I have always been camera-shy, which went hand-in-hand with my biggest fear that I would wake up on the morning of a big event with a huge zit dominating my face. No one wants their acne immortalized in photos! I made it through my graduation photos okay, and I had clear enough skin for the big grad party, but there have been several occasions since then when I was not so lucky. There are many different types of acne, and while none of them are particularly pleasant, some can actually be quite easy to cover with makeup. Whiteheads and blackheads are two types of non-inflammatory acne that generally aren’t noticeable from a few feet away. Even pustules, which are larger and more inflamed, can be hidden with skillful makeup application. But what if the inflammation goes deeper? Is there anything that can be done for papules or cysts to make them less noticeable?
Cortisone is a steroid hormone that, along with adrenaline, is released from the adrenal glands when the body experiences stress. Cortisone has many functions, including maintaining steady blood pressure, but one of the most important roles of cortisone is its ability to decrease inflammation through suppression of the immune system. For this reason, cortisone is used in the treatment of shoulder bursitis, arthritis, lupus, severe asthma, tennis elbow, carpal tunnel syndrome, and several sports injuries involving ligaments and tendons. When used as a medication for the human body, synthetic cortisone can come in a few different mediums, but the primary form is as an injection, either locally or systemically. It is as a dilute intralesional injection that cortisone is used in acne medication.
Acne becomes red and irritated when bacteria within a clogged pore begin to reproduce. This irritates the cells around the pore, and triggers an immune reaction. Cortisone can help an acne lesion by stifling this immune reaction. Once injected into a papule or cyst, there is an immediate reduction in redness and inflammation. As the inflammation decreases, the pain disappears, and the pimple itself flattens out so that it is more easily camouflaged by makeup. All this generally happens within 24 hours of the injection. As a further bonus, cortisone is thought to help pimples heal more quickly by preventing the buildup of scar tissue underneath the blemish.
So long as cortisone is injected in a very dilute form, there are minimal side-effects. One of the more serious consequences of injecting too much cortisone into the lesion is skin atrophy. This is where the skin actually shrinks, leaving a superficial indentation where the blemish had been. It often heals itself, but if the atrophy seems permanent, there are procedures that can be done to elevate the atrophied area so that it is even with the surrounding skin. Another side-effect is a lightening of skin color at the site of the injection. There are limited suggestions for how to counter this particular side-effect, but a dermatologist would be able to give you more information.
If faced with a growing acne lesion a few days before an important event, it sounds like a cortisone injection could be an ideal way to minimize the pimple quickly and effectively. Another plus is that the procedure is reportedly fairly quick, and can sometimes even be performed last-minute, without a pre-booked appointment. If you think this might be a route you’ll consider in the future, it might be worth talking to your dermatologist now, before you’re in a rush and stressed about acne ruining your big day. In the meantime, keep that skin care regimen going, and maybe cortisone won’t even be necessary!