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What is coke?

Cocaine, commonly known as coke, is a powerfully addictive stimulant drug made from the leaves of the coca plant native to South America. Although health care providers can use it for valid medical purposes, such as local anesthesia for some surgeries, cocaine is an illegal drug. As a street drug, cocaine looks like a fine, white crystal powder. Street dealers often mix or “cut.” it with things like cornstarch, talcum powder, or other white crystal powder to increase profits. They may also mix it with other drugs such as illegal stimulants. According to the National Institute on Drug Abuse (NIDA) [1], overdose deaths from cocaine use are rising, with more than 16,000 people dying in 2019.

Coke Bloat
Coke bloat,” when the face—particularly the cheeks—appear aged, bloated and puffy

What Is coke bloat?

When a regular cocaine user experiences a puffy and bloated appearance in the face, especially the cheeks. It’s not uncommon to experience puffiness and facial bloating after using cocaine. It even has its own name: “coke bloat.” It’s often most noticeable in the cheeks and under the chin.

We often imagine cocaine users as sickly individuals, having not eaten for days at a time while dripping calories on the dance floor (or just talking fast). And while that may be true to some degree, many who use cocaine eventually develop “coke bloat,” a considerable ballooning of the cheeks that contributes to the general appearance of weight gain. Examples include pretty much every celeb ever.

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Why do some people have a puffy face after using cocaine?

Coke bloat could result from several common complications of sustained cocaine use, such as fluid retention or hormonal disturbances. However, perhaps the most likely cause is simply straying from the pure stuff. Though there may be a great deal of factors at play, perhaps one reason why those with sustained cocaine use often appear with a face that looks ‘puffy’ or ‘swollen’ could be the adulterant present in most cocaine samples. 

Levamisole is used primarily as an anthelmintic drug, which is used to get rid of worms and other internal parasites. The FDA previously approved its use in the treatment of colon cancer, but it’s no longer used in the U.S. and Canada because of reports that it caused a condition called agranulocytosis, which causes a severe reduction of white cells in the blood. 

Levamisole is a common cutting agent in cocaine. It’s estimated to be present in approximately 80 percent of the cocaine seized in the U.S., so it’s exceedingly prevalent [2]. Levamisole, when metabolized, creates a compound called aminorex that has psychostimulatory properties of its own. As a result, levamisole prolongs the stimulatory effects of cocaine use. This, in addition to its physical similarity to cocaine, is likely why it’s also addictive.

In addition to many, many side effects, levamisole causes glands to swell, and one of the glands that can possibly explain a ‘puffy’ face is the parotid gland. The parotid glands are the largest salivary glands and are right in front of the ear. When met with an irritant such as levamisole, swelling is a great possibility. 

Additionally, the combination of cocaine, the nasal inflammation that happens through the act of insufflation [snorting] and the vasoconstriction of blood vessels that can cause a backup of lymphatic fluid around the face are all factors that may explain the change in appearance.

coke bloat
For anyone suffering from coke bloat, there is a cure: giving up the goods.

How to get rid of coke bloat

For anyone struggling with coke bloat, there is a cure: giving up the goods. Cocaine is a highly addictive drug, and the most effective — and healthiest — way of preventing unwanted cocaine side effects is discontinuing use of the drug through the help of addiction specialists. In addition to the appearance of a ‘puffy’ face, cocaine can induce heart failure, cause inflammation of the heart, an aortic rupture, kidney failure or brain damage, among many adverse effects. Long-term use is also associated with cognitive deficits and impaired decision-making.

Does coke bloat go away?

The internet is full of anecdotal coke bloat cures that people swear by, but there’s no evidence to back them up.

Here are some of the most commonly recommended tips:

  • Gently massage your face for 5 to 10 minutes, followed by Applying a cooling mask
  • Applying a cold compress or taking a cold shower
  • Using a derma roller on your face
  • Applying hydrocortisone cream

There’s no guaranteed fix, and while you can try the above strategies, they might not offer much relief. As the cocaine leaves your system, though, the bloating should start to subside.

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What about general bloating?

Abusing cocaine may also cause non-facial bloating for a few reasons. For one, cocaine causes vasoconstriction, or narrowing of blood vessels, resulting in a buildup of lymphatic fluid that can cause bloating and swelling.

This vasoconstriction may also add up to the development of peritonitis or inflammation of the inner lining of the abdomen. One of the main symptoms of peritonitis is bloating. Finally, not staying hydrated can also play a huge role. When the body isn’t getting enough water, it can slow down or stop digestion and hold onto excess water to help counter the effects of dehydration. As a result, the individual can experience some general bloating.

How does taking cocaine affect your skin?

We all know that cocaine is bad for our health. It affects the entire body – including the skin, which is the largest organ in the body. Effects will be more noticeable if someone uses coke in large amounts or long-term, but even occasional use can have an impact.

Cocaine is a ‘vasoconstrictor’, meaning that it reduces the blood supply to cells in the body, reducing their levels of oxygen and nutrients. The cheeks may appear emaciated and sunken, making one look prematurely aged. The skin may look pale and puffy. Here is a thought, if you can’t get proper nutrients and oxygen to your skin, it’s going to start looking pretty washed out and gloomy. If you wish for a natural glow, doing coke will tear that to shreds.

The decrease of blood supply to your skin can indicate it doesn’t heal or regenerate as quickly and won’t absorb active ingredients as easily. So if you’re applying your face with retinol after a coke binge, you’re wasting your creams and your money – it won’t make its way into the cells to have a proper effect.

That lack of regeneration is pretty important, no matter your skin type. Regeneration affects cell turnover, which is crucial for anti-aging benefits as well as the removal of blemishes. If your skin isn’t functioning the way it should, you’ll end up with dead skin cells staying around and clogging up your pores.

Using coke will also restrict down your skin’s capacity to heal, meaning it won’t regenerate as quickly as before. This can result in worsening of acne and premature aging. Even if you think you don’t abuse cocaine, possibly just consuming a small amount at the weekend, this will still have a major effect on the skin.

Not only will it cause the skin to become dehydrated and dry, it will also increase your chance of rashes, but it can have a detrimental impact such as skin necrosis, which means the skin is literally dead. Cocaine can kill the skin cells, which can lead to red or brownish patches on this skin. The reason this happens is that taking cocaine reduces the lack of oxygen and blood supply, and as a result, it damages the white cells of the blood, leading to skin necrosis.

The contraction of blood vessels, as well as increased inflammation, can also trigger redness, eczema, skin irritation, and even the appearance of ulcers. And because wounds will take longer to heal, you may end up with scarring.

This isn’t just a problem for people with preexisting skin conditions, to be clear. Anyone can react to cocaine with irritation, rashes, and blisters. Cocaine abuse can result in ulcers appearing all over the skin. It can cause purpuric rashes, especially on ears, cheeks, and extremities, with a red (erythema) border. So sores, blisters, and discoloration of the skin are very common among cocaine users.

Then there’s the impact cocaine has on how you treat your skin. First off, you’re perhaps less likely to stick to your skincare regimen after a heavy night on the sniff. When you’re up ’til the early hours, washing off your makeup, exfoliating, double-cleansing, and moisturizing doesn’t feel like much of a priority. Do that every weekend, and you’ll end up with clogged pores, signs of premature aging, breakouts, dullness, and dryness.

coke bloat
Because the majority of users sniff or snort cocaine through their nose, there are a variety of nasal and sinus diseases linked to cocaine abuse.

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Common Skin Problems Caused by Cocaine Abuse

Cocaine can also make you more inclined to suffer from skin picking disorder, therefore, increasing the possibility of infection and damage. Individuals who abuse coke or meth shows signs of dermatillomania – an obsession with picking at the skin.

Sometimes they have the sensation of bugs crawling on or in their skin, called delusions of parasitosis. There are coke users who use needles and blades to cut their skin open to remove the bugs. Other times, coke users just have itching or tingling on their skin, resulting in deep scratches and excoriations.

They often focus on tiny imperfections on their skin and pick at them until they bleed, causing scars and discoloration. This leads to a cycle of even more picking, where they scratch the scabs that occurred from their initial picking. The constant scratching and picking of the skin leads to inflammation, ulcers, scarring, and pigmentation.

Vasculitis and Retiform Purpura

  • It is damage to the blood vessels due to inflammation. This causes a dark, speckled pattern on the skin. Vasculitis can lead to a condition known as Retiform Purpura. Retiform Purpura is a more intense version of Vasculitis. Fortunately, this type of bruising and ulceration is reversible when it comes to cocaine use. Your body will slowly recover if you quit using the drug. 


  • It is the hardening of the connective tissues. This forms a splatter pattern on the user’s body.

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Treatment For Cocaine Addiction

Millions of people in the United States use cocaine each year. At least one million live with a cocaine use disorder. Treatment for cocaine addiction generally begins with cocaine detox, followed by an inpatient rehab program. The physical treatment begins with removing the toxic effects of cocaine from the body, known as detoxification or “detox.” In order to successfully handle cocaine withdrawal symptoms, supervised and medically-assisted detox is recommended. Cocaine withdrawal can range from a few days to months—the risk of returning to use increases during this time as the body attempts to rebalance.

Treatment for cocaine addiction may include:

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Some people detox from cocaine at home. However, it is not advisable to detox by yourself at home because of the dangerous effects of cocaine withdrawal. Most importantly, the risk of cocaine overdose is high regardless of a person’s experience with the drug, and it is necessary to get people into a drug rehab center at the first sign and symptoms of drug abuse, and that includes coke bloat.

coke bloat

Please, do not try to detox on your own. The cocaine detox process can be painful and difficult without medical assistance. However, getting through the detox process is crucial for continued treatment. We Level Up NJ provides proper care with round-the-clock medical staff to assist your recovery through our Cocaine Detox Program. So, reclaim your life, call us to speak with one of our treatment specialists. Our counselors know what you are going through and will answer any of your questions.

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[1] NIDA –

[2] NCBI –