Acne.org Products
I had a super bad dent on the side of my chin from picking once, looked horrible for a long time, probably because the skin is thinner there and the tissue swells up funny but that is the one scar that did get a lot better to where it doesn't bother me anymore. I did needle it quite a bit, I think subcision can work well there. Also massage it. I bet in time you chin spots look a lot better. Now my cheek scars just don't want to improve much anymore. They did get some better over time, but not like the chin area. Try the filler, but in my experience fillers never worked good. Try not too see your life's value as how you look right now. Don't let scars own you like that. I have learned to be tougher and generally not base my happiness on superficial things. Also, the dermaflage didn't work for me either. It just doesn't work for wide depressions.
Anyone else have success stories or any follow up information on this? I had four indentations now from cortisone injections
I recieved 3 weeks ago. One filled in suddenly and unexpectedly after a couple weeks but the other 3 don't show any signs of improvement. I have a appointment with a plastic surgeon to injer filler next week since I can't bear to live with these indentations for 6-12 months, which is as long as people are saying they take to fill in on their own. I wish my derm. Im going to confront my derm about this since he is responsible and warned me of these side effects. He should be responsible or fixing instead of me forking over $700 for filler to correct his mistake. In miserable over this. It's making me depressed to the point where I want to quit my job and hide. I get no joy out of life right now. I desperately need help. It is affecting my marriage, job, friends, etc.
Sorry for all the typos. I posted from my phone.
My (ex) dermatologist injected what he thought was scar tissue with 8mg solution of kenalog, only for me to find out later that is WAY TOO MUCH. It has looked like this for 6 weeks now and I feel like it's still getting worse. It has jagged edges and the skin feels very unhealthy. I have a plastic surgery consult tomorrow, based on pictures he thinks the entire area will need to be excised. I WANT TO SUE, I have cried over what that horrible man has done to my face. My new derm thinks it will fill in. YEA RIGHT.
The best part? I've got this on the other side of my mouth as well, a long line running down the side of my face. I'm a freakshow.
My (ex) dermatologist injected what he thought was scar tissue with 8mg solution of kenalog, only for me to find out later that is WAY TOO MUCH. It has looked like this for 6 weeks now and I feel like it's still getting worse. It has jagged edges and the skin feels very unhealthy. I have a plastic surgery consult tomorrow, based on pictures he thinks the entire area will need to be excised. I WANT TO SUE, I have cried over what that horrible man has done to my face. My new derm thinks it will fill in. YEA RIGHT.
The best part? I've got this on the other side of my mouth as well, a long line running down the side of my face. I'm a freakshow.
You have nothing and I mean nothing to worry about. What I'm about to tell you I wish someone could have told me a four years back but you really have to go trough the experience yourself to believe it. So a four years ago I got a large pimple on my back and I was no stranger to bane back then. I made a mistake of going to my general practitioner instead of a derm., needless to say I love the guy (I can say that now ) but he's no steroid injection guru .. A couple weeks after a hugeee dent where the injection had happened and the skin had turned white .. The dent kept on getting bigger .. A small pimple turned into a huge mess .. I researched on the web and turns out he had injected into healthy tissue casting serious complications .. So I went through the emotions .. Denial .. Anger.. Sadness ... Acceptance.. And then a positive outlook on life .. It was on back so a lot easier to ignore .. A year and a half later it was gone .. Completely filled in .. Even the whiteness had returned to normal colour .. Right now I never hesitate to get something injected but I have s good derm now for this.. Because I've been through the worst case scenario and I know from personal experience that it is completely reversible no matter how huge the dent .. I've also had many minor atrophies over the years and they all and I mean all have filled in a few months .. Time heals everything .. Even scars .. Except a keloid scar .. Which gets worse .. You have nothing to sorry about
VERY similar cortisone atrophy to the photos posted here...exact area of the face and similar shape and sized depression.
I am thinking saline injections cant hurt? Any contrary opinions OR agreement?
My problem..I placed an order for .9 saline vials and diabetic syringes and got an email back asking for my state license!?
Can anyone give me detailed instructions regarding where to buy the saline and syringes in PA?
Also, I read where Dr. Sire injected 5cc saline into ONE depressed scar? The 30 guage syringes I have seen on the internet are only 1/2cc OR 1cc...The saline bottles are 10 ML so I guess for one area I would use half of the bottle?
As you can tell, I have zero medical background...but my derm who does have extensive medical background messed me up with this HUGE depressed scar from a cortisone treatment so not sure that my lack of medical background will mess me up any worse. I am middle age, so I am probably fighting a losing battle with hoping that this depression from cortisone will ever heal but I am trying to be positive and do SOMETHING instead of nothing I guess.
This is a nightmare...I have enough skin problems without this new one. I got the injection 1 month ago. depression occurred within a week
I would not self treat! It is in your best interests to leave it alone. I know it's hard.
It has been 4 months tomorrow and I can say it has actually gotten better, the two long lines are almost completely filled in its like a damn miracle. I still hate one of them but im trying to be patient. I will post pics but I want to see if it gets even better so I will post an update at 6 months.
I have an appointment tomorrow with a different dermatologist...I was going to ask if she would do a saline injections but have a feeling she will push restalyn or another filler. I am definitely not putting any type of injectable product into this crater except saline...I am even afraid that will make my situation worse!
I feel so desperate and depressed over this stupid dent...I cant believe I had a hand in this disfigurement! I could have lived with the cyst and was so stupid to have it injected without researching first. Whats worse is that it is only a month since the injection, I fear more "cave in" can still come my way!
I just wish I knew if I will ever heal...I dread waking up every morning and looking in the mirror. I guess there is a real chance that this could be permanent.
hey 2worriedmom i bet your indent will fill in as well. it might take a few months or even up to six but it should fill in. my derm sad 95% of the time they do fill in so just give it time. the not knowing part is hard because i have been there but i am pretty sure you will be fine.
That is great! I am glad someone can get some relief. You must be so happy to just go on with your life.
I would not self treat! It is in your best interests to leave it alone. I know it's hard.
It has been 4 months tomorrow and I can say it has actually gotten better, the two long lines are almost completely filled in its like a damn miracle. I still hate one of them but im trying to be patient. I will post pics but I want to see if it gets even better so I will post an update at 6 months.
Thanks Tracy521...you are so right...I just have no idea if this will ever self correct and the unknown of it all is haunting. I wish I could just hide out for the rest of 2013 so no one had to look at me.
i can feel your pain i had the same issue back in february from a shot i had in january. it got worse for a month then slowly but surely it got better. it was near my jawline and it was from a huge cyst i had injected twice. i cant remember how long it took to totally fill in but it was at least a few months. i had to stop focusing on it so much because i was driving myself and my hubby nuts!! what i would do is take a pic now of it and then in say 2 months take another pic and you should see it should look a lot better. i remember thinking when i got it that now i had really done it. ugh the waiting sucks but you are not alone!
Thanks much for all those posting reassuring stories. I am dealing with a dent that has now been there for about 2.5 months and the improvement is glacially slow - I am getting so discouraged.
Planning to beg my doctor to try saline injections but if he won't do them I'm extra worried this will either take many more months to go away or not at all. Ugggggh.
(. I did have Perlane injected into the indent about 3 weeks ago. It has helped but the skin is still very thin where the pit Is/was. I hope it returns to normal. Just a quick update. I went to a new dermatologist on July 31...she was completely familiar with the saline injection method for cortisone atrophy. I one saline shot...3 days later I have noticed no improvement yet but am trying to stay positive.
Both this new derm and her assistant both told me that they had cortisone atrophy in the past and assured me that mine WILL heal but it does take a long time. Of course they both had perfectly clear and dentless skin while I sat there in tears and felt like a freak.
I don't know, I just cant imagine the day when this stupid dent will be gone. Right now I feel like it is a neon sign!
I have another saline shot scheduled in 3 weeks.
Hello everyone! I've had a few people message me about atrophy and I just wanted to 'Fill you in' (pun intended) on my experience. I had 4 cortisone injection-induced indentations filled in about a week ago using a recently FDA approved filler called Boletera Balance. It is special because it doesn't leave the blue hue under the skin that other fillers do, which means it can effectively treat fine superficial lines, wrinkles and acne scars. It was not cheap (close to $700) but I am happy with my results. The 4 depressions are all filled in quite nicely and are barely noticeable (aside from the acne red marks of course). The doctor didn't finish the whole vial so I can go back in a few weeks/months for touch ups if necessary using my remaining filler but he said the treatment should last at least 6 months. He tried the filler on a few real acne scars, which didn't really work because those scars seem to be tethered and the filler went around the scar (the donut effect) rather than filling in the pock mark. I would only suggest these fillers on actual depressed scars that are not tethered by scar tissue. It seems to be the perfect remedy for cortisone atrophy.
I confronted my dermatologist about the atrophy and he said 98% of the time they fill in on their own after a few months or up to a year. I did have one depression that filled in for the most part (still a little lower than the rest of the skin but hardly noticeable other than the red mark), so that does give me some hope the others will as well. I'm hoping when the filler wears off in 6 months, the depressions won't come back because maybe they will have naturally filled in on their own.
I will never get a cortisone shot ever again! In the meantime, check out Boletera. I would definitely recommend it if you can afford it. In my case, I was so depressed about my atrophy, I would have paid almost anything to make me feel better. Luckily, it worked for me.
Good luck and keep me posted everyone!
Even though I have had my indentations successfully filled in using filler, the skin is still very thin and red, so the area is still noticeable--just no longer depressed.
Does that thin skin thicken like the surrounding skin and return to normal after 6 months/a year?
I'll give an update as well. I convinced my doctor to try the saline injection (bringing the printout of the article was key to convincing him) and he injected 5cc's of saline into the dent on my chin. The area was quite swollen but that went mostly down within 30-45 mins.
Except then came the bruising. I REALLY wish I had put ice on it right away (I bruise easily) but being stupid I left it alone and over 24 hours a really deep purple bruise developed. Interestingly the bruise is only exactly where the indentation was and not over the whole area where the saline went. (Thankfully because then it would be HUGE.)
It's been three days and the bruise still looks hideously purple/black but the dent is about 80-90% flatter. For now. I'm assuming as the bruise and the underlying swelling heals it will dent in again but maybe the longer it is raised the more time there is for collagen to fill in underneath? Who knows, I'm trying to cling to some hope here because right now this bruise is uglier than the dent.
My advice for now: do the saline but ask for ICE! Will update later.
Thanks for the update. Please keep us posted on the saline injections. I would be interested in trying it out because it is much cheaper!
I took a closer look at my indentations this evening and it is looking like the indentations are still there--not completely filled in like I said earlier today. It's been less than a week (today is Monday, had the filler Wednesday) so it must have looked more filled in because of swelling. The filler was very lumpy at first but it smoothed out and feels natural. I am going to go back this week for more. It will be free since I didn't go through the whole vial and have plenty left over. I don't think the filler is wearing off---I just don't think enough was injected. Everything seemed filled in when I left the office but he said give it two weeks and come back if you think you need more.
Ugh, I hope this works out.
Ok it's now been about 9 days since the saline injection. The plumping effect of the saline has been gradually wearing off - initially perfectly gone for a few days, then gradually sinking back down to maybe 70-80% improvement. The biggest change occurred after about 7-8 days, when I'd say it went down to about 40-50% improvement, which is about where I am now. I think. But honestly it's hard to say because the dark bruise is still there and makes it harder to judge the depth.
I will hold off on judgement about the saline injection until this bruise finally heals up. Right now I feel pretty terrible that I have a dark bruise AND a dent, making the whole area just a lot more noticeable, but if it helps with the dent in the long run I will consider it a success.
I'm not planning on having another saline injection for a few weeks - I actually read one statement from a doctor who uses the technique saying that one flush is usually enough and that the fat should re-build within 3-4 weeks, and at that point some people may need another flush. So since I'm wary of more bruising, I'm just going to wait and see what happens.
Will keep updating.
HI Supernova30, When did you have the dreadful cortisone shot that started this whole nightmare?
It sounds like we did our saline injection at about the same time.(my first saline was July 31; stupid cortisone on June 28)
How do you know that you got 5 cc of saline...did you ask the derm? I think I got a very small amount of saline as I barely had a small bump for a while and never have enjoyed any improvement whatsoever in the dent. (Dent is easily a half inch long...truly looks like a scar from some type of accident!)
I go for another saline injection on August 21...I don't know, I think I have a very long road of embarassement ahead and am not quite a believer in this thing ever truly going away. Thankfully there are some success stories on this thread so I try to hold on to some hope.
Ok it's now been about 9 days since the saline injection. The plumping effect of the saline has been gradually wearing off - initially perfectly gone for a few days, then gradually sinking back down to maybe 70-80% improvement. The biggest change occurred after about 7-8 days, when I'd say it went down to about 40-50% improvement, which is about where I am now. I think. But honestly it's hard to say because the dark bruise is still there and makes it harder to judge the depth.
I will hold off on judgement about the saline injection until this bruise finally heals up. Right now I feel pretty terrible that I have a dark bruise AND a dent, making the whole area just a lot more noticeable, but if it helps with the dent in the long run I will consider it a success.
I'm not planning on having another saline injection for a few weeks - I actually read one statement from a doctor who uses the technique saying that one flush is usually enough and that the fat should re-build within 3-4 weeks, and at that point some people may need another flush. So since I'm wary of more bruising, I'm just going to wait and see what happens.
Will keep updating.
Hello,
I had the cortisone injection May 8th - dent showed up a couple of weeks later, had the saline injection Aug 1. So I had had the dent already for about 2.5 months by the time I had the saline injection. It was starting to show some improvement already but veeeery slow, as I'm sure you can appreciate.
I knew that my doctor injected 5cc's because it was his first time doing a saline injection so he followed the directions from the journal article and that's what it recommended. I think he only stuck the needle in once (at an angle) but moved it around while it was under there and said he could feel it hitting scar tissue (gross). Maybe this movement caused the terrible bruise but maybe it also helped to spur along some collagen production, I don't know, but I'm optimistic it did something to help. This is on my chin and it initially looked like I had been punched but the swelling and redness subsided really fast. Maybe when you go in next, ask the dermatologist to do 5 cc's? I promise the swelling will go down fast but you might want to ice it if you bruise at all easily.
As I said before, right now it's really hard to tell how much improvement I have (I'm pretty sure at least some) - I'm trying to stay optimistic that I'll see some progress over the next month.
I fully sympathize with how awful this is. I'm holding out hope that we'll get decent resolution - even if it's not perfect - since the overwhelming majority of people do.
HI Supernova30, When did you have the dreadful cortisone shot that started this whole nightmare?
It sounds like we did our saline injection at about the same time.(my first saline was July 31; stupid cortisone on June 28)
How do you know that you got 5 cc of saline...did you ask the derm? I think I got a very small amount of saline as I barely had a small bump for a while and never have enjoyed any improvement whatsoever in the dent. (Dent is easily a half inch long...truly looks like a scar from some type of accident!)
I go for another saline injection on August 21...I don't know, I think I have a very long road of embarassement ahead and am not quite a believer in this thing ever truly going away. Thankfully there are some success stories on this thread so I try to hold on to some hope.
Ok it's now been about 9 days since the saline injection. The plumping effect of the saline has been gradually wearing off - initially perfectly gone for a few days, then gradually sinking back down to maybe 70-80% improvement. The biggest change occurred after about 7-8 days, when I'd say it went down to about 40-50% improvement, which is about where I am now. I think. But honestly it's hard to say because the dark bruise is still there and makes it harder to judge the depth.
I will hold off on judgement about the saline injection until this bruise finally heals up. Right now I feel pretty terrible that I have a dark bruise AND a dent, making the whole area just a lot more noticeable, but if it helps with the dent in the long run I will consider it a success.
I'm not planning on having another saline injection for a few weeks - I actually read one statement from a doctor who uses the technique saying that one flush is usually enough and that the fat should re-build within 3-4 weeks, and at that point some people may need another flush. So since I'm wary of more bruising, I'm just going to wait and see what happens.
Will keep updating.
Yes, you are right...I too try to stay optimistice but then look in the mirror and get depressed everytime!!
I think I am very very concerned because age is certainly not on my side..I am in my upper 40's...not exactly banner years for collagen production or quite frankly anything good related to my skin. The last time I had so many skin woes I was a teenager and ended up taking accutane!
Please keep me posted on your progress.
Thanks!!!
Just thought I'd post some information regarding saline injections used to treat cortisone atrophy since I have access to some journal subscriptions that others might not. There is the main article by Shumaker et al. You can read the abstract by googling "Treatment of Local, Persistent Cutaneous Atrophy Following Corticosteroid Injection with Normal Saline Infiltration"
And then there is this interesting response letter by Dr. Shiffman (excerpt provided here):
Letter to the Editor:
I read with great interest the article by Shumaker and colleagues concerning the use of normal saline injection for treating steroid fat atrophy in four patients with great success. ... I have lectured on the technique since 2000 in Germany, Mexico, Romania, Korea, Colombia, and Japan. I have received many e-mails from and made personal contacts at meetings over the years with physicians who have used the technique on a variety of areas of the face and body with successful results.
My personal theory as to why the saline injection works is that the steroid crystals in the tissues are placed back in suspension with the saline, and the body macropahges treat them as foreign bodies, removing the crystals from the local region. . . it is not necessary to reinject the saline every week because the fat reaccumulation will occur given enough time (approx 34 weeks). It may be necessary to give a second injection after 1 month in an occasional case if not enough saline is injected initially, which is why I prefer to tumesce the area with saline. Even on the face, the saline swelling will dissipate over night so that the patient can return to regular social contacts.
MELVIN A. SHIFFMAN, MD, JD
Section of Surgery, Newport Specialty Hospital,
Tustin, California
Quick update on progress 2 weeks after my first saline injection: I would say the dent has improved by about a third.
It hasn't been a miracle exactly but this is about the same amount of improvement I saw in the previous 1.5 months, so it definitely helped. Waiting another week or two to see if there is further improvement before I get another saline shot.
How are you guys doing?
It has been 16 days since my first saline injection...no improvement here. 
I go for a second saline injection next week. This is really getting me down and I'm sorry to be the downer on this thread.
My situation may be a bit worse than others I guess because of my age(late 40's) which, of course, makes one assume collagen production not great; and because my dent is on the lower, front jaw area which is a very dynamic spot that dents in even further with movement. When I talk, the dent gets deeper...lovely.
I am going to see if the derm will be a bit more aggressive with the quantity of saline injected on this second injection. I believe she injected a low amount the first time since I had minimal swelling. According to the articles I have read, there should be a significant "wheal" (not misspelled!..quoting article) after the saline is injected.
Oh well, as advised by others who HAVE had success with this atrophy healing, I really need to stop analyzing this thing daily and look for progress perhaps monthly. IF mine does ever go away, I am probably one of the people who will need 6 months~1 year of time to heal. In the meantime, I have been trying to find a good filler/silicone makeup. Dermaflage seems a bit tricky to use since it says one cannot use makeup over it. If anyone has suggestions on filler makeup, please advise. I am not yet ready to do a cosmetic filler such as restalyn at this point. Based on my bad luck with injections, I don't want to add anything else to this mess that is semipermanent and requires months of waiting to wear off.
I appreciate anyone who posts progress...sadly I check this thread way too often looking for hope!!!
I would not self treat! It is in your best interests to leave it alone. I know it's hard.
It has been 4 months tomorrow and I can say it has actually gotten better, the two long lines are almost completely filled in its like a damn miracle. I still hate one of them but im trying to be patient. I will post pics but I want to see if it gets even better so I will post an update at 6 months.
I am glad the wait and see approach is working for you. I just read through this thread and I could feel your desperation.