Cortisone shots are synthetic hormone injections similar to the stress hormone cortisol. These shots are used to provide short term relief from large cystic acne.
Cortisone shots help reduce redness, swelling, and pain of the inflammatory acne in a few days’ time. They are also used for shrinking hypertrophic scars and keloid scars(1)
Do Cortisone Injections Really Work For Cystic Acne?
Cortisone injection provides short term relief from inflammation and can be used to shrink the large cyst. These injections can be used on the face and body.
The injection is given directly into the acne cyst or nodule. It also contains a small amount of steroid such as triamcinolone, which is a powerful anti-inflammatory.
The needle used for cortisone shots is smaller than those used in vaccinations or blood draw.
The Cortisone injection procedure is quick. To reduce pain the doctor might numb the area with topical lidocaine before getting started.
The cysts resolve in a week or two and resolve on their own. The steroid can help reduce redness, swelling, and pain within a few days.
What Is Cystic Acne?
Acne occurs as the skin’s pores get clogged with dead skin and oil. Sometimes bacteria such as P.acnes are also involved.
These clogged pores break deep into the skin forming large bumps or nodules that are pus-filled and inflamed. These last for weeks or longer. There are various factors that lead to the occurrence of acne:
- Hormones such as testosterone, estrogen, and androgen
- History of acne in parents
- Environmental factors such as high humidity, excessive perspiration, makeup, lotions, and cleansers
- Drugs and chemicals such as lithium, corticosteroids, isoniazid, and phenytoin
Benefits of Cortisone Shots For Cystic Acne
Cortisone shots are used in large cystic blemishes and help shrink tissues. They are of no use in reducing the pus build-up.
It reduces the chance of scarring and can be helpful for those prone to hyperpigmentation after the breakout.
You can go ahead with cortisone shot in the following conditions:
- If you have massive, inflamed pimples that have not healed for months.
- There is a painful and swollen blemish
- In case there is a breakout and there is an important event to attend.
These intralesional steroid injections along with blackhead removal can improve the appearance of disease(2)
Side Effects Of Cortisone Shots For Cystic Acne
Cortisone shots are really effective in healing large blemishes but should be used with care as they can lead to side effects.
Pitting of the skin is the main side effect. It is caused if a large amount or a strong dilution of cortisone is used. Due to the overuse of cortisone, the skin around the site of injection experiences atrophy, leaving a visible depression. In some cases, the loss of tissue is permanent while in a few the depression goes away on its own.(3)
This permanent pitting may not always be caused by the injection. Sometimes severe breakout can cause pitting that can be corrected with dermal fillers.
The second side effect of a cortisone injection can be hypopigmentation or white spot of the skin. It mostly occurs in people with a dark complexion. It is a temporary side effect and fades on its own.
If more than the normal limit of steroid is injected, it gets absorbed into the bloodstream and can lead to systemic effects.
Cortisone injection may make the breakouts to heal quickly but would not stop them from occurring. They cannot clear up the acne.
In case you want to clear up the acne, an acne treatment involving the use of topical retinoids, antibiotics, salicylic acid, and isotretinoin (in severe cases) are required.
For regularly occurring acne, prescription acne medication is required.
How Frequently Can Cortisone Be Injected In Cystic Acne?
Multiple injections can be given in a session, with each injection going in a different area.
If you want the steroid to be injected on the same spot, you need to wait for at least 6 months.
Cortisone shots are the occasional treatment for specific cysts and nodules. They cannot be a regular part of acne treatment.
If prone to severe breakouts consult a dermatologist. Also, it is important to consult a board-certified dermatologist if going ahead with a cortisone injection for acne.