How to treat skin atrophy from cortisone/kenalog injection? (Photos)

Question

Is there anyway to reverse skin atrophy from a kenalog/cortisone injection? I had it injected into my pimple and now I have a huge divot in between my eyebrows that won’t go away. It’s causing me a lot of distress and making me feel like I don’t even want to go out. My Dermatolgist has injected saline 2x and I see no improvements at all— if anything it’s getting worse. I need some help please?!

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

Nadir Qazi, DO · Answer

Skin atrophy is a potential side effect of cortisone injections, which are commonly used to treat a variety of skin conditions, including acne. The injection can cause the skin to thin and lose its natural elasticity, resulting in a visible depression or divot in the area where it was injected.
While it can be distressing to deal with this type of skin atrophy, there are treatment options available that may be able to help improve the appearance of the affected area.
One option to consider is the use of platelet-rich plasma (PRP) therapy. This involves using your own blood, which is processed to concentrate the platelets, and then injected into the affected area. The platelets contain growth factors that can help promote the growth of new collagen and improve the texture and thickness of the skin.
Another treatment option is the use of dermal fillers, which can be used to fill in the depressed area and create a smoother surface. Hyaluronic acid fillers are often recommended for this type of treatment, as they are well-tolerated and provide natural-looking results.
In addition to these treatments, it's important to work with your dermatologist to develop a comprehensive skincare plan that can help support the healing process. This may include the use of topical products that contain ingredients like retinoids, vitamin C, and peptides, which can help promote collagen production and improve the texture of the skin.
It's worth noting that the healing process for skin atrophy can take time, and results may not be immediate. However, with the right treatment plan and a little patience, it's possible to improve the appearance of the affected area and regain your confidence. Be sure to work closely with your dermatologist to find the best treatment options for your specific needs.

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