Are Steroid Injections for Keloid Scars Painful?

Question

I read somewhere that it is painful to get steroid injections to treat keloids and sometimes it burns. Is this true?

Steven H. Williams, MD · Answer

Thank you for your question.

	As with all injections, steroid injections for the treatment of keloids can be painful. In our San Francisco Bay Area Practice we combine our steroid injections with lidocaine (numbing medication) to decrease the discomfort for our patients.  For those who are extra sensitive to injections a topical numbing medication may be used in addition.

	I hope this helps.

Raffy Karamanoukian, MD, FACS · Answer

Keloids are amenable to cortisone and TAC injections.  These injections are not painful, but patients may experience discomfort with any manipulation of inflamed keloid scars.

Otto Joseph Placik, MD · Answer

As stated, it really depends on how firm the scar is. Typically scar management will require a series of injections. The first injection tends to be the most difficult because the scar is the most dense with the intial treatment. It softens almost immediately and subsequent injections tend to be less painful. Your physician may mix the steroid with anesthetic as well or use a topical anesthetic but the latter is of little benefit.

Steven Wallach, MD · Answer

If the keloid is very thick, the first few times they are injected, it can be painful. I usually mix the steroids with some local anesthetic to ease the discomfort.

Hisham Seify, MD, PhD, FACS · Answer

Kenolog could be diluted with local anaethesia which makes it less irritant when injected. An intra-keloid injection is key in making sure the drug is delivered in the correct location. All the best.

Arnold R. Oppenheim, MD (retired) · Answer

The needle is small, and the steroid is painless. However, injection into a tight, firm space like a keloid can cause pain. This may be amerliorated to an extent with cr;yotherapy ( which also decreases the keloid) or a cooling device such as the Zimmer unit. Caution: in dark skin cryotherapy can cause hypopigmention as it may damage melanocytes.

Are Steroid Injections for Keloid Scars Painful?

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