Does past cocaine use lead to irreversible nose damage?

Damage Is Possible: Cocaine users often snort powdered Cocaine up their nostrils so that the drug can be quickly absorbed by fine capillaries which line the nasal passages. Cocaine is toxic to the tissue, but it also acts as an anesthetic agent so the user does not feel the tissue damage. Chronic use can destroy the mucosa as well as erode the nasal septum. The mucosa can regenerate but not the nasal cartilage.

Cocaine: This really depends on what the damage was. Perforations are permanent (they can be surgically covered-but if you are a Cocaine user it is unlikely that you will find a surgeon to help you).