Cortisone injections

A cortisone injection delivers a corticosteroid directly into a lesion - not into the bloodstream and not into a joint. In skin medicine this is called an intralesional injection, and it works by suppressing inflammation and, over time, reducing the excess collagen in raised scar tissue.

Corticosteroids are prescription-only medicines, so this treatment requires a doctor's consultation and assessment. Australian law prevents us naming or promoting prescription medicines in advertising to the public.

What it is used for

Inflamed acne cysts

A single deep, painful nodule or cyst can be settled with a small dose of dilute corticosteroid. Swelling and pain typically reduce within 24 to 48 hours, and the lesion flattens over several days.

This is a targeted intervention for an individual lesion - useful before an event, and useful because a cyst that resolves quickly is less likely to scar. It is not a treatment for acne as a condition; see acne for that.

Keloid and hypertrophic scars

The main medical use. Intralesional corticosteroid reduces the bulk, redness, itch and discomfort of a raised scar. See scars.

This is a course, not a single injection - typically every four to six weeks over several months, because scar tissue responds gradually.

Other inflammatory skin conditions

Localised inflammatory lesions where a targeted dose is more appropriate than a topical or oral treatment.

What to expect

The area is cleaned and a very fine needle is used to inject a small volume directly into the lesion. It stings briefly; for a tender cyst the injection itself is the uncomfortable part, and it is over in seconds.

Each injection takes a minute or two. There is no downtime and you can return to normal activity immediately.

For a cyst, expect noticeable improvement within one to two days. For a scar, expect gradual softening over weeks, with the full effect after a course.

The risks worth understanding before you agree

Corticosteroid injected into skin does its job by suppressing tissue activity - and that same action can go further than intended. The two effects people are most often not warned about:

• Skin atrophy - thinning of the skin at the injection site, which can leave a visible depression or dent. Usually improves over months, but can be long-lasting.
• Hypo-pigmentation - a pale patch at and sometimes around the site, more noticeable and more persistent in darker skin.

Both are more likely with higher concentrations and repeated injections into the same spot. Using the lowest effective dose is the way that risk is managed, and it is one reason this is a doctor's decision rather than a routine add-on.

Full risks

• Pain at the time of injection
• Skin thinning (atrophy) and a depression at the site
• Hypo-pigmentation, sometimes with a pale halo around the site
• Visible small blood vessels (telangiectasia) at the site
• Bruising and bleeding
• Infection
• Recurrence of the cyst or scar
• Incomplete response - some keloids respond poorly
• Rarely, systemic effects from repeated or high-dose injections
• Allergic reaction

Tell your doctor if you are pregnant or breastfeeding, have diabetes (corticosteroid can raise blood glucose), have an active infection, or take other steroid medication. See risks and complications.

What results are realistic

For an inflamed cyst, the response is usually quick and satisfying. For keloid and hypertrophic scars, expect meaningful flattening and relief of itch and discomfort over a course - but keloids frequently recur, and are managed over time rather than resolved once.

Individual results vary.

Cost

As at September 2024 and including GST, a consultation with a Cosmetic Doctor is $150. Treatment is quoted at consultation and depends on the number of lesions and sessions. Treatment of a medically indicated condition may attract a Medicare rebate; Me Clinic is not a no-gap provider.

Booking

Me Clinic, 4 Burke Road, Malvern East VIC 3145. Phone 1300 852 050 or (03) 9569 3511, or use the online consultation form.

Related: scars, acne scars, all skin treatments.

Individual results may vary. Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.