Steroid Injections for Acne: Benefits, Precautions, Side Effects & Costs

Acne is one of the most common skin disease affecting millions of people across the globe.

A lot of new treatments were developed to treat these acne scars which so often make us shy of socializing.

This article shall discuss one such method, that of using steroid injections also otherwise known as intra-lesion steroid injections or cortisone injection.

Please feel free to use the Table of Contents below to jump to the relevant section

What is a Steroid injection?

Steroid injections are injections that introduce corticosteroid in the body which helps in shrinking raised scars.

They are also popularly known as intralesional injections. The corticosteroid used can either be triamcinolone or acetonide with is injected directly into the lesion or below the skin.

Corticosteroid uses its anti-inflammatory property to suppress the raised scar and soften the skin.

Do Steroid injections Help in Acne Scars?

The cortisone that is injected reduces inflammation, softening the blemishes which flatten out.

The corticosteroid is used in a diluted concentration.

Not only does it shrinks the raised acne but also lessens the chances of developing scars or hyper pigmentation .

Types of scars it treats

The steroid injection method is usually effective in the treatment of keloid or hypertrophic scar:

Keloid scar: These scars usually result from the aggressive healing process.

It might extend and grow beyond its borders. It usually develops on the earlobe, chest or upper back area though it also might appear elsewhere on the skin.

It has chances of growing severe and in extreme cases may also hamper the movement of the person concerned.

It is usually persistent in people from African, Asian or Latin descent.

Hypertrophic scar: These are raised red scars similar to keloids but do not cross the border. It may reduce in size over time and become less noticeable.

Different kinds of corticosteroid

The amount and potency of corticosteroid in terms of inflammatory property and mineral corticoid content differs with a different corticosteroid.

• Among others, fludrocortisones has the most potent mineralocorticoid action (salt-retaining power) and is therefore preferred over others in spite of its strong anti-inflammatory action.
• Hydrocortisone and synthetic cortisones mostly exhibit glucocorticoid effect and are used for their inflammatory activities. Synthetic corticoid includes bethamethasone, prednisone, etc. prednisone is not effective in the body unless converted to prednisolon by liver enzymes. Hence, it is not given to patients who have liver disorders.

Administration of the steroid injection

It is injected directly into the skin lesion after cleaning the spot with an antiseptic.

The injection must be intra-dermal and not subcutaneous lest it might cause a dent in the skin.

The concentration of the dose depends on the size and area of the lesion, however, the generally administered dose is 0.1 ml per square centimeter of skin involved.

The solution can either be concentrated or diluted. It might require repetition after 4 to 8 weeks.

Cost of the treatment

The cost of one injection might be anything from 50$ to 75$ and there may also arise a need of taking the injection every month or once in a few months.

Benefits of using Steroid Injections for Acne Scars

Steroid injections have been known to have some advantage over other forms of treatment for acne scars.

The relative and individual benefits of steroid injections are enumerated below:

• Unlike topical steroids, this method reduces the chances of thinning of the surface skin, also otherwise known as epidermal atrophy.
• It delivers a relatively higher concentration of the chemical required at the site of scar when compared to topical treatments.
• It might be used intra-muscularly to treat conditions like hay fever and skin disorders like atopic dermatitis and lichen planus.
• It can be used as an alternative to oral corticosteroid.
• Triamcinolone injections can also be used to treat tendonitis, arthritis and synovitis.

Issues with Steroid Injections

The use of steroid injections, specifical triamcinolone might cause certain side effects. Some of them have been enumerated below:

• Pain, bleeding and bruising just after the treatment.
• Minor chances of bacterial or viral infection.
• The presence of preservatives might cause contact dermatitis.
• It might slow down the process of healing.
• It might cause the development of cutaneous or subcutaneous lipoatrophy at the site of the treatment. These might appear as dimples.
• It may also cause long-term emergence of a white mark or leukoderma and brown marks or hyperpigmentation.
• Steroid injections might give way to the development of telangiectasia otherwise known as small dilated blood vessels at the site of treatment. These are however treatable.
• Steroids increase hormone growth and may lead to steroid acne.
• It can cause weight gain or swell in the legs due to retention of sodium and other fluids.
• There are chances of high blood pressure.
• It may also stimulate hair growth.
• Loss of diabetes control.
• Ulcer in the stomach, though cases are rare.
• Its long-term use may cause osteoporosis.

Side effects specific to the use of triamcinolone injections are listed below:

• An allergic reaction may cause local urticaria and respiratory distress in severe cases.
• Intra-muscular injections in very high doses of triamcinolone acetonide might have a severe adverse impact which includes: congestive heart failure, hypertension, fluid retention, menstrual irregularities, and aseptic necrosis of hip and shoulder bone, muscle weakness, insomnia, mood swings and glaucoma among various other defects.

Possible Drug interaction

Some drugs tend to interact with systematic corticosteroid. These must be avoided when undergoing the steroid treatment. Some of these drugs have been listed below:

• Troleandomycin, erythromycin, and clarithromycin reduces the ability of the liver to break down corticosteroid and may alleviate the side effects caused due to it.
• Phinobarbital, ephedrine, phenytoin, and rifampin may reduce the blood levels of corticosteroid by increasing the breakdown by the liver which might cause administration of increased doses.
• Estrogen increases the effects of corticosteroid by increasing its breakdown in the liver.
• Coagulation level should be monitored when taking it along with warfarin.
• It should not be taken with drugs that reduce potassium level as it might cause hypokalemia and heart failure in certain cases.
• Since corticosteroid tends to increase blood glucose, the level must be monitored carefully when on it.
• Cholestyramine decreases the absorption of oral corticosteroid from the stomach and might reduce the blood level of corticosteroid.

Customer reviews of Steroid Injections

We did an analysis of online consumer review’s to see how the experiences of people have been while undergoing this treatment.

Here is a summary of what they liked and disliked about the treatment:

What they liked about it

Inexpensive: One thing that prompted a lot of consumers to try this method was that it was a relatively cheaper option.

One injection would cause anywhere from 50$ to75$ as opposed to the rather expensive laser treatment costing more than 300$ at one go.

What they did not like about it

Follow up: A few consumers were unhappy with the fact that this treatment gave its best results only when followed by other kinds of treatments like the laser treatment.

This caused a lot of difficulties. Though it must not be forgotten that the follow up is not a compulsory plan.

Summary

Steroid injections have been widely used and are known mostly for its time effectiveness and result effectiveness in the treatment of raised scars.

It does not require hospitalization and one can resume with his/her activities in less than 24 hours of the treatment.

Furthermore, this is a relatively inexpensive option which a good thing because most insurance companies are reluctant to cover the cost of such treatments categorizing them under cosmetic improvements.

If nothing has worked on your scars before, this one is worth a try, as it won’t be a burden on your pocket either.