I just noticed it this morning and I had a Kenalog injection in March 2012! Help---does massage help stop the destruction?
Corticosteroid Risks - For those with an indentation from soft tissue injections, find medical article "Treatment of Local, Persistent Cutaneous Atrophy Following Corticosteroid Injection with Normal Saline Infiltration" by PETER R. SHUMAKER, MD, JAGGI RAO, MD, AND MITCHEL P. GOLDMAN, MD. The article is in the following journal: Dermatol Surg 31:10:October 2005. Apparently, saline infiltration which is easy to do, works to fix the indentation by flushing out the steroid crystals. You should be able to find the abstract for the article online and the paper at a medical school library. A good dermatologist should know about this technique or be willing to investigate it for you - apparently it's simple, your pcp can do it. This doctor is familiar with the technique and it might be worth contacting him about the procedure: MELVIN A. SHIFFMAN, MD, JD Section of Surgery, Newport Specialty Hospital, Tustin, California.
Corticosteroid Risks - See Dr. Shiffman’s letter below from “Dermatologic Surgery” journal in response to the article referenced in my comment above ("Treatment of Local, Persistent Cutaneous Atrophy After Corticosteroid Injection with Normal Saline Infiltration") 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. The authors stated that ‘‘To our knowledge, there is no precedent in the use of saline or any other compound to treat this problem.’’ Apparently, the authors did not find the articles that had been previously published concerning the tumescent use of saline in the treatment of steroid fat atrophy. The initial case was treated in June 2000, and 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 (B3–4 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