Plastic surgeon issues warning as number of patients with ‘coke nose’ increases: ‘Even occasional users are affected’
Rising numbers of adults in the UK are suffering irreparable damage to their noses due to cocaine use, leading doctors have warned.
Britain is now believed to snort around 117 tonnes of cocaine per year, according to the UK’s National Crime Agency amid a huge explosion in use.
The UK also has the second highest rate of cocaine use in the world, with one in 40 adults — 2.7 per cent of the population — using the party drug, more than any other country in Europe, the United Nations Office on Drugs and Crime says.
But patients, some of whom may have only taken the drug infrequently, could still be at risk of losing part of their nose, surgeons have argued.
Thomas Jacques, a consultant ear, nose and throat surgeon at The Cadogan Clinic, in London, said the phenomenon, dubbed ‘coke nose’, causes holes in the septum from reduced blood flow, leading to tissue damage.
Nasal damage triggered by cocaine use, however, doesn’t just affect ‘yuppies’ and ‘bankers’ that are stereotypically users of the drug, he added.
It comes as Paris Jackson, who has been open about her past drug use, last week revealed she had a hole in the middle of her nose as a result of sniffing cocaine.
The 27-year-old daughter of Michael Jackson celebrated five years of sobriety earlier this year, also admitted she makes a noticeable ‘whistle’ sound when breathing through her nose.
Britain is now believed to snort around 117 tonnes of cocaine per year, according to the UK’s National Crime Agency amid a huge explosion in use
Cocaine’s effects have been publicised previously by former EastEnders actress Daniella Westbrook, who was left with a hole in her nose.
Mr Jacques said: ‘You don’t have to be what most people would consider a ‘heavy habitual user’.
‘There do seem to be some patients where it can cause a lot of damage from occasional recreational use.
‘Some patients report having quite nasty inflammation and severe destruction, even from small amounts of the drug.
‘There isn’t a safe amount. It’s best to completely avoid it.
‘Because once the damage is done, the fix is possible, but it’s not easy. There’s no magic wand and the surgery can be complex.’
‘I think that patients who have had damage of their nose from taking cocaine often do feel a lot of shame about it.
‘But we try and reassure patients that it’s not something that other people need to know about, and we try very hard to be non-judgemental.
Paris Jackson, who has been open about her past drug use, last week revealed she had a hole in the middle of her nose as a result of drug use
He added: ‘People take cocaine from all walks of life, genders, age. I’ve seen older patients. I’ve seen young patients.
‘It’s a very broad range of society that can be prone to overuse of cocaine.’
When snorted, cocaine causes the blood vessels to contract very strongly, known medically as vasculitis.
For those that take just a small amount of cocaine, this can cause minor sniffles and slight congestion.
But for other who are much more sensitive to the drug, or who regularly take cocaine, inflammation starts to compromise the blood supply to the tissue of the nose, resulting in more serious consequences.
‘This can cause whistling, bleeding, and crusting in the nose, but some people don’t even know they have it, and don’t have any symptoms,’ Mr Jacques said.
‘If people use cocaine really heavily over a long period of time, it can affect other parts of the nose.
‘The second most common thing is that it can cause the bridge of the nose to collapse inwards, which is caused a saddle nose deformity, and that’s actually quite common.
Cocaine’s effects have been publicised previously by former EastEnders actress Daniella Westbrook, who was left with a hole in her nose
‘Less commonly, we see destruction of the skin between the nostrils, which effectively creates one big nostril, like Daniela Westbrook famously had.
‘It can also rarely cause perforations in the outer surface of the nose, or a hole through the roof of the mouth.
‘I’ve seen all of those things, although they are pretty rare.’
Before any treatment, patients must completely stop using the drug, Mr Jacques said.
For septum perforations, patients don’t always need surgery, and may instead be able to treat the problem with nasal irrigations and creams for the inside of the nose to help the lining settle down, along with complete cessation of the drug.
‘They can have a septal button put inside, which is a small piece of silicone, like a disc, that blocks the hole and stops it crusting up and whistling’, Mr Jacques added.
‘You can also have an operation to attempt repair the hole.
‘Understandably some patients want the perforation closed in order to close a chapter or erase memories of previous drug use.
‘However, repairing a septal perforation using surgery, is very complex, and even in the best hands, doesn’t have a success rate more than about 70 to 80 per cent because the blood supply to the septum is really delicate.
‘Sometimes the lining of the nose tries to grow over the hole but fails to heal completely.
‘With a smaller perforation, you can repair it by creating a “flap” from a piece of healthy lining of the septum that’s rotated in to the hole.
‘With a larger perforation, one of the things we can do is to use connective tissue from under the scalp.’
Reconstructive rhinoplasty’s are an option for those with saddle nose deformities, to correct the external appearance of the nose.
It is possible to get treatment for a perforated septum on the NHS, but for more complex surgeries, such as for a saddle nose deformity, treatment can cost up to £15,000 privately.
