Hi, Read This Before Getting a Cortisone Shot for Your Zit
Fact: I’ve probably gotten 30+ cortisone shots in my adult life—and I freakin’ love them. No, I don’t have a kink for needles—I just have a super-sensitive face/system that can’t tolerate traditional acne treatments. So whenever I get one of those deep cystic zits on my chin (which, on me, takes 3-4 months to heal and then leaves me with a year-long scar), I have two options: accept it or inject it. Most of the time, I inject it.
And though I am a huge fan of cortisone shots, I’m also fully aware that acne injections are (1) an actual medical procedure that shouldn’t be taken lightly (much more on that below), and (2) a straight-up privilege that not everyone without health insurance can afford. Still, if you are someone who is dealing with an inflamed cystic zit and is in the position to try a cortisone shot, I’m 100 percent yer girl for everything you need to know first.
What is a cortisone shot for acne?
Cortisone shots—often called steroid shots—are injections filled with cortisone (a synthetic hormone) that neutralize inflammation and shrink cystic zits. “When your hormones stimulate excess oil production in your pores, bacteria settles in, feasts on the oil, and creates inflammation that leads to a cystic pimple,” says Mona Gohara, MD, dermatologist and associate clinical professor at Yale School of Medicine.
Yes, you read that correctly—your throbbing zit isn’t an infection; it’s your skin’s inflammatory response to bacteria. “The shot delivers the cortisone directly to the pore and the surrounding skin to shut the inflammation down and help your skin heal faster and calmer,” says Dr. Gohara. And surprisingly, it doesn’t really hurt (think: 4-5 seconds of “ouch, this sucks,” and then it’s over).
How long does it take for a cortisone shot to work on acne?
Despite what you’ve likely read, cortisone shots do not get rid of your pimple overnight, or even within a day or two. In general, cortisone shots will cut your acne’s lifespan in half, usually over the course of 4-7 days (though, of course, it also depends on how massive or inflamed your zit is to begin with).
So, for example, if your cystic zit tends to throb for a week before hardening and slowly healing over the next three weeks, a cortisone shot can cut that timeline in half—bringing your total zit time down from four weeks to two weeks. And the less time your skin spends inflamed, the less intense the hyperpigmentation and scarring will be. For someone like me, whose skin is left with a year-long red mark after every single zit, that’s a huge plus.
What kind of acne can be injected?
Cortisone shots are best for inflammatory acne, like cystic pimples, swollen papules, and tender nodules. The steroid works by shutting down inflammation, so little whiteheads and closed comedones won’t cut it, though your dermatologist will make the final call.
When’s the best time to get a cortisone shot?
As soon as humanly possible—like, for real. “If you inject the zit when it’s a baby, it’s not going to turn into a monster,” says Dr. Gohara. “As soon you feel one coming on, like as soon as it’s palpable, your dermatologist can inject it.” So don’t feel silly running to the derm with a barely visible bump—that’s the ideal time. Speaking from major experience, if you can nab a last-minute derm appointment, do it.
Cortisone shots for acne don’t always work
Sometimes, a single cortisone shot isn’t enough to squash a really deep, inflamed zit. “It’s not an exact science,” says Dr. Gohara. “You want to inject just enough cortisone to calm inflammation and flatten the zit, without injecting too much cortisone that will lead to a divot in the skin” (more on that below). And even though dermatologists are basically wizards, they still can’t see the future. “You don’t know a zit’s growth potential when you’re injecting it,” she says. “Like, is it going to be a LeBron James or Danny Devito? You have to find the sweet spot.”
For me, I’d estimate that 75 percent of my injections were effective the first time, while 25 percent of them could have used a second shot (which, honestly, I rarely went back and got, because ~laziness~). That’s not to say those 25 percent of shots didn’t work—they still sped up the healing time and calmed inflammation, just not as quickly or efficiently as the others.
Are there side effects to cortisone injections for acne?
Here's the gist: If your dermatologist injects too much cortisone or injects it too deeply, the steroid can leave a small dent, divot, or depression in your skin as the zit heals. But please note: This. Is. Not. Common. Like, at all—despite the chaotic “horror” stories you've probably read on Google.
Not only are cortisone shot divots pretty much never as severe as the pictures you see on Google Images (like, so confusingly rare that Dr. Gohara herself was shocked by the photos), but they’re also fixable. “Though denting is a potential risk, it’s pretty uncommon and usually goes away on its own after a few months,” says Dr. Gohara. And if you don’t feel like waiting, you've still got options: “Microneedling, resurfacing lasers, PRP, and/or fillers can all help fill out the dent faster,” she says.
I actually polled a bunch of beauty editors, including the Cosmo beauty team, and out of our collective 100+ cortisone shots, there’s only been one dent—mine, two years ago, on my chin. The divot was so small and shallow that I could only see it if I contorted my mouth, and it eventually went away within two months. This is not to downplay the potential risks of cortisone shots—they're very real, and very possible. So if you’re concerned, make sure to talk it through with your (board-certified!) dermatologist, first.
How much do cortisone shots for acne cost?
Usually, cortisone shots for acne are covered by insurance (so your only fee would be your copay), but if you’re paying out of pocket, the cost could be anywhere from $50-$200, depending on how much is injected, where you live, and how much the office charges. Always call ahead to verify your coverage and costs.
How often can you get cortisone shots for acne?
Honestly, as frequently as you/your wallet/your insurance allows (though make sure to tell your dermatologist if you’ve recently had a cortisone shot by another dermatologist; you should only inject the same zit a few times within six weeks).
Still, even though cortisone shots are excellent for quick acne emergencies, it’s important to note that they’re only a Band-Aid, not a long-term acne treatment. If you’re dealing with persistent cystic acne, your dermatologist can create an actual treatment plan for you that includes topical medications, oral medications, and even drugstore retinoid products (like one of the below), making it so you hopefully never need a cortisone shot again.
How can I get rid of my cystic zit at home?
If you can't get a cortisone shot right now, but you still want to zap your cystic zit at home, you can try to kill the inflammation by dabbing on a cocktail of benzoyl peroxide and 1 percent hydrocortisone cream every morning (dab on the BP, let it dry, then dab on the hydrocortisone cream). It's nowhere near as effective as a cortisone shot, but the combo will help calm some of the swelling while your body takes care of the rest. Sound good? Good.
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