Last Updated:
September 23rd, 2025
For many people, the first alarm bells about cocaine use don’t come from hidden health issues, but from what they see in the mirror. A once healthy complexion begins to fade, weight fluctuates alongside confidence, and smiles become harder to muster.
These aesthetic changes represent more than just surface-level changes. They are indicators that major damage has already taken place, and will only worsen as an addiction erodes the body from the inside out.
Why do we sometimes overlook the aesthetic risks of cocaine?
If we paint a mental picture of a person with cocaine addiction, we often imagine the toll it is taking on internal systems or a person’s mental health. Yes, we may imagine a person breaking out into sweats or having shaky hands, but we often don’t conceptualise some of the external damage, or we might imagine that outside effects are just a “cosmetic” or surface-level concern.
As we take time to ponder the future consequences of cocaine addiction, we envision a person who is not their current self, in the here and now. Yet aesthetic risks can develop quicker than most people realise, and these “cosmetic flaws” are visible warnings of deep and serious harm.
It is unfortunate to imagine how many people realise that cocaine is impacting their health only when they see the changes staring back at them in the mirror. This is why it is so critical to look beyond the idea that aesthetics are only “surface level.” They function as undeniable markers that parts of the body are breaking down. Recognising outward signs will help not only a person’s self-image and confidence, but could also function as the trigger that prompts them to seek urgent help.
In any case, the earlier action is taken, the better.
What is happening in the nose when cocaine is snorted?
We should first understand the primary area that is affected by repeated cocaine snorting, which is the nose and the nasal passages. Cocaine is a potent vasoconstrictor, meaning it narrows the vessels that carry blood. Over time, a person’s repeated cocaine use deprives those delicate tissues of oxygen, so the lining of the nose becomes dried out and weak. The nose also becomes more vulnerable to ulcers and infections.
The cartilage that separates the nostrils (the septum) can start to erode. Most people will experience chronic nasal congestion and regular nosebleeds, even before deep addiction has deepened. Even on a person’s first try of cocaine, the following day will come with sometimes alarming feelings around the nose and throat, and these can both be indicators that damage has already taken place.
What are the aesthetic signs associated with snorting cocaine?
Prolonged cocaine abuse will increasingly highlight how the body is dealing with severe damage. Each can indicate a deeper level of physical decay, and the most frequently occurring aesthetic signs include:
- Septum erosion: Cocaine’s vasoconstriction starves your nasal septum of blood, which means the cartilage will weaken and die. This may form holes (septal perforations) that can whistle when breathing. Nosebleeds become more common and the nose can gain an unhealthy and “hollow” look. Research shows that long-term intranasal use is one of the most common non-surgical causes of septal perforation.
- Nose deformities: As the structures inside the nose collapse, the bridge can appear to “sink,” leading to a “saddle shape” deformity. In more advanced cases, this change may be irreversible without reconstructive surgery. Living life with this deformity often shatters a person’s confidence and can be emotionally damaging.
- Chronic sinus inflammation: Snorting cocaine irritates and inflames the delicate tissues of the sinuses. Over time, this leads to a persistently swollen look, especially around the cheeks and the nasal area. People often mention the physical sensation of pressure alongside the visible puffiness, making them appear constantly unwell.
- Fluid retention and bloating: Cocaine disrupts circulation and puts stress on the body’s blood vessels. This often leads to excess fluid being trapped in the face. A puffy, bloated appearance develops around the eyes and jawline, changes that become more noticeable over time.
- Dry, pale, or blotchy skin: There will be visible effects on the skin as cocaine reduces circulation across the body. A person’s general complexion can appear uneven or patchy. Many people report their skin being drier or dull.
- Broken capillaries: In people with a prolonged cocaine addiction, you may have sometimes noticed small, bluish veins prominent on the nose, face, or other body parts. Broken capillaries appear like spider legs and generally cannot be restored to their previous look.
- Accelerated ageing: In a person’s skin, cocaine reduces collagen production, which can, in fact, speed up the visible signs of ageing. There may be fine lines or sagging in the body, with deeper wrinkles forming earlier than the person expects.
- Bloodshot eyes and dilated pupils: Cocaine stimulates the central nervous system, and its effects on your blood pressure can lead to red and inflamed eyes. At the same time, many people experience pupil dilation, giving eyes a wide and “glassy” look, making someone appear “wired.” These effects are noticeable immediately and will worsen with prolonged use.
- Dark under-eye circles: A combination of poor sleep hygiene, dehydrating effects and malnutrition often creates a hollowed and fatigued look around a person’s eyes. Dark circles usually deepen with continued use, creating a broadly unhealthy look. This aesthetic change is one of the most clear indicators of declining overall health.
- Appetite suppression: Cocaine is well-known to blunt appetite, as it stimulates your nervous system and increases dopamine activity. Natural and healthy hunger is suppressed, which affects metabolism. Many people skip meals entirely and over time, the body is robbed of the nourishment needed from vitamins, minerals and protein.
- Visible gauntness and unhealthy thinness: A person’s prolonged cocaine use can often cause rapid weight loss and the appearance of “muscle wasting.” These effects will be visible across both the body and face, making cheeks appear sunken with a hollow and drawn-out look. Skin can sag without proper fat or muscle support, and the outward frailty is more than an aesthetic issue. It reflects how the body is wasting away under nutritional neglect.
I want to change. Where can I get help for my addiction?
Cocaine is known as one of the most addictive drugs on the planet. If you recognise an addiction developing in yourself or someone you love, please remember that early help may indeed save a life. Aesthetic changes are signs of deeper harm that will only worsen without support.
Reach out to UKAT today for a confidential conversation with the admissions team. One step you take today could be the turning point that protects your health and your entire future.
(Click here to see works cited)
- Businco LD, Lauriello M, Marsico C, Corbisiero A, Cipriani O, Tirelli GC. Psychological aspects and treatment of patients with nasal septal perforation due to cocaine inhalation. Acta Otorhinolaryngol Ital. 2008 Oct;28(5):247-51. PMID: 19186454; PMCID: PMC2689536.
- “New York Treatment for Saddle Nose Caused by Cocaine Use or Illicit Drugs.” Saddle Nose Repair, 13 July 2020, www.saddlenose.com/cocaine-use-or-other-illicit-drugs/.
- Ersche KD, Stochl J, Woodward JM, Fletcher PC. The skinny on cocaine: insights into eating behavior and body weight in cocaine-dependent men. Appetite. 2013 Dec;71:75-80. doi: 10.1016/j.appet.2013.07.011. Epub 2013 Aug 3. PMID: 23920064; PMCID: PMC3863945.
