2 months post op cortisone injection, I have fat atrophy. Is this normal?

Question

I had a cortisone injection for a minor blemish about 2 months ago, and the skin began to atrophy. I then went and saw my dermatologist and he put a juvaderm filler in it. I think it looks worse, see a blue almost bruised tint? It has now been a little over 2 months since initial cortisone shot and I don't know what to do. I am seeing a plastic surgeon in 2 weeks to discuss. Please look at my face and help me- no makeup on the spot. Suggestions welcome.

George C. Peck, Jr, MD · Answer

The skin depression will get better with time but it may take one to two years. Fillers can be used to temporarily treat this problem. Best wishes

Joseph A. Eviatar, MD, FACS · Answer

This problem is a known possible complication after steroid injection.  Filler can improve the appearance and stimulates collagen so gives more than just a temporary improvement .  Usually I reserve surgery as a last resort since filler often works well.

Rebecca Baxt, MD · Answer

It's rare to get an indentation after a cortisone injection but it can happen. It goes away on it's own but it can take a few weeks or months on occasion depending on the severity. Juvederm is a great hyaluronic acid filler but all these types of fillers can cause the Tyndall effect of blue green discoloration if they are too superficial. It eventually goes away on it's own or juvederm can be dissolved with hyaluronidase injection. It sounds like you need a great board certified dermatologist or plastic surgeon to help you with your issues.

F. Victor Rueckl, MD (in memoriam) · Answer

Atrophy can happen after cortisone is injected anywhere on the body. If the cortisone isn't injected right into the acne cyst itself it can get out and cause a small divet. It will repair itself with time, but it can take a long time, even a year or more. Sometimes this can be filled with a filler like Juvederm or Restylane (which you had). I nearly always prefer Restylane, as Juvederm will get a bluish tint like you had if it's too superficially injected into an area. I would not recommend anything other than filler be done - surgical excision, etc. as that's really the only other option. If you go down this road you will be left with a scar there no matter what. So, if something eventually will fix itself on it's own, I would not do a surgical procedure. You can have the site refilled with Restylane as the site fixes itself. This is your best route. "This answer has been solicited without seeing this patient and 
cannot be held as true medical advice, but only opinion. Seek in-person 
treatment with a trained medical professional for appropriate care."

2 months post op cortisone injection, I have fat atrophy. Is this normal?

Answers (4)

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