Fat atrophy from kenalog-40 injection for acne spot - Does it have hope of filling in on its own? (photo)

Question

I had a small blemish injected with kenalog-40 and within about 4-5 days a depression in the skin appeared. It has now been about 3 weeks with no worsening or improvement... I care very much about my appearance and having this depression in a highly visible spot (my forehead) is very distressing. Does it have hope of filling in on its own? Or should I get filler now?

Lucas Bryant, MD · Answer

Thanks for your question. I like to use diluted steroid injections for raised, thick scar areas. For depressed areas, you want to even out the contour or add volume. This can be done with filler or fat grafting, laser etc.
If you recently had a steroid injection and have noticed tissue thinning in the area, I would give it a couple months and let the injected area evolve. Typically, as long as the treatment isn't repeated, you will get a return of some of the lost volume you are describing. Warm regards.

Nelson Lee Novick, MD · Answer

First, let me say that I am very sorry you have experienced this. In general, experienced dermatologists typically inject small acne blemishes with dilutions of 1:9 of Kenalog-10: saline, which is sufficient to bring down the acne bump in one to three days with little chance of causing atrophy.  Kenalog 40 is best reserved for injecting stubborn keloid scars, not acne blemishes) that have not improved with lower concentrations. Kenalog atrophy can be permanent in some cases, and may resolve spontaneously in others.  However, repeated injections of normal saline into the depression at two to three week intervals have proven helpful via the presumed mechanism of flushing away and diluting any residual steroid crystals that may persist under the injection site. The use of fillers to elevate and smooth the depression is certainly possible, in the event that the above approach has not proven successful and the depression persists. Going forward, with regard to any future acne problems, make sure that you are consult with a board certified dermatologist. Best of luck.

Maloney Plastic Surgery · Answer

Any lesion injected with Kenalog runs the risk of causing a depression on the skin. The forehead and chest and nasolabial folds are particularly subject to this effect. I usually use a very dillute amount of steroid for these areas. After a depression occurs, a laser may be used to distribute heat and stimulate collagen or filler could be placed in the area to help elevate the tissue, or both of these in combination. Microneedling will also help stimulate collagen to help the depression to resolve. Generally, they do not completely resolve on their own without one of these about treatments. Thank you for your question.

Fat atrophy from kenalog-40 injection for acne spot - Does it have hope of filling in on its own? (photo)

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Fat atrophy from kenalog-40 injection for acne spot - Does it have hope of filling in on its own? (photo)

Answers (3)

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Everything you need to know about Dermal Fillers

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