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Are Steroid Injections for Keloid Scars Painful?

I read somewhere that it is painful to get steroid injections to treat keloids and sometimes it burns. Is this true?

Doctor Answers 6

Reducing Pain of Keloid Injections

Thank you for your question.

As with all injections, steroid injections for the treatment of keloids can be painful. In our San Francisco Bay Area Practice we combine our steroid injections with lidocaine (numbing medication) to decrease the discomfort for our patients.  For those who are extra sensitive to injections a topical numbing medication may be used in addition.

I hope this helps.

Keloids and keloid scar injections

Keloids are amenable to cortisone and TAC injections.  These injections are not painful, but patients may experience discomfort with any manipulation of inflamed keloid scars. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 64 reviews

Steroid injections for keloids

If the keloid is very thick, the first few times they are injected, it can be painful. I usually mix the steroids with some local anesthetic to ease the discomfort.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 20 reviews

Is keloid scar injection painful?

As stated, it really depends on how firm the scar is. Typically scar management will require a series of injections. The first injection tends to be the most difficult because the scar is the most dense with the intial treatment. It softens almost immediately and subsequent injections tend to be less painful. Your physician may mix the steroid with anesthetic as well or use a topical anesthetic but the latter is of little benefit.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 56 reviews

Moderately painful

The needle is small, and the steroid is painless. However, injection into a tight, firm space like a keloid can cause pain. This may be amerliorated to an extent with cr;yotherapy ( which also decreases the keloid) or a cooling device such as the Zimmer unit. Caution: in dark skin cryotherapy can cause hypopigmention as it may damage melanocytes.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.5 out of 5 stars 13 reviews

Less discomfort with local anaesthesia

Kenolog could be diluted with local anaethesia which makes it less irritant when injected. An intra-keloid injection is key in making sure the drug is delivered in the correct location. All the best.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.