Question:

I have done cocaine- years ago and now get nose scabs in nose. They are against the hard part that separates each nostril and they hurt. I constantly have this scab that if it dries…. seems to build upon itself and I can FEEL it inside like a large booger that I need to have gone. Because of this, I will try to break down the scab with a wet cutip, but normally have to pick it out. This hurts too and causes bleeding. This has gone on for YEARS and most doctors give me a nose gel and tell me to keep the area moist. Now, it seems the drainage (that creates this scab) is going down my throat. It feels like there is something caught in my throat at the back where I swallow. But there is nothing there and when I looked in the mirror, it seems a line of sticky like saliva mucous is hanging from my uvula onto the back of my tongue. This is the feeling of something there as I can`t swallow the mucous gone. At the same time, my upper teeth on the side of the scabs hurt. I have had 2-3 root canals and crowns in the past few years- and now think I need another one. This makes me suspicious. Why do I need so many root canals on that side? Why does it seem that the roots of the teeth are dying on the same side as the scabs? Sometimes when the scab comes loose, it is greenish or bloody-ish (dried blood). When I blow my nose, it seems greenish. I just had a CT Scan and am seeing an ENT, but I am SO afraid that I have nose cancer or something. I believe the scabs is my nose trying to heal itself in a spot where maybe there is a hole or gap of tissue. Because sometimes the scabs are flat and seems to look like skin regrowth. When the scab is there, I can breathe and feel them and hear my nose whistling a bit. All this is driving me crazy and I am ready to cut my nose off my face!!! I really think I need surgery to fix whatever is wrong. Any ideas? Please help!

Answer:

Chronic crusting on the anterior nasal septum, the structure that divides your two nostrils, is not uncommon.  It is generally caused by dryness and excessive finger manipulation.  The use of cocaine can cause scarring of the delicate membrane that lines the septum, making you even more susceptible to the crusting. 

Each time you pick the crust you generate more inflammation and repeat crusting.  Keeping it moist is the right idea, although I realize this is easier said than done.  The use of cocaine can sometimes disrupt the blood supply to the septum, and this may result in a hole or perforation, something you suspect you may have, and which will crust even more.

I would aggressively apply a saline or salt water spray, and apply antibiotic ointment, such as bacitracin, at night and in the morning.  Consulting an ENT physician is the right move.  He may be able to provide you with additional more effective measures for humidification.  Sometimes placement of splints against the septum can give things a chance to heal.  If you have a hole or perforation, then sometimes a button may be placed or surgery performed to cover or repair the hole, respectively.

For more information:

Go to the Ear, Nose, and Throat Disorders health topic.