Hole In Your Nose, Whole Lot Of Trouble: What To Know About Septal Perforations

If your nose whistles, it could be a sign you have a hole in your nose—one that’s not supposed to be there. 

Yes, a hole in the nose sounds strange, but a septal perforation can be a potentially painful and serious condition. 

Here’s what you need to know: 

What it is

Your septum is the strip of bone and cartilage that separates your nose into left and right nostrils. When there is a tear, defect or hole in your septum, this is known as a septal perforation. 

It differs from a deviated septum where the septum is crooked and may protrude to one side of the nose (a more common condition that’s often present from birth).  

When the septum is perforated, however, an actual hole develops through the septum, which allows air from one nostril to spill over into the other one.


There are a variety of reasons why you may have a hole in your septum. Potential causes include nasal trauma from an accident or injury, complications from a previous nasal surgery such as a septoplasty or rhinoplasty, an infection or inflammatory disorder, long-term use of certain medications or illegal drugs (such as snorting cocaine or crushed-up prescription pills), and problems from nasal piercings. In very rare cases, cancer can also cause a perforated septum. 


Much can depend on the size of the hole, the location, and the extent of the tissue damage.  A perforated septum may not always cause symptoms. Generally, the closer the perforation is to the nostrils, the more likely it is to cause symptoms. Larger perforations usually have more severe symptoms.

The most typical symptom is a consistent whistling noise while breathing.  Other possible symptoms of this condition can include difficulty breathing, nasal blockage and pressure, discomfort or pain, crusting, and bloody discharge. 


There are many treatment options available to manage septal perforations. The specific treatment often depends on the size and severity of the perforation and its symptoms.  Common treatments that can help alleviate symptoms often include medications such as nasal sprays or topical ointments. 

When symptoms persist or cause severe pain, however, more advanced measures such as surgery may be needed or desired to repair the damage and definitively deal with the source of the problem. There are several surgical techniques that can be used to correct the problem, depending on the individual factors involved in your case. 

Occasionally, a perforated septum can heal on its own, but in other cases, it can also be more likely to get worse if left untreated. Finding the cause of the perforation can be vital to your health.

If you have any symptoms of a perforated septum, it’s generally best to see a doctor, experienced in diagnosing and treating disorders involving the nose.

Contact our office today to schedule an appointment or learn more. We’ll be happy to discuss the latest treatment options and assist you in any way we can.