Improvement in Scars using Steroid Injections / Intra-Lesional Steroid (Triamcinolone) Therapy

[Drsumitra]

What is Intra-Lesional Steroid Therapy?

Intra-lesional corticosteroid therapy is a procedure where a
steroid solution is injected into the scar with the aim to
improve the appearance and decrease the size of the scar.

The steroid most commonly used is called triamcinolone.

This works by increasing the activity of an enzyme called
collagenase. This enzyme breaks down collagen in the scar
so that the scar becomes less thick and red.

The steroid does not change the amount of collagen made
by the cells nor does it decrease the number of cells making
collagen; its action is primarily to remove some of the
excess collagen from the scar.

This technique is commonly used in dermatology and plastic
surgery, either alone or in combination with other forms of
treatment, to treat a number of skin conditions.

Often multiple small injections are carried out and you will
need more than one session of treatment.

Side Effects of the Treatment

There are a few side effects which you may experience;
these tend to improve with time, your clinician may halt
treatment if these cause any concern.

Common Side Effects

Pain: the procedure is generally well tolerated but injections
into certain areas of the body, for example, palms of hands
or soles of feet can be more sore.

Bleeding: small amounts of spotting with blood can occur
after the injection.

Occasional Side Effects

Atrophy: shrinkage of the tissue at and around the sites of
injection may occur. This results in a white depressed area,
or small scar like areas. The face, genitalia and lips are
more susceptible to this than other parts of the body.

Hyper / Hypo-Pigmentation: changes in pigmentation can
occur at and around the sites of injection with either
lightening or darkening of skin colour.

Telangiectasia: infrequently, tiny dilated blood vessels or
small red spots called purpura may become visible at the
injection site.

Rare Side Effects

As the total dose of steroid being injected into the skin is
small, the risk of the steroids being absorbed into the blood
stream and producing generalised or systemic side effects
are extremely small.