How Cortisone Shots Work for Acne

Intralesional Corticosteroid Injections

Preparing an injection
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Everyone hates those huge, monster blemishes. They’re big, painful, and take (what seems like) forever to go away. Don't you wish you could magically make them disappear, or at least heal more quickly?

Although not quite as extraordinary as a magic wand, cortisone shots may be the next best thing. Done in your dermatologist’s office, this treatment quickly reduces inflammation, flattens and heals the breakout in just a few days.

The technical term for this procedure is intralesional corticosteroid injection, but many acne sufferers just call them steroid shots, cortisone injections, or cyst injections.

How Cortisone Shots Work

Intralesional corticosteroid injections are used to treat deep papules, nodules, or cysts. A very dilute corticosteroid is injected directly into the blemish.

Don’t worry, it's a small needle! It's quick and nearly painless.

The cortisone reduces inflammation quite quickly. Over the next few days, you'll notice your blemish softening and flattening out.  Most lesions heal within a week after treatment.

And healing those big zits quickly isn't strictly for looks—it also lessens the chance that the blemishes will cause scars. This is especially valuable if you are prone to scarring or hyperpigmentation.

Corticosteroid injections are also used to help shrink hypertrophic and keloid scars that you may already have.

Possible Side Effects

If too much cortisone or too strong a dilution is used, the fat around the injection site can atrophy. You’ll notice depressions, or pitting, of the skin in the area.

Fortunately, these depressions usually go away. This can take a long time, though (up to 6 months). Sometimes, this loss of tissue is permanent.

Incidentally, if you develop permanent pitting of the skin, it isn’t necessarily caused by the injections. Severe breakouts often cause atrophic scars. Dermal fillers may be a good solution in these cases.

Cortisone Shots Heal Existing Pimples, But Won't Clear Up Your Acne

Cortisone injections have plenty of benefits, but there is one thing they just can't do—clear up your acne.  True, they help big breakouts heal up quickly, but they can't stop more breakouts from forming.

For that, you'll need to use a daily acne treatment medication. Your dermatologist will prescribe a treatment that is best for your skin. Some options: topical retinoids, combination acne medications, or even isotretinoin (depending on how severe your acne is). 

Unless you only get a random big zit very occasionally, you'll need a prescription acne medication. For those big blemishes, over-the-counter acne products just don't have enough oomph.

Using an acne medication daily stops breakouts from forming so, ideally, you won't need cortisone injections at all anymore.

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Article Sources
  • Taub AF. “Procedural treatments for acne vulgaris.” Dermatol Surg. 2007 Sep;33(9):1005-26.
  • “Treating Severe Acne.” AcneNet. 2008. American Academy of Dermatology.