An Ear, Nose, and Throat (ENT) doctor, also known as an otolaryngologist, specializes in conditions affecting the head and neck, with a particular focus on the ears, nose, and throat. This medical field addresses a wide range of issues within these interconnected systems, including those related to the nasal passages. While nose picking is a common habit, an ENT can identify physical signs and potential medical implications associated with chronic nose picking.
The ENT’s Examination Approach
When examining the nasal cavity, an ENT utilizes specific tools and procedures to gain a clear view of the internal structures. A nasal speculum is commonly used to gently widen the nostril, allowing for better visibility. This is often combined with a bright light source, such as a headlamp, to illuminate the nasal passages.
For a more detailed and magnified inspection, an endoscope may be employed. This is a thin, flexible or rigid tube equipped with a light and a small camera at its tip. The endoscope allows the ENT to visualize deeper areas of the nose, including the nasal septum, turbinates, and mucous membranes, which might not be visible with a speculum alone. These examination methods provide the ENT with the necessary insight to observe any changes or damage within the nasal cavity.
Physical Indicators of Chronic Nose Picking
An ENT can observe physical signs indicative of repeated trauma from chronic nose picking. A common indicator is irritation and inflammation of the nasal lining (mucosa), particularly in the anterior septum. This manifests as redness, swelling, or tenderness in the affected area.
Abrasions and scabs are often seen. These are small cuts, sores, or crusts of dried mucus and blood on the nasal septum or inside the nostrils. Repeated removal of these scabs can further damage the delicate nasal lining.
Nasal vestibulitis, an inflammation and infection of the skin at the nostril opening, is another sign. It presents with crusting, tenderness, and sometimes pimple-like lesions. It is caused by bacteria, such as Staphylococcus aureus, introduced from fingers into the nasal cavity.
Dried blood, indicating recent or past nosebleeds, can be present. Persistent irritation can lead to thinning or erosion of the delicate nasal lining, making it more susceptible to injury. In severe cases, chronic trauma can contribute to or worsen conditions like a deviated septum or, rarely, a septal perforation (a hole in the nasal septum). While an ENT cannot definitively state a patient picks their nose without admission, these physical effects provide strong clinical evidence of repeated self-induced trauma.
Potential Health Complications
Chronic nose picking can lead to several medical problems and health risks. Recurrent nosebleeds (epistaxis) are a common complication due to damage to delicate nasal blood vessels. The repeated trauma can make these vessels fragile and prone to bleeding.
Introducing bacteria from fingers into the nasal cavity can cause bacterial infections. Staphylococcus aureus, a common skin bacterium, can cause infections like nasal vestibulitis, folliculitis (inflamed hair follicles), or more serious conditions if untreated. These infections can lead to pain, swelling, and pus formation.
Nose picking can spread bacteria and viruses. Mucus traps pathogens; transferring them to other surfaces or people can facilitate illness transmission. In rare but severe instances, persistent trauma to the nasal septum can lead to a septal perforation (a hole through the cartilage). This can cause symptoms like whistling sounds during breathing, persistent crusting, and ongoing nosebleeds.
When to Seek Medical Consultation
Consult an ENT if nose picking leads to persistent or concerning symptoms. Frequent or heavy nosebleeds difficult to stop require medical attention. Recurrent nasal infections, painful sores inside the nose, or persistent crusting are also reasons to seek evaluation.
Difficulty breathing through the nose due to swelling or crusting warrants an ENT visit. If a septal perforation is suspected (indicated by whistling sounds when breathing), an ENT can diagnose and discuss treatment. Consulting an ENT is also beneficial if the habit causes significant distress, impacts daily life, or raises concern about infection spread.