Treatment of Local, Persistent Cutaneous Atrophy Following Corticosteroid Injection with Normal Saline Infiltration

Abstract

Normal saline infiltration offers a safe, tolerable, relatively rapid, and effective treatment for local, persistent corticosteroid-induced atrophy.

Adjuvant triamcinolone acetonide injections in oro‐pharyngeal pemphigus vulgaris

“…Considering that one of the factors involved in CS‐induced atrophy appears to be the presence of CS crystals, it is likely that in our patients, the dilution of TA had relied on the resuspension and redistribution of poorly soluble TA crystals. Indeed, it has been demonstrated that the use of serial saline injections may represent a safe, relatively rapid, cost‐effective and non‐complicated therapeutic tool to CS‐induced atrophy by fostering the gradual disappearance of CS crystals from the tissue 21 …”

Use of Intralesional Poly-L-Lactic Acid in the Treatment of Corticosteroid-Induced Lipoatrophy

“…There are just a few reports of corticosteroid‐induced lipoatrophy treatment with injectables. In one report, a series of four patients with cutaneous atrophy resulting from acneiform cysts or intramuscular corticosteroid injections were treated with serial saline injections leading to complete resolution . Each of these patients improved within 4–8 weeks after the initial saline injection, and there were no side effects.…”

Cutaneous Atrophy and Alopecia After Greater Occipital Nerve Injection Using Triamcinolone

“…The risk of cutaneous complications in fact depends upon the quantity and solubility of corticosteroid injected. 13 The mechanisms by which local corticosteroids produce thinning of the skin with decrease in the size of sebaceous glands and cessation of hair growth seem to be due to intense vasoconstriction and deposits of insoluble corticosteroid crystals at the site of injection that persist for months. 14 Furthermore, high-solubility agents, such as methylprednisolone and betamethasone that have a lower atrophogenic potential, are the agents of choice for superficial soft tissue injections.…”

“…The risk of cutaneous complications also depends on the depth of the injection, with deeper injections being associated with lower risk. 13 The protocol used in our practice involves inserting the needle into the suboccipital fossa until it touches the occipital bone and the solution injected in 3 directions around the GON territory. 2 This deep injection likely contributes to the very low rate of cutaneous complications in our practice.…”