Cortisone Injection vs Scar Revision

Cortisone Injection: A tiny shot of diluted steroid into one inflamed acne cyst. It flattens that spot in a few days. It treats the bump, not the acne.

Scar Revision: The whole set of procedures used to make an existing scar less noticeable — cutting it out and closing it more neatly, flattening it, releasing it, or resurfacing it. No procedure erases a scar. Revision trades the scar you have for one you would rather live with.

Reviewed by Dr. Schwarz, Board-Certified Dermatologist
Last updated: 10/22/2026

Editorial illustration for Cortisone Injection, based on the entry’s treatment or equipment reference.

Editorial illustration for Scar Revision, based on the entry’s treatment or equipment reference.

Choose if Key differences What is it?What it treats Treatment areas Skin tones How it works Before your treatment Day of treatment After your treatment Risks Cost Questions Related

Choose Cortisone Injection if…

Choose for one painful acne cyst that needs to flatten fast, or for keloids and patchy hair loss.

A single painful cyst before an event
A raised keloid
A patch of alopecia areata

Choose Scar Revision if…

Choose to trade a scar you dislike for a neater one — no procedure erases a scar.

A wide, raised or puckered scar
The scar is at least a year old
You accept a new, better-placed scar

Often combined

Can you have both?

Cortisone injections are often used after scar revision to keep raised scars and keloids from coming back.

Key differences

● Cortisone Injection

● Scar Revision

DowntimeNone → 2+ weeks

None

1–2 weeks

PainMinimal → Needs anesthesia or sedation

Mild

Moderate

Results showImmediately → 3+ months

Within days

3+ months

How long it lastsWeeks → Years or permanent

Weeks

Years or permanent

Visits neededOne → Every few months

Every few months

A short series (2–3)

Cost per visit$ → $$$$$

$$$

ReversibleYes, can be undone → No, permanent

No, permanent

What is it?

Cortisone Injection

Scar Revision

What is it?

It is injected into a lesion.

An intralesional steroid calms local inflammation or scarring.

It differs from joint injections.

It is not a systemic steroid treatment.

The diagnosis matters.

Infected or uncertain lesions should not be injected.

Side effects can last.

Skin thinning, fat loss and pigment change may persist.

It improves scars.

It aims to improve appearance, comfort or movement.

It uses several methods.

Surgery, injections and resurfacing may be combined.

It does not erase scars.

It modifies scar tissue rather than restoring unscarred skin.

Keloids need special care.

Excision alone can cause a larger recurrence.

What it treats

Evidence level

Cortisone Injection

Scar Revision

Strong evidenceMost established uses

Acne

Flattens a painful cyst within days.

A raised, smooth, firm scar on the upper chest on light skin. It is shiny pink-red and hairless, and its edges spread well past the small mark it grew from.

Keloids

Softens and flattens raised scars.

Alopecia Areata

Regrows hair in patches.

Scars

Improves width, texture and color.

Moderate evidenceSome supportive research

A smooth, dome-shaped lump about two centimetres across on the upper back on pale skin, with a tiny dark pore at its center and faintly pink skin over it.

Epidermal Inclusion Cyst

Calms an inflamed cyst.

Keloids

Combined with injections to prevent return.

Acne Scarring

Punch excision for deep scars.

Little evidence

—

Two areas of fair skin side by side on a hip. New pink-red bands sit above, and older flat silvery-white bands below, with only a small difference in color between the pale marks and the skin around them.

Stretch Marks

Usually treated with lasers or needling.

Not effective

dark keratin plugs in dilated pores on the nose and adjacent left cheek, with the face turned to the person’s right on light skin.

Blackheads

Not for clogged pores.

—

Can make it worse

Acne Scarring

Can cause dents in skin.

—

Treatment areas

The specific lesion, scar or affected patch determines the treatment site; there is no fixed body distribution.

Skin tones

Skin tone

● Cortisone Injection

● Scar Revision

Lighter skin

Low risk

A small dent is possible.

Low risk

Scar fades over a year.

Medium skin

Some risk

Lighter patches can show.

Some risk

Dark marks possible.

Deeper skin

Some risk

Lightening and dents are more visible; low doses help.

Higher risk

Keloids can return larger; injections or radiation are often combined.

How it works

Cortisone Injection

Scar Revision

How it works

Cortisone Injection mechanism diagram. Medicine is placed in a lesion: A clinician injects an appropriate corticosteroid preparation. Inflammatory signaling decreases: The steroid reduces local immune and inflammatory activity. The lesion may soften or flatten: Response depends on the condition, dose, and placement.

Scar Revision mechanism diagram. The scar is assessed: Its shape, location, and tension guide the surgical plan. Tissue is revised or rearranged: A surgeon changes the scar and carefully closes the wound. A new scar matures: Appearance may improve, but scar tissue remains.

Diagram explanation

Medicine is placed in a lesion: A clinician injects an appropriate corticosteroid preparation. Inflammatory signaling decreases: The steroid reduces local immune and inflammatory activity. The lesion may soften or flatten: Response depends on the condition, dose, and placement.

Schematic illustration. Technique and response vary. This explains a mechanism and does not specify treatment settings.

The scar is assessed: Its shape, location, and tension guide the surgical plan. Tissue is revised or rearranged: A surgeon changes the scar and carefully closes the wound. A new scar matures: Appearance may improve, but scar tissue remains.

Schematic illustration. Technique and response vary. This explains a mechanism and does not specify treatment settings.

Before your treatment

Cortisone Injection

Scar Revision

Earlier planning

Not specified

6 to 12 months: Waiting: Surgeons want 6 to 12 months of natural settling first.

2–4 weeks before

Not specified

Sun: Keep the scar out of the sun and use SPF 30 or higher.

2 weeks before: Smoking and vaping: Stop both at least two weeks before and after surgery.

The week before

Do not pick: Do not pick, squeeze or heat the spot.

Not specified

Day of treatment

Cortisone Injection

Scar Revision

Before you arrive

Clean skin: Wash your face and skip makeup on the area.

What to bring: Old photos: Photographs from before the injury, if you have them.

Arrival & prep

The provider checks that the spot is an inflamed acne cyst and not a boil.

The scar is photographed and examined relaxed and stretched.

Treatment

The skin is wiped with alcohol.

A very fine needle goes just into the bump and a small amount of fluid goes in, under 10 seconds per spot. The sting is sharp for a few seconds, worse if the cyst is already tender, but most people rate it lower than they expect. Numbing does not help much — the needle stick is the whole procedure.

A steroid injection takes minutes and meets real resistance.

Surgical revision cuts the scar out as a narrow ellipse and closes it in layers, usually 30 to 90 minutes. A Z-plasty swaps small flaps to change direction. Punch excision removes a small round scar. Laser or microneedling takes 20 to 45 minutes. Expect pressure, not sharpness.

Before you leave

A tiny red dot, sometimes a small raised bleb that flattens within an hour.

Tape over the line, wound care instructions, and a date for stitch removal — 5 to 7 days on the face, 10 to 14 days on the body.

After your treatment

Cortisone Injection

Scar Revision

First 24 hours

Days 1 to 2: The bump softens and the ache fades.

First 2 weeks: Swollen, bruised and tender.

Days 2–7

First few days: A pinprick mark, sometimes a small bruise, fading over a few days.

Days 3 to 7: Most cysts are flat.

Not specified

Weeks 2–4

Not specified

Weeks 2 to 8: The new line turns pink, firm and slightly raised — normal healing, not failure.

Beyond 1 month

Not specified

Months 3 to 18: Redness fades and the ridge softens from month 3 to 6, with massage and silicone doing the work.

Time to results

24–48 hours for a cyst

Over 6–12 months

How long results last

Treats only that spot

Permanent

Risks

Dent in the skin
Lighter patch of skin
Visible small vessels

A scar thickening or spreading again
Itching, burning or tenderness in the scar
A dent or pale patch after an injection
A new dark patch
Numbness or odd sensation

Cost

Per session

Roughly $50 to $250 per office visit in the US, usually billed as an office visit plus a procedure charge rather than per spot.

In the US this varies more than almost any other dermatology procedure, because "scar revision" covers a five-minute injection and a ninety-minute operation.

Insurance

Insurance often covers it, since acne cysts count as medical rather than cosmetic.

Insurance often pays when a scar limits movement or vision, interferes with function, or follows cancer surgery or an injury.

Questions

Cortisone Injection

Scar Revision

Individual Questions

How fast does a cortisone shot work on a cyst?

Softening begins within 24 to 48 hours and most spots are flat by day three to five. That figure traces back to one small 1983 trial — it matches what dermatologists see but has never been tested at scale. The mark left behind takes weeks longer, and the injection does not speed that up.

Will it leave a dent?

It can. A shallow depression happens when the dose is too strong, so a lower concentration is the main protection. It is uncommon — most dermatologists see it in well under one patient in a hundred — and it often fills in over several months. But it is not reliably temporary. About half the clinicians who do see it report it lasting more than six months, and occasionally it is permanent. That is why you ask what concentration is being used.

Can I get one before an event?

Yes, the most common reason people ask. Aim for three to five days ahead so the swelling has time to drop. A same-day injection rarely looks better by that evening.

Does it stop acne from coming back?

No. It treats only the spot it is injected into. Preventing the next cyst needs a daily treatment plan, and the guidelines call this an add-on.

Is it safe on deeper skin tones?

Yes. The risk is a lighter patch at the site, more noticeable and slower to fade on deeper skin tones. A lower concentration reduces it, so ask.

Is this approved for acne?

Not in the United States, strictly speaking. The FDA labeling lists intralesional use for keloids, alopecia areata, discoid lupus and others. Acne is not on it. Off-label use for an acne cyst is routine, legal and recommended by the American Academy of Dermatology, but almost nobody says it out loud. In the UK, NICE withdrew its recommendation in 2026 after UK-licensed triamcinolone injections stopped being available — a supply and licensing decision, not a safety one.

Can a scar be removed completely?

No. Every treatment replaces the scar with a different one — flatter, narrower, paler, or running in a less obvious direction. Often a large improvement, not removal.

How long should I wait before revising a scar?

Usually 6 to 12 months, because most scars keep improving on their own in that time. Scars that limit movement and raised scars still growing are treated sooner.

What is the difference between a keloid and a hypertrophic scar?

A hypertrophic scar is raised but stays within the original wound borders and often flattens over a year or two. A keloid grows beyond them, keeps going, and does not settle by itself. Keloids come back after surgery much more often, so they are usually injected rather than cut.

Will scar revision help my acne scars?

Some of them. Rolling scars respond to subcision, needling and laser; deep icepick scars often need punch excision or a targeted acid technique; boxcar scars sit in between. Expect a course and partial improvement, not one operation.

Does insurance cover it?

Sometimes — when the scar restricts movement or vision, causes symptoms, or follows cancer surgery or trauma. Revision for appearance is cosmetic. Ask the office to check with your insurer before you book.

I have deeper skin tone, and I keloid. Is anything safe?

Yes, but the order changes. Injections, silicone and pressure come first, elective surgery on high-risk sites is approached carefully, and if a keloid is removed, something is always done alongside to control the healing. Tell the provider at the first visit.

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