Wrinkles, Texture & Pores

Acne Shots

What is an acne (intralesional) steroid therapy?

Acne or intralesional injections, also known as cortisone shots, are used to help shrink large, inflammatory acne cysts. Done in your provider’s office, this treatment quickly reduces inflammation, flattens and heals the breakout in just a few days.

This procedure involves the injection of a dilute steroid solution into small acne cysts, with the aim of improving its appearance or reducing symptoms. The steroid most frequently used in this procedure is called Kenalog (triamcinolone acetonide).

How do steroids work?

Corticosteroids have a variety of properties, but it is their effects on suppressing inflammation that are particularly utilized in the treatment of skin conditions.

The injection of a steroid into the skin has two advantages over topical and oral steroid treatment; firstly, it will often be more effective in treating deep-seated conditions than a steroid cream or ointment, and secondly, it will have only a local effect rather than the general effects of a steroid taken by mouth.

Corticosteroid injections are used to treat deep nodules, or cysts. A very dilute corticosteroid is injected directly into the blemish.

The injection is done with a small needle, the same kind used for Botox injections. In fact, the needle used for acne cortisone injections is much, much smaller than what is used for vaccinations.

The whole procedure is quick and almost painless. Most people describe it as a little pinch. Although if your acne cyst is very painful, it can be a bit painful when the needle is inserted. Regardless, the entire process is over in just a few seconds.

The cortisone reduces inflammation quickly. Over the next 24 hours, you’ll notice your blemish softening, shrinking, and flattening out. While they may not completely disappear, they will be noticeably smaller and definitely less red and painful. Most blemishes heal within a week after treatment.

While cortisone shots work well on cysts, they have minimal effects on normal pimples or pustules. Cortisone doesn’t do anything for the pus that makes up the core of a pimple. Instead, it shrinks inflamed tissue. So cortisone shots are reserved for large, cystic blemishes. Cortisone shots can be use to treat blemishes on both the face and the body.

What are the side effects of this treatment?

Immediate side effects:

  • Pain – the procedure is usually well-tolerated, although injections into certain parts of the body, can be more uncomfortable. Local anesthesia can be used to reduce pain of the procedure.
  • Bleeding – spots of blood may occur at the injection sites.
  • Infection – occasionally infection can be introduced by the injections, and this may develop into an abscess, requiring antibiotic therapy.
  • Allergic reaction – this is very uncommon, but may occur to one of the constituents of the injection preparation.

Delayed side effects:

  • Atrophy (thinning of the skin) or pitting of the skin – this is confined to the area that has been injected and is the result of too strong of medication and results in a slight thinning or dimpling of the skin surface. Fortunately in most cases this can resolve within 6 moths. Alternatively dermal filler can be used to fill in the divot. But keep in mind, severe breakouts can cause depressed or pitted acne scars in of themselves.
  • Telangiectasia – the small blood vessels within the treated area become much more visible than normal. Pigmentation changes – the skin at and around the treatment site may lighten or darken in color, especially in dark-skinned people.
  • Treatment may not be effective, or the condition may recur.

Intralesional steroid therapy is, by and large, a safe procedure, and will not cause you to put on weight or develop excess hair. The amount of steroid injected at any one time is small, and the risk of steroid being absorbed into the bloodstream in sufficient amounts to produce internal side effects is very low.

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