One of the defining characteristics of krokodil use is what happens to users’ skin. Krokodil users often get scaly, black, and green skin that resembles crocodile skin. In fact, the crocodile-like skin that shows up on krokodil addicts bodies is thought to be one of the reasons why the drug got its name.
Krokodil effects on skin
In krokodil users, there are reports of the skin becoming swollen and inflamed around the injection site. Additionally, blood vessels are often damaged (thrombophlebitis) and the surrounding skin can develop sores, called ulcerations, which can get infected. Although, there are cases where the ulcers develop without infection.
In some medical reports, doctors mention users developing gangrene, which is characterized by the scaly, green-black skin discoloration.
Sometimes if users miss the vein when injecting the krokodil it can create an abscess, which if left untreated will sometimes cause the flesh around the area to die off. This is known as necrosis.
Depending on the level of severity, the necrotic skin sores can progress to severe muscle and cartilaginous tissue damage. There are even reports of skin falling from the bone giving a “zombie-like” appearance.
In the U.S. krokodil drug became known as the “flesh-eating drug” due to the extreme skin peeling associated with its use.
Pictures of late-stage krokodil addicts are disturbing. Flesh turns a grey color and peels away to leave bones exposed. People basically rot to death.
Research notes that krokodil seems to be more associated with gangrenous and necrotic tissue destruction than other intravenously injected illicit substances, including heroin.
The skin tissue effects of krokodil usually occur at the drug injection site but they can also appear on other parts of the body, such as the skull and forehead.
Krokodil skin can look similar to other dermatological skin diseases such as necrotizing fasciitis, also known as flesh-eating disease, or pyoderma gangrenosum, which is a rare condition that causes large, painful sores to develop on the skin.
What causes krokodil skin?
The exact mechanism behind how krokodil affects the skin remains unknown but research suggests that the krokodil skin results from the toxic substances that are left after the drug has been cooked.
Addicts often use poisonous and impure solvents like battery acid, gasoline, and paint thinner when cooking krokodil. If the toxic solvents aren’t fully removed before injection, the strong acids and bases can contribute to tissue damage and infection.
Also, researchers have observed that depending on the type of toxic additives that were in the krokodil drug, different effects are noticed.
For example, if red phosphorous (matchbook striking surface) is present that can cause damage to cartilage tissue and bones. Researchers have also found that it can cause atypical jaw osteomyelitis, where the bone marrow in the jaw becomes inflamed.
Whereas, if gasoline and hydrochloric acid are in the drug it can cause discolored scaling and sores. Iodine has been said to cause severe damage to the muscles and endocrine system.
Other experts have suggested that the extreme pain-relieving effect of krokodil can contribute to users ignoring the severity of the skin consequences and delays them from seeking medical treatment.
How is krokodil skin treated?
If caught soon enough the infected skin can be treated with antibiotics. However, if left too long doctors need to cut away the dead skin and treat the exposed area with skin grafts.
In severe cases, limb amputation or cutting out infected bones, such as the jaw bone, has been reported with long-term users.
Sources:
https://time.com/3398086/the-worlds-deadliest-drug-inside-a-krokodil-cookhouse/
https://www.bhpalmbeach.com/blog/authorities-wary-designer-drug-krokodil-appears-american-streets/
https://www.drugs.com/illicit/krokodil.html
https://www.deadiversion.usdoj.gov/drug_chem_info/desomorphine.pdf
https://www.healthline.com/health/krokodil-desomorphine#krokodil-ingredients
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864092/
https://pubmed.ncbi.nlm.nih.gov/25710781/