Intralesional Corticoid Injection for Scars

Intralesional corticosteroid injection is a well-established medical treatment for hypertrophic (thickened) and keloid (overgrown) scars. A diluted corticosteroid solution is injected directly into the raised scar tissue, suppressing the overactive collagen-producing cells that cause the scar to grow beyond the wound boundary or remain significantly raised. Over a series of monthly injections, the scar flattens, softens and fades to match surrounding skin more closely. At DermaClinique Písek, this therapeutic procedure is performed by MUDr. Kateřina Jůzlová, Ph.D., whose dermatovenerology and corrective dermatology background makes her well-suited to assessing scar type and planning the injection course.

Hypertrophic scars and keloids represent the two main types of abnormal scar formation. Hypertrophic scars remain within the original wound boundary but are raised, firm and often pruritic (itchy). Keloids extend beyond the original wound margins and can continue to grow over years — they are most common on the chest, shoulders, earlobes and upper back, and are more frequent in people with darker skin phototypes. **Why corticosteroid injection works:** Corticosteroids — typically triamcinolone acetonide, the most widely used agent — suppress the activity of fibroblasts within the scar tissue. Fibroblasts are the cells that produce collagen; in pathological scarring they remain overactivated long after the wound has healed. Injecting corticosteroid directly into the scar creates a localised anti-inflammatory and anti-proliferative effect, reducing collagen synthesis and breaking down existing excess collagen fibres. The result over multiple sessions is a flatter, softer, less symptomatic scar. **What to expect during the session:** The scar is cleaned. MUDr. Jůzlová uses a fine needle to inject the corticosteroid solution directly into the raised scar tissue. In firm keloids, this requires significant pressure and can be mildly uncomfortable. The session is brief — typically 10–20 minutes depending on scar size. No anaesthesia is usually needed, though EMLA cream (available for +100 Kč) may be applied beforehand for larger or particularly sensitive scars. **Results:** Visible softening and flattening begins within 4–6 weeks of the first injection. A series of 3–6 injections at monthly intervals is typically required for clinically meaningful improvement. After completing the course, results are reassessed; maintenance injections may be needed if the keloid tendency persists. **Monitoring:** MUDr. Jůzlová tracks response between sessions. If the scar is not responding adequately to corticosteroid alone, she may combine the approach with other interventions (fractional laser resurfacing is available at the clinic and synergises well with intralesional treatment for acne scars and hypertrophic post-surgical scars). **Potential side effects:** Skin atrophy (thinning) and hypopigmentation (lightening) at the injection site are the most common side effects of intralesional corticosteroids. These are dose-dependent and technique-dependent; a dermatologist's precision in placing the injection within the scar — not the surrounding normal tissue — minimises this risk. **Contraindications:** Active skin infection, allergy to corticosteroids. Discuss any systemic corticosteroid use with the doctor before treatment. **Not suitable for:** Atrophic (sunken) acne scars — these require volume-adding treatment such as dermal fillers or biostimulators; fractional laser resurfacing is another option available at the clinic.