Trade the topicals for the big guns—otherwise known as cortisone shots—if you need an under-the-skin blemish gone, stat.

By Jaclyn Smock
December 09, 2019

As far as breakouts go, deep-rooted, painful-to-the-touch cystic flare-ups are mood ruining. Not only do they take up a ton of facial real estate, but they also are impossible to conceal and take a long time to heal. They're considered to be the most severe of breakout types and require treatment beyond your normal creams and lotions—which explains why they're most effectively treated in your dermatologist's chair with a cortisone shot. "A cortisone shot is an injection of a corticosteroid into the skin, used to reduce inflammation," explains Dr. Dennis Gross, a board-certified dermatologist and dermatological surgeon. It works to diminish the inflammation of the breakout "within a day or two," explains Dr. Arash Akhavan, a celebrity dermatologist. Ahead, everything you need to know about this acne treatment—from how the shot works to how often you can get one.

Getty / Delmaine Donson

Related: Here's Why You Struggle with Adult Acne—Plus, How to Get Rid of It

Cortisone shots are reserved for cystic pimples.

Cortisone shots are typically "reserved for acne cysts or acne nodules that are tender and swollen and don't respond to traditional acne therapies," notes Dr. Alan Durkin, a plastic surgeon affiliated with the brand BABOR. You don't, however, want to inject "flatter zits and small acne spots," says Dr. Akhavan, since you could risk leaving a permanent mark on the skin, called an indentation.

The shot contains powerful anti-inflammatories.

Once a dermatologist identifies the breakout as a cyst and explains that it can be treated with cortisone, they will prepare the shot and inject it directly into the breakout. "The redness, tenderness, and size all decrease within 24 to 48 hours," explains Dr. Durkin.

The steroid dosage is surprisingly very small.

The steroid found in cortisone shots "is triamcinolone, commonly called Kenalog, which is a powerful anti-inflammatory. These injections are typically diluted when injected into acne on the face. The actual amount injected is very small—such as 0.1 to 0.2 cc per acne cyst," continues Dr. Durkin.

Cortisone shots should be a last resort.

Cortisone shots are considered a last resort course of treatment by doctors. "While you technically can do it as frequently as a new cystic spot appears, you should be aware of the side effects of repeated cortisone shots in the same area," explains Dr. Gross." You could see the skin thinning and pitting in the areas you've repeatedly been injecting cortisone, and this scarring may not go away. Cortisone shots should not be a consistent means of treatment for acne."

You should see results quickly—but if not, you might need another injection.

"If the zit persists five to seven days after the injection, I would want to see the patient back for a repeat evaluation and possibly an additional injection," shares Dr. Caren Campbell MD, a San Francisco board-certified cosmetic dermatologist. "Usually, the treated zits are resolved in one to three days post-injection, but in the rare instance it persists it would be appropriate to retreat."

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