2 months ago I received 2 kenalog injections for acne keloidalis nuchae. It left these white spots - are they permanent? (Photo)

Question

I have not seen any improvement. i was told it will take a few months but its been 2 months and 1/2 but no signs of starting improvement. im scared that this is permanent. the dermatologist told me had we not done the injections it would be likely that the acne keloidalis would still be present. will the color fully regain or is this my fate?

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jeff Rapaport, MD · Answer

Post-injected steroid hypopigmentation, often seen after corticosteroid injections, can be challenging to treat. Some potential treatments include:
Topical Therapies: Bimatoprost,  Vitamin C,  retinoids and  may help stimulate melanocytes and promote repigmentation.
Laser Therapy: Various lasers, especially Eximer laser and sometimes fractional lasers or Q-switched lasers, can target hypopigmented areas to encourage melanin production.
Microneedling: This technique involves creating micro-injuries in the skin, stimulating collagen production and potentially aiding in repigmentation.
The permanence of your lesions is likely without treatment. Find a scar expert.
Jeff Rapaport MD FAAD 
Realself Hall of Fame 
Castle Connolly Top Doctor

2 months ago I received 2 kenalog injections for acne keloidalis nuchae. It left these white spots - are they permanent? (Photo)

Answers (2)

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Everything you need to know about Scar Removal

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2 months ago I received 2 kenalog injections for acne keloidalis nuchae. It left these white spots - are they permanent? (Photo)

Answers (2)

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Recommended reading

Everything you need to know about Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.