Intralesional Steroid Injection Dermatologist2025-01-10T22:18:04+00:00

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I can use intralesional steroid injections to improve the appearance and symptoms in conditions where the skin is abnormally thickened and in some cases of hair loss.

I CAN PERFORM THESE INJECTIONS ON THE SAME DAY AS YOUR CONSULTATION

What are intralesional steroid injections?

Intralesional steroid injections are injections of a corticosteroid that dermatologists will inject directly into an affected area of skin. The procedure causes minimal discomfort and can be performed on the same day as your consultation.

What do intralesional steroid injections treat?

Intralesional steroid injections can address scarring, cysts, some types of hair loss, lichen planus and more.

intralesional steroid injections dermatologist berkshire

What happens during a procedure?

I inject the steroid directly into your affected skin. This approach can have certain advantages over steroid creams and ointments. For example, it allows me to deliver a specific dose of corticosteroid directly into the affected skin, thereby acting more effectively.

How do intralesional steroid injections work?

Intralesional corticosteroids work by suppressing local inflammation and prevent further collagen production in the skin. This means that we can effectively treat abnormally thickened areas of skin, and reduce inflammation within patches of hair loss to allow hair to regrow.

intralesional steroid injections dermatologist berkshire
intralesional steroid injections dermatologist berkshire

What can you expect after treatment?

You can expect to see an improvement over the next few weeks. In some cases, you may require a course of treatments, spaced a few weeks apart.

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More information about the intralesional steroid injections

FOR THOSE WHO WANT THE DETAILS

Intralesional steroid injections are injections of a corticosteroid that dermatologists will inject directly into an affected area of skin.

I can perform this on the same day as your consultation without the need for a local anaesthetic.

I can use intralesional steroid injections to improve the appearance and symptoms in conditions where the skin is abnormally thickened and in some cases of hair loss.

  • Keloid scars or hypertrophic scars
  • Acne cysts
  • Alopecia areata (a type of autoimmune hair loss)
  • Hypertrophic lichen planus
  • Sarcoidosis
  • Discoid lupus erythematosus

I mainly use intralesional steroid injections in cases where there is an abnormal thickening of the skin.

Abnormal thickening is particularly common in cases of excessive scar tissue, such as in keloid or hypertrophic scars. Other skin conditions where we find unusually thickened skin lesions are sarcoidosis and hypertrophic lichen planus.

I also use intralesional steroid injections in cases of alopecia areata where topical corticosteroids are ineffective or where there are residual patches of hair loss.

I can also inject intralesional steroid injections into lone acne cysts. Usually, I would only offer this treatment once your skin has been clear of acne for some time, to ensure that the acne doesn’t flare up again.

Intralesional steroid injection is a straightforward intervention that I can perform on the same day as your consultation without the need for local anaesthetic. I can do so after I’ve determined that this is the appropriate treatment for you.

I inject the steroid directly into your affected skin. This approach can have certain advantages over steroid creams and ointments. For example, it allows me to deliver a specific dose of corticosteroid directly into the affected skin, thereby acting more effectively. It can also do away with the need for you to take oral corticosteroids (used in some conditions), which carries the potential for more side effects.

Intralesional corticosteroids can suppress local inflammation and prevent further collagen production in the skin.

Essentially, we are taking advantage of a known side effect of corticosteroids (that is, thinning of the skin) to treat abnormally thickened areas of skin.

Having intralesional steroid injections

First, I clean the skin. Then I inject small amounts of steroid directly into the affected skin.

I may need to give one or more injections. The procedure, however, is not particularly uncomfortable. Patients generally tolerate it well without the need for anaesthetic.

You can expect a small amount of pinpoint bleeding immediately after I inject the skin. I place a small dressing over the injected area.

You can expect to see an improvement over the next few weeks. In some cases, you may require a course of treatments, spaced a few weeks apart.

There is a potential risk for the skin to thin more than we desire. Therefore, I take great care with the amount of steroid I inject. There is a further risk of lightening of the skin, especially in people with darker skin types. The risk of subsequent bleeding, infection or allergic reaction is relatively low.

Are there any alternative treatments to intralesional steroid injections?

In the majority of cases, I initially try topical steroid preparations in the form of an ointment and/or steroid impregnated tape. The reason for this is that these preparations can be useful in certain individuals without the need to proceed to injections.

However, if the topical preparations haven’t helped enough, I will offer you intralesional steroid injections. These deliver a dose of steroid directly into the affected skin.

Don’t steroids thin the skin?

One of the known side effects of corticosteroids is that they can thin the skin (that is, cause steroid atrophy) by suppressing collagen production. That is why I offer intralesional steroid injections in cases where the skin is abnormally thickened, as we are taking advantage of that very side effect.

I take great care to prevent over thinning of the skin, by only injecting small amounts on each occasion. This approach allows for more control, with a gradual reduction in the abnormal thickness of the affected area.

Can you use intralesional steroid injections in all cases of alopecia areata?

Intralesional steroid injections are best used in those cases of alopecia areata with small to moderate sized patches of hair loss, especially where these have failed to respond to topical corticosteroids.

Where there is more extensive hair loss, I find other treatments more preferable and appropriate.

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About the author

Dr Penelope Pratsou | Consultant Dermatologist

MBChB, MRCP (UK) (Dermatology)

I’m Dr Penelope Pratsou, a skilled independent Consultant Dermatologist based in Berkshire. I have specialist expertise in the diagnosis and management of all skin cancers, and in performing mole checks. I’m a trained skin surgeon and remove skin cancers, moles, skin tags, cysts and warts.

I also have invaluable experience in dealing with all skin conditions, from the common skin complaints of acne, rosacea, eczema and psoriasis, to the rarer and more complex skin problems, having seen it all through years of NHS work.

After I obtained my Membership to the Royal College of Physicians, I undertook rigorous specialist training in dermatology, before being appointed as a Consultant Dermatologist at the Royal Berkshire Hospital, Reading. There, I helped set up and lead a busy clinic for the diagnosis and treatment of suspected skin cancer. I was also actively involved in supervising and training both dermatology and GP trainees.

Alongside my increasingly busy private practice, I have maintained an NHS practice in Oxford in order to continue to engage with challenging cases and to develop my specialist interest in skin allergy.

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