Do Cortisone Shots Work for Acne?

To reduce the inflammation, swelling, and pain of cystic acne, a dermatologist can inject a diluted corticosteroid directly into a cyst.

This treatment is usually reserved for tender, swollen acne nodules, or cysts that aren’t responding to typical acne therapies. It can be very effective in shrinking nodules and cysts.

While a dermatologist may refer to the treatment as an intralesional corticosteroid injection, it’s widely known as a cortisone or steroid injection shot, or a cortisone injection.

Read on to learn more about the benefits and side effects of these injections.

A cortisone shot is the injection of a synthetic hormone. It’s used for short-term relief of inflammation and to shrink large cysts. The injections can be used on both the face and the body.

The shot, which is injected directly into an acne cyst or nodule, typically contains a small amount of a steroid, such as triamcinolone (Kenalog), a powerful anti-inflammatory.

Cysts and nodules may take weeks to resolve on their own. A steroid injection can reduce the swelling, redness and pain in a few days.

Are there side effects to cortisone injections for cystic acne?

While this procedure can be quick and effective, there’s a possibility of side effects. These include:

Pitting or thinning of the skin at the site of the injection. This can result in a visible depression where the cyst was. These depressions are often temporary and resolve on their own. Otherwise, your dermatologist may recommend dermal fillers.
Hypopigmentation, an area of lighter than normal skin or a white spot. Over time, this often goes away on its own.
Systemic effects from the steroid. This could be caused if more than the limit is injected and absorbed into the bloodstream.

How often can I get cortisone injections for cystic acne?

You can get multiple injections in one session, with each injection going to a different area. You must wait about 6 weeks between injections in the same spot.

These injections are meant to be an occasional treatment for specific cysts and nodules. It’s not meant to be a regular part of your acne treatment or skin care regimen.

Acne is usually caused by your skin’s pores becoming clogged with dead skin cells and oil. Bacteria, such as Propionibacterium acnes (P. acnes), is also often involved.

Sometimes a clogged pore breaks deep inside the skin forming large tender, painful bumps known as cysts (pus filled bumps) or nodules (inflamed bumps). These bumps can last for weeks or longer.

What causes cystic acne?

Cystic acne, like other acne, is caused by the interaction of a number of different factors:

Hormones. Testosterone, estrogen, and androgen are linked to cystic acne.
Genetics. If one of your parents has cystic acne, you’re more likely to develop it.
Environment. High humidity, excessive perspiration, makeup, lotions, and cleansers can cause cystic acne.
Certain drugs and chemicals. Lithium, corticosteroids, isoniazid, and phenytoin are associated with cystic acne.

What other treatments are there for cystic acne?

Other treatments your dermatologist may discuss with you include:

isotretinoin
antibiotics (tetracycline)
topical retinoids (adapalene, tazarotene)
spironolactone
oral contraceptives (for women)

While cortisone injections aren’t meant to be used as a regular acne treatment, they can be very effective with cystic acne.

If you have large, red, painful bumps deep in your skin that don’t form a head, you may have cystic acne. Consult with a board-certified dermatologist about recommended treatments, including cortisone injections.

Also check with your insurance regarding coverage. Some policies may classify cortisone injections as a cosmetic treatment and not cover them.

Last medically reviewed on September 4, 2020

How we reviewed this article:

Acne Treatment

Acne treatment encompasses a range of therapies aimed at managing and reducing acne breakouts, inflammation, and scarring. Acne can affect individuals of all ages and is caused by various factors, including excess oil production, clogged pores, bacteria, hormonal fluctuations, and inflammation.

Common acne treatments may include:

Topical Treatments: Over-the-counter or prescription topical medications containing ingredients such as benzoyl peroxide, salicylic acid, retinoids, or antibiotics may be used to reduce oil production, unclog pores, and kill acne-causing bacteria.
Oral Medications: Oral antibiotics, hormonal medications (e.g., birth control pills), and isotretinoin (Accutane) may be prescribed by a dermatologist to address more severe or persistent cases of acne by targeting inflammation, bacteria, and hormonal imbalances.
Professional Treatments: Dermatological procedures such as chemical peels, microdermabrasion, laser therapy, photodynamic therapy (PDT), or acne extractions may be recommended to accelerate acne healing, reduce inflammation, and improve skin texture and tone.
Lifestyle Modifications: Adopting a consistent skincare routine, avoiding harsh or comedogenic skincare products, managing stress levels, maintaining a healthy diet, and avoiding excessive sun exposure can help improve acne symptoms and prevent future breakouts.
Complementary Therapies: Some individuals may benefit from complementary therapies such as light therapy, acupuncture, herbal supplements, or dietary changes to address underlying factors contributing to acne and promote overall skin health.

By working closely with a dermatologist or skincare professional, individuals can develop a personalized acne treatment plan tailored to their specific needs and goals. With consistent treatment and proper skincare habits, many individuals can achieve clearer, healthier skin and regain confidence in their appearance.

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How we vet brands and products

More than 45 million people in the United StatesTrusted Source have acne. So, it should come as no surprise that there are many treatments and products out there that claim to treat this common skin condition.

Proactiv is likely one of the acne treatments you’ve heard about. Ads for it are everywhere, and plenty of celebrities seem to swear by it.

The ringing social media and TV endorsements seem to imply that Proactiv will work for your acne, even if you’ve already tried everything else without success.

So, should you try it? Is it better than other acne treatments on the market? Read on to find out.

Does Proactiv work?

Lots of celebs say that Proactiv works for them. Keep in mind, though, that they’re probably getting paid to say that.

It’s also likely that the glowing skin and flawless complexions of your favorite singers, actors, and reality TV stars are the result of plenty of cosmetics, expensive beauty treatments, great lighting, and more than a little photo editing.

With that being said, Proactiv may be an effective treatment option for mild to moderate acne outbreaks and scarring. But it’s not a miracle cure, and it won’t work for everyone.

According to its product description, Proactiv doesn’t work on cystic or nodular acne. It’s also not the best option for severe acne.

A dermatologist can diagnose your acne as mild, moderate, or severe.

What are the active ingredients in Proactiv?

Proactiv’s acne treatment products contain several clinically proven active ingredients. Each ingredient works in a slightly different way to target acne.

Benzoyl peroxide: works by killing bacteria on your skin that can cause acne. ResearchTrusted Source has shown that benzoyl peroxide is an effective acne-fighting ingredient. It may cause your skin to peel, bringing newer skin cells to the surface. Over-the-counter (OTC) Proactiv contains a 2.5 percent concentration of benzoyl peroxide.
Sulfur: works in a similar way to benzoyl peroxide by targeting acne lesions that are triggered by dirt, bacteria, and hormone imbalances. Unlike benzoyl peroxide, sulfur has less of a drying effect on your skin.
Glycolic acid: a type of alpha-hydroxy acid that’s used in a variety of skin care products. It helps with exfoliation, meaning it removes dead skin cells and allows for new skin cell generation.
Adapalene: a retinoid ingredient that works in a similar way to benzoyl peroxide. In a 2009 studyTrusted Source that compared the effectiveness of these two ingredients, the results were similar. Both ingredients did a good job of treating acne.
Salicylic acid: an exfoliant that helps to clean out the bacteria and other debris from inside your pores.

How much does it cost?

Proactiv costs around $40, plus shipping, for a 60-day supply.

It’s often pricier than other OTC acne treatments. You can probably find a product that contains the same main active ingredient, benzoyl peroxide, for around $10 at your local pharmacy.

Compared to prescription treatments for acne, Proactiv is supposed to be less expensive. But that may not be the case for everyone.

If acne medication is covered or partially covered by your insurance, you might be able to get a similar prescription product at a lower price.

How is Proactiv different from other acne products?

Proactiv is different from other acne products in that it’s not simply a cream, a gel, or a lotion. Instead, it’s a multistep skin care regimen that consists of several products.

There are different types of Proactiv kits, each with different products and variations of the active ingredients, but most kits include a cleanser, toner, and an acne-fighting gel treatment to use on a daily basis.

Depending on your skin and type of acne, you may not want to target acne with every step in your skin care routine. Some skin care experts believe that it may damage your skin barrier.

Talk to your dermatologist to find out if using Proactiv products is the right skin care routine for you.

Are there any side effects?

Proactiv is upfront about the fact that there can be side effects from using their products. Most of the side effects are minor and temporary. Serious side effects are rare.

Some side effects may include:

a red rash at the site of treatment
dryness, itchiness, or peeling, usually after several days of use
stinging or burning right after use

There’s usually a period of adjustment when you first start using Proactiv. You’re more likely to experience side effects for a few days or weeks after starting this product, as your skin gets used to the ingredients.

In rare cases, some people may have a severe allergic reaction to Proactiv when they first start using it. Symptoms of an allergic reaction include:

small red bumps on the treated skin
intense itching of the treated area
swollen, scaly, or blistered skin

If you develop an allergic reaction after using Proactiv, stop using the product, and make sure to follow up with your doctor or dermatologist.

If you have mild to moderate acne and have yet to treat it with benzoyl peroxide, Proactiv may be a good option.

But if your acne symptoms are more severe, you may be better off trying a prescription treatment recommended by a dermatologist.

Proactiv targets acne that’s caused by clogged pores and bacteria on your skin. If your acne is caused by something else, Proactiv won’t help.

It’s important to note that you shouldn’t use Proactiv if you’re pregnant or nursing.

Are there ways to prevent acne?

The inconvenient truth about acne is that there isn’t much you can do to prevent it. In many cases, acne is genetic. It’s mainly caused by hormones that are active during puberty.

That said, there may be things you can do to possibly limit your acne breakouts and keep your symptoms in check. Try these tips to help limit acne breakouts:

Wash your face twice a day to remove oil, dirt, and sweat.
Use an alcohol-free cleanser.
Add a few drops of tea tree oil to your moisturizer or cleanser.
Avoid touching your face.
Avoid wearing makeup, or if you do, keep it light to prevent pores from getting clogged.
Use oil-free, noncomedogenic shampoos, shaving creams, and hair styling products.
Stay hydrated.
Keep your stress levels in check.
Avoid high-glycemic foods, like candy, chips, sugary beverages, and baked goods made with white flour.

These tips may or may not work depending on whether your acne outbreaks are hormonal, caused by bacteria on your skin, or by lifestyle factors.

When to see a doctor

Acne isn’t a life-threatening condition. Even if your acne is ongoing, it typically won’t pose a risk to your health.

But acne can affect your emotional health and well-being, and lead to anxiety and depression. If your acne is interfering with your everyday life, or making you feel self-conscious, make an appointment to see your doctor or dermatologist.

Some insurance plans have recently added acne care to their covered conditions, so it might be less expensive than you think to get medical care.

The bottom line

Proactiv contains acne-fighting ingredients that may help treat mild to moderate acne breakouts. It won’t help you if you have severe acne or cystic or nodular acne, though.

Keep in mind that a good skin care routine should focus on keeping skin healthy, in addition to targeting and fighting acne.

If your acne is more severe, or if it won’t clear up with OTC products, be sure to talk with your doctor or dermatologist about the treatment options that are right for you.