Treatment for Acne Cysts and Scars
Intralesional Steroid Injection
Treatment for Acne Cysts and Scars
An intralesional steroid injection involves a corticosteroid such as triamcinolone acetonide injected directly into a lesion on or immediately below the skin. It delivers anti-inflammatory and collagen reducing substances into the skin to help with acne cysts and scarring conditions like hypertrophic scars. In Australia, steroid injection is available in 2 strengths: 10 mg per ml and 40 mg per ml.
What conditions can be treated with intralesional steroid injection?
• Acne cysts and inflamed epidermoid cysts
• Keloid/hypertrophic scar
• Alopecia areata an autoimmune condition causing hair loss
• Discoid lupus erythematosus
• Necrobiosis lipoidica
• Granuloma annulare
• Other granulomatous disorders such as cutaneous sarcoidosis or granuloma faciale
• Hypertrophic lichen planus
• Lichen simplex chronicus (neurodermatitis)
• Localised psoriasis
Intralesional steroid injections are not recommended for those with active skin infection, those with an allergy to triamcinolone, those on oral steroids, those with tuberculosis or fungal infections, peptic ulcer disease, diabetes, hypertension, severe depression, or psoriasis.
What are the benefits of intralesional steroids?
Compared to topical steroid cream, intralesional steroid
• Bypass the barrier of a thickened skin
• Reduce the chance of surface skin thinning
• Deliver higher concentrations to the site of the problem
What are the possible side effects of an intralesional steroid injection?
• Pain, bleeding, bruising
• Contact allergic dermatitis due to the preservative, benzyl alcohol
• Impaired wound healing
Delayed adverse effects include:
• lipoatrophy (most common) — skin indentations or dimples around the injection sites a few weeks after treatment
• Hyper or hypopigmentation at the site of injection these may resolve or persist long term
• Telangiectasia (broken vessels) at the site of injection, which can be treated if necessary, by laser or intense pulsed light (IPL).
• Localised hair growth - hypertrichosis
• Localised or distant steroid induced acne
Systemic steroid adverse effects like mood changes, insomnia, irritability, Cushing's Disease are very rare unless very high doses are used.
What can someone expect from the results of an intralesional steroid injection procedure? The results of an intralesional steroid injection will develop gradually and over time through a series of injections spaced at least 4 weeks apart.
MEET DR. MAY MARR
Dr May Marr is a Flinders University Medical School graduate and a member of the Royal Australasian College of Physicians. She has a long-held interest in aesthetic medical procedures and evidence-based skin care. She holds a passionate belief that people should have access to procedures and products that are research-backed, ethically prescribed and skilfully delivered.
Dr Marr has trained with Dr Jacque Le Coz at the Institute of Mesotherapy in Paris. She holds an Advanced Diploma in Dermatology from the Australian Institute of Dermatology and in 2020 completed her Dermatology Fellowship.
The ethical, educational and procedural standards that Dr Marr brings to aesthetic medicine have been recognised by some of the largest aesthetic companies in the world. She holds advanced injector status and her extensive clinical experience sees her regularly called upon as an industry educator.
“OUR PHILOSOPHY IS TO KEEP OUR PATIENTS LOOKING NATURAL – NOT ‘DONE’.”
DR MAY MARR