Steroid Injections

What is a steroid injection?

A steroid injection is simple bedside procedure where your doctor will inject minute amount of steroid onto the skin. As steroid possesses potent anti-inflammatory properties, when used for suitable skin conditions, it helps with aesthetic appearance of scar and promotes hair growth

What can steroid injections be used on?

  • Keloid scars
  • Alopecia areata
  • Cystic acne

What results can I expect?

Steroid injection on keloid scars allow flattening and shrinking of the scars, this allows better scar appearance overtime

In hair loss conditions such as alopecia areata, steroid injection accelerates hair regrowth.

How can steroid injections help with hair loss?

In autoimmune conditions such as alopecia areata, the hair loss is secondary to inflammation from immune cells over the hair follicles. By administering steroid intralesional over the superficial skin surface/ hair follicles, the local inflammation can be dampened, and this promotes hair regrowth overtime.

New hair growth can be noticed within 4-6 weeks after steroid injection, though results may vary depending on the patient’s response to the injection.

How do steroid injections help with cystic acne?

As cyst-nodular acne can take weeks to resolve and they can be very painful. Steroid injections allow a potent anti-inflammation steroid to be administered directly to the acne lesion, leading to rapid reduction in pain, swelling and inflammation. The shot helps improve cystic acne within days.

How many sessions do I need?

Depending on individual skin response, some patients may need repeated session ranging from monthly-6 monthly.

Steroid Injections

FAQS

Most patients tolerate the procedure well as the injection needle used is small and suitable for superficial skin lesions. If you have reduced pain threshold, do inform your doctor as there are various clinical methods such as distraction methods, numbing cream, cold therapy to minimize pain.

Effects usually last 1-2 months before slowly waning away. Your doctor may advise you for follow up in a few months time to monitor the effect. In certain circumstances, your doctor may advise for a repeat injection shot.

Common immediate side effect over injection sites includes:

  • Pain
  • Bleeding
  • Paler skin
  • Skin thinning
  • Bruising
  • Temporary facial flushing
  • Impaired wound healing

Longer term side effects over injection sites may include:

  • Visible fine blood vessels (telangiectasia)
  • Excessive abnormal hair growth (hypertrichosis)
  • Post inflammatory hypopigmentation
  • Dimpling or skin indentation
  • Local steroid acne

As the steroid injection is on superficial part of the skin, and the injection is administered through a fine needle, the procedure has minimal downtime and good aesthetic outcome. Interestingly, some patients may notice fine/increase hair growth over injection site.

Yes, often local superficial steroid injection is used to thin and shrink down the size of a big (hypertrophic) scar or the excessive scar tissues such as keloids.

You will notice the scar to shrink a little. Annoying symptoms such as itch or pain that you may be experiencing due to the scar itself may subside after steroid injection. Over time, (with repeat steroid injection), the size of the scar will get flatter and smaller over a period of 3-6 months.

Unfortunately, some of the keloids may recur after treatment. Your doctor usually will guide you on the symptoms to monitor for, and follow up your condition over 6-12 months. Occasionally, if the keloids do regrow, your doctor may advise you for further intralesional steroid injection to control and shrink the scar again.

After the procedure, some patients may notice a mild headache that usually goes away with simple analgesia such as paracetamol or resolve spontaneously. There can be small bleeding spots on the injection site. Some patients may notice slight skin thinning with visible blood vessel over the scalp. Your doctor will usually follow you up in 4 to 6 weeks after the procedure to gauge your hair growth response to the injection and advise on whether there is a need for further injection.

Injecting the lesions on the hands or feet can be more painful due to more sensory nerves over the areas. Your doctor may guide you with distraction technique, cold therapy, numbing cream to reduce the pain sensation.

As the effect may wear off after 30-40 days, your doctor usually will follow up on your progress. Depending on the skin condition, and individual response to steroid injection, your doctor may advise you to consider a repeat injection session in 2-3 months time.

As intralesional triamcinolone injection is a localized, superficial skin injection procedure, systemic side effects from steroid such as weight gain and water retention does not commonly occur.

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