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Targeted corticosteroid injections delivered directly into skin lesions for the treatment of keloids, hypertrophic scars, cysts, alopecia areata, and inflammatory conditions.
Intralesional steroid injections are a widely used dermatological procedure in which a corticosteroid medication is delivered directly into a skin lesion. This targeted approach allows for high local concentrations of the medication at the site of pathology while minimizing systemic exposure. The technique is effective for a variety of inflammatory, fibrotic, and immune-mediated skin conditions.
Intralesional corticosteroid injections exert their therapeutic effects through potent local anti-inflammatory and immunosuppressive mechanisms. The corticosteroid reduces the production of inflammatory mediators, decreases immune cell activity, and inhibits collagen synthesis within the treated tissue. These actions result in a reduction of swelling, redness, pain, and abnormal tissue proliferation.
Triamcinolone acetonide is the most commonly used agent for intralesional injection in dermatology. The concentration and volume of the injection are adjusted based on the type of lesion, its size, and its anatomical location. This customization ensures that an appropriate dose is delivered to achieve the desired therapeutic response.
Intralesional steroid injections are used to treat a broad range of dermatological conditions, including:
For keloids and hypertrophic scars, intralesional corticosteroids help flatten and soften the scar tissue by reducing collagen overproduction. In alopecia areata, the injections suppress the localized immune response that is targeting hair follicles, promoting hair regrowth in treated areas.
The procedure is performed in the clinic and typically takes only a few minutes. The treatment area is cleaned, and the corticosteroid is injected directly into the lesion using a fine-gauge needle. Multiple injection points may be used for larger lesions to ensure even distribution of the medication throughout the tissue.
Mild discomfort may be experienced during the injection, though this is generally well tolerated. No anaesthesia is typically required. Patients can resume normal activities immediately following the procedure. Depending on the condition being treated, a series of injections spaced several weeks apart may be recommended for optimal results.
Improvement is typically observed within days to weeks following treatment, depending on the condition. Keloids and hypertrophic scars may require multiple treatment sessions to achieve significant flattening and softening. Alopecia areata patches often show early signs of hair regrowth within four to eight weeks after injection.
Cystic acne lesions typically respond rapidly, with a noticeable reduction in inflammation and pain within 24 to 48 hours. The frequency and number of treatment sessions are determined by the clinical response and the nature of the underlying condition.
Intralesional corticosteroid injections are generally safe when administered by an experienced dermatologist. Potential side effects may include localized skin atrophy (thinning), hypopigmentation (lightening of the skin), telangiectasia (visible small blood vessels), and mild pain at the injection site. These effects are typically temporary and reversible.
The risk of side effects is minimized through careful selection of the corticosteroid concentration, appropriate injection technique, and limiting the total dose administered per treatment session. The treating dermatologist discusses potential risks and benefits prior to the procedure.
At the Centre for Medical and Surgical Dermatology, Dr. Maksym Breslavets performs intralesional steroid injections as part of a comprehensive treatment approach for inflammatory and fibrotic skin conditions. Each treatment is tailored to the individual lesion and clinical context, ensuring safe and effective outcomes.
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The Centre for Medical and Surgical Dermatology provides comprehensive care across all areas of dermatology. To schedule a consultation with Dr. Breslavets, please obtain a referral from your healthcare provider.