potential

Abusing cocaine has the potential to significantly damage the nose and nasal passages. The nose is a fairly sensitive part of the body. It isn’t equipped to handle consistently snorting large quantities of a fairly harsh substance like cocaine. 

The longer one abuses cocaine and the less careful one is when abusing cocaine, the more likely it is that lasting damage will occur. This damage can only be mitigated so much, although some practices to reduce its potential for harm are discussed later.

Snorting cocaine can cause a loss of sense of smell, nosebleeds, inflammation, and more.[1] This is in addition to the many other ways cocaine use can harm the body. The drug has a significant risk of addiction with repeated use, and its use brings an increased risk of stroke, seizures, and other neurological problems. This is discussed in more detail later.[1] 

Snorting can irritate and rupture blood vessels in the nose, and this leads to a lot of nasal damage.[4] Additionally, cocaine may be cut with other agents that can be rougher on the nose, sometimes causing small cuts and tears to the lining of the nose. This has the potential to cause microscopic bleeding that may not be immediately obvious to the person snorting cocaine.[5]

Harm Reduction

It isn’t safe to snort cocaine or use it in any other way. Chronic use of cocaine can do significant harm. However, it’s worth discussing ways to reduce the harm a person might experience from cocaine use. If you choose to abuse cocaine, there are steps you can take to lessen the damage it might have on your nose.

One common and good piece of advice is to only use your own equipment to snort cocaine and to dispose of that equipment after a single use. This greatly reduces the risk of contracting an infection or blood-borne virus as a result of snorting drugs. 

Sharing drug equipment is a relatively common way in which dangerous diseases like HIV can be spread. Many people use colored straws when snorting cocaine to easily identify whose equipment is whose. Don’t use paper money or anything else that has passed through many hands to snort cocaine. These surfaces can carry many germs.[5] 

There are also ways to reduce how irritating snorting cocaine is. The finer the powder, the easier it is on the nose. You can rinse the nose with lukewarm water after snorting to help reduce nasal damage, dissolving any drugs left in your passages.[5]

Again, these practices don’t make snorting cocaine safe in any way. But they may reduce some of the potential damage somewhat.

What to Expect

The potential damage cocaine use can cause exists on a spectrum. In the early stages of use, damage is likely to be minor and will often go away on its own with enough time. Your nose may feel irritated and inflamed after using cocaine, and you may occasionally experience nosebleeds. You might notice a temporary reduction in your ability to smell. 

However, damage can worsen over time in severity, and cocaine use can cause more lasting harm. Chronic cocaine use can lead to very bad nosebleeds, excessive mucus production, and more. Because of the damage cocaine has caused your nose, it will be easier for you to both transmit and contract blood-borne diseases.[5]

Eventually, cocaine use can do such severe damage that it may destroy your septum, eating through the cartilage that divides the nose. As a general rule, continued cocaine use is going to cause progressively worse damage. 

If you start to experience some of the negative symptoms of snorting cocaine, talk to a doctor or addiction treatment professional if you feel you cannot stop using cocaine. They can help you find an inpatient or outpatient treatment program that can help you to safely stop cocaine abuse. In treatment, you’ll build habits to help you resist cocaine cravings in the future, and you’ll begin to build a better life in recovery.

If you continue to use cocaine, you should at least temporarily take it via a different route, such as by swallowing it.[5]

Is the Damage Reversible?

The early kinds of damage associated with cocaine snorting should generally be reversible. However, blood-borne viruses like HIV can still be contracted at this stage, and not all these diseases (including HIV) are easily treated. If your nose is inflamed or you occasionally experience nosebleeds after snorting cocaine, it is likely that stopping your snorting of cocaine for an extended period will give your nose time to heal. 

However, more serious damage from long-term cocaine use might require advanced treatment or surgery. A severely damaged or destroyed septum won’t generally be able to fully heal on its own, although continued cocaine use will likely make the problem even worse. If your sense of smell has been damaged or destroyed, it likely won’t be possible to fully return that to you, even with medical intervention. 

Updated March 21, 2024
  1. What are the long-term effects of cocaine use? National Institute on Drug Abuse. Published May 2016. Accessed February 19, 2024.
  2. Jalali A. Cocaine nose correction: A nonsurgical approach using a novel hyaluronic acid filler. Plastic and Reconstructive Surgery Global Open. 2023;11(10):e5329.
  3. Di Cosola M, Ambrosino M, Limongelli L, et al. Cocaine-induced midline destructive lesions (CIMDL): A real challenge in diagnosis. International Journal of Environmental Research and Public Health. 2021;18(15):7831.
  4. Jackson RT, Hersey SJ. Interaction of cocaine with nasal mucosa. Archives of Otolaryngology–Head & Neck Surgery. 1991;117(9):975-979.
  5. Swallowing & snorting. Ontario Harm Reduction Network. Accessed February 19, 2024.
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