Would filler be a good options for cortisone atrophy/indent in forehead? (Photos)

Question

Hi! I had a cortisone injection on the side of my forehead for an acne cyst 2 months ago. About 3 weeks after the injection I noticed an indent from it. I’ve been dealing with the indent for about 5 weeks now. Once I noticed it, I went to the derm and got a saline injection. I’ve since received weekly saline and have seen very little improvement. I’m very distressed by it and need resolve . Would filler be a good option? Is 5-6 weeks too soon to get filler for an indent? Thank you!

Falguni Patel, MD, FACOG · Answer

Traditionally speaking in the US, we did not have a product that was truly safe to inject into high-risk areas, such as the forehead, to correct such issues as you have reported here. However, we now have access to very delicate fillers which may be safe to use in the forehead. My recommendation would be to try and start with non-invasive treatments such as microneedling to help build your own natural collagen and then use some dermal filler as the finishing touch. I as a provider would only use a product like RHA1(Redensity) in that area of the face.

Eric M. Joseph, MD · Answer

In that regard, it would be a good idea to sit tight for a while. In our experience, when a steroid related indentation does not go away, microdroplets silicon 1000 injections may be a terrific way to permanently solve the situation. I hope this helps. Sincerely, Dr. Joseph

Nelson Lee Novick, MD · Answer

Take a breath. Help is on the way. Subcision, which I have personally been performing for nearly thirty years with gratifying results, is a simple,inexpensive and proven safe and effective means for elevating and smoothing indentations from all causes. It is often combined with the use of an HA Filler for added benefit. You would be wise to consult with a board certified cosmetic dermatologist. Hope this helps and Best of luck.

Anna Chacon, MD, FAAD · Answer

Here are some considerations regarding the use of fillers for cortisone-induced indentations:

Understanding Cortisone Atrophy
Cortisone atrophy occurs when the steroid injection causes localized thinning of the skin and subcutaneous tissue, leading to an indentation. This is a known side effect and can sometimes resolve on its own over time, but the duration can vary widely among individuals.

Saline Injections
Saline injections are often used to help stimulate the body's healing process and may help in some cases. However, as you've experienced, they might not always provide significant improvement, especially in a short period.

Use of Fillers
Fillers can be an effective temporary solution for cortisone-induced indentations. Here are some points to consider:

1. Timing: 
   - Generally, it's advisable to wait a bit longer before opting for fillers. The skin and tissue can continue to recover from cortisone atrophy for several months, sometimes up to 6 months or more. However, if the indent is causing significant distress and hasn't shown signs of improvement, some dermatologists might consider fillers sooner.
   - At 5-6 weeks, it might still be early, but given the emotional impact and lack of improvement with saline injections, it could be reasonable to consult with a dermatologist experienced in cosmetic procedures to evaluate the potential benefits and risks of using fillers at this stage.

2. Type of Filler: 
   - Hyaluronic acid fillers (such as Juvederm or Restylane) are commonly used for this purpose because they are temporary and can be dissolved if necessary. They provide immediate volume and can help smooth out the indentation.
   - The choice of filler and the technique used will depend on the specific characteristics of your skin and the depth of the indentation.

3. Professional Evaluation:
   - It's crucial to have a thorough consultation with a board-certified dermatologist or a cosmetic specialist. They can assess the severity of the atrophy, discuss the potential benefits and risks of fillers, and determine the best course of action.
   - They might also explore other options, such as microneedling or platelet-rich plasma (PRP) therapy, which can help stimulate collagen production and improve skin texture over time.

Recommendations:
1. **Consultation**: Schedule a detailed consultation with a dermatologist who has experience in treating cortisone atrophy and cosmetic procedures. They can provide a personalized recommendation based on your specific situation.
   
2. **Consider Alternatives**: Discuss other potential treatments that might aid in the natural healing process, such as microneedling or PRP, which might be beneficial in conjunction with or instead of fillers.

3. **Mental Health Support**: Given the distress this issue is causing, consider seeking support from a mental health professional. They can help you manage the emotional impact while you work on the physical resolution.

In summary, while fillers can be a good option for addressing cortisone atrophy, it's essential to have a professional evaluation to determine the appropriate timing and approach for your specific case.

Camille Cash, MD · Answer

Typically filler is not used for high risk areas such as the forehead.  Other alternatives such as Morpheus8 or SkinPen may be better options and carry less risk. They are safe for all skin types. You can learn more about these treatments by visiting my website or a provider near you.

Eeshara Vithana, MBBS, MSc, MD · Answer

HiThis is a common complication of cortisone injection You can correct this with a filler or you can have low grade co2 laser Exosomes injection would be another option with or without co2 laser

Would filler be a good options for cortisone atrophy/indent in forehead? (Photos)

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