Scar tissue after cortisone shot - how can i help it to become less raised? (Photos)

Our treatments use combination therapy to improve the epidermis and dermis. We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to discuss the best treatment options for your type of skin. .

Best,
Dr. Karamanoukian
Realself100 Surgeon

Since the scar remains raised three months after a cortisone (triamcinolone acetonide, Kenalog) injection, and the surrounding area is atrophic, the most effective next steps are to continue conservative scar management and allow more time for remodeling, as significant improvement can still occur up to 6–12 months post-injection.

Key recommendations:

Silicone gel sheets or silicone-based creams: These are proven to help flatten hypertrophic scars and can be started as early as two weeks after injury, but are still beneficial months later. They work by increasing hydration and local skin temperature, which can reduce scar thickness. Apply the gel sheet or cream as directed (often several hours per day for gel sheets, or 3–4 times daily for creams with massage).
Scar massage: Regular, gentle massage of the scar with a bland moisturizer or silicone cream can help soften and flatten the tissue over time.
Observation: Most hypertrophic scars begin to flatten and lose redness around 6 months, with continued improvement for up to 2 years. It is reasonable to wait the full 6 months post-injection before considering further intervention, as your physician advised.
Repeat steroid injections: If the scar remains raised after 6 months, additional intralesional steroid injections may be considered, as multiple sessions are often required for optimal flattening.
Other modalities: If the scar is persistent, options such as laser therapy, pressure therapy, or surgical revision may be considered, but these are typically reserved for scars that do not respond to first-line treatment.
If you are concerned the bump may be cartilage rather than scar tissue, a clinical examination is necessary. Scar tissue is usually softer and more mobile than cartilage, which is firm and fixed. If the area does not feel hard and is not fixed to underlying structures, it is more likely to be scar tissue than cartilage.

Summary:
Continue silicone-based therapy and gentle massage, and allow more time for natural scar remodeling. If the scar remains raised after 6 months, further treatments such as repeat steroid injections or other modalities can be considered