Cortisone Injection for Acne Cysts in Singapore: What It Does and When It Suits
Medical Director Dr Sin Yong explains what a cortisone injection does to an acne cyst, which spots suit it, the side effects to know about, and why it is never the whole acne plan at IN Eternity Clinic.
WhatsApp to Enquire →Key facts ↓A cortisone injection for acne is a tiny dose of dilute corticosteroid, a prescription medicine, injected by a doctor into a single painful nodule or cyst. It often flattens the lump within a few days, which is why it is used before events or for very painful spots. It treats that one spot, not acne itself, and too strong a dose can leave a temporary dent. See cystic acne treatment.
- Guidelines: the 2024 American Academy of Dermatology acne guideline lists adding intralesional corticosteroid injections for larger acne lesions as a good practice statement [1].
- Low dose works: in an early study, triamcinolone at 0.63 mg/mL was as effective on nodulocystic acne as 2.5 mg/mL; betamethasone had little effect compared with saline [2].
- In practice: in a survey of 100 dermatology clinicians, the commonest concentration was 2.5 mg/mL (52.5%) and the commonest volume 0.05 mL; 88.8% said fewer than 1% of patients returned with side effects [3].
- Comfort: in 64 people injected for nodulocystic acne, cold anaesthesia lowered average pain scores from about 5.9 to 3.7 out of 10 [5].
- Scarring: in 185 people with acne, facial scarring was present to some degree in 95%, and delays of up to three years before adequate treatment were linked with more scarring [6].
What is a cortisone injection for acne?
“Cortisone injection”, “cortisone shot”, “pimple injection” and “cyst injection” all describe the same procedure: a very small amount of dilute corticosteroid, most often triamcinolone, injected with a fine needle into the centre of an inflamed acne lesion. The steroid switches off the local inflammation, so the lump shrinks, softens and stops throbbing. It is a prescription medicine and is given by a doctor after the spot has been examined.
It is meant for one kind of spot: a deep, tender nodule or cyst that has no head to drain and would otherwise take weeks to settle. These lesions sit in the dermis, where creams barely reach; a single one is often called a blind pimple. The American Academy of Dermatology’s 2024 acne guideline includes intralesional corticosteroid injection for larger acne lesions as a good practice statement, alongside, not instead of, treatment of the acne itself [1].
Cortisone injections are also used for keloids and raised scars, where the dose and schedule are different; see keloid and hypertrophic scar treatment. Injections into joints and tendons are a separate medical field and are not covered here.
Which pimples suit a cortisone shot, and which do not?
The decision is about depth and type. A firm, painful lump under the skin is the classic indication. A spot with a visible yellow head is close to the surface and usually settles by itself or with topical treatment. Blackheads and whiteheads are blocked pores, not inflammation, and need extraction or a retinoid instead. Some lumps that look like acne are something else: an epidermoid cyst with a central pore, a boil, hidradenitis in the armpits or groin, or uniform itchy bumps from fungal acne, and each needs a different plan.
| Lesion | Injection? | Why |
|---|---|---|
| Deep, painful nodule or cyst | Often suitable | Inflammation in the dermis; the injection settles it within days |
| Deep spot without a head (“blind pimple”) | Sometimes | If large and painful, or before an event |
| Pustule with a yellow head | Rarely | Close to the surface; usually settles with topical care |
| Blackheads and whiteheads | No | Not inflamed; extraction or a retinoid suits |
| Epidermoid (sebaceous) cyst | Not as acne | A different lesion; may need drainage or removal |
| Itchy, uniform bumps on forehead or chest | No | May be fungal folliculitis, which steroid can worsen |
| Hot, spreading, very painful lump | No | Possible infection; examined and treated medically |
How fast does a cortisone injection work on a cyst?
Most people notice the lump softening and the pain easing within one to three days, and a flatter spot over the following days. How fast depends on the size and age of the lesion; a cyst that has been present for weeks, or one that has already ruptured deep in the skin, takes longer, and some need a second look. Results vary between people and lesions.
Less is often enough. In an early controlled study, triamcinolone at 0.63 mg/mL worked as well on nodulocystic acne as 2.5 mg/mL, while another steroid, betamethasone, had little effect compared with saline [2]. A survey of 100 dermatology clinicians found the commonest concentration in practice was 2.5 mg/mL and the commonest volume 0.05 mL, a fraction of a drop [3]. A 2025 study comparing 0.1% and 0.2% triamcinolone found the higher strength more helpful for more severe lesions, with no adverse events in any group; it was open-label, and part of it tested device-assisted self-injection under prescription, which is not routine practice [4]. The dose is matched to the lesion, not to how quickly you want it gone.
What are the side effects of a pimple injection?
The main risk is too much steroid in one spot. That can thin the skin and fat beneath it, leaving a small dent (atrophy), or lighten the skin, which shows more in darker skin types. These changes usually recover, but slowly: in the clinician survey, 88.8% said fewer than 1% of their patients returned with side effects, yet 48.4% said that when atrophy did happen it lasted more than six months [3]. Small visible vessels, a small bruise and brief stinging are the other common effects.
The injection itself stings for a second or two. Cooling helps: in 64 people injected for nodulocystic acne, cold anaesthesia lowered average pain scores from about 5.9 to 3.7 out of 10, with no discolouration or scarring recorded [5]. Infection is uncommon when the skin is cleaned first. Repeated injections into the same area, or treating many lesions at once, raise the risk of dents, so injections are kept for the spots that matter most.
Why does a cortisone shot not treat acne itself?
An injection settles the lesion it is placed in. It does nothing for the oil glands, blocked follicles, bacteria and hormones that produce the next one. If deep spots keep appearing, the useful question is why, and the answer is usually prescription treatment: a topical retinoid with benzoyl peroxide, a limited course of an oral antibiotic, hormonal treatment in suitable women, or isotretinoin for severe or scarring acne [1].
Timing matters because deep acne scars. In 185 people attending acne clinics, facial scarring was present to some degree in 95%, scar severity tracked the original acne grade, and delays of up to three years between onset and adequate treatment were associated with more scarring [6]. A cortisone shot can stop one nodule from doing damage; controlling the acne stops the rest. See acne treatment, hormonal acne and isotretinoin and procedures.
How are acne cysts injected at IN Eternity Clinic?
Dr Sin Yong examines the lump first to confirm it is an inflamed acne nodule rather than an epidermoid cyst, boil or fungal folliculitis, and asks about previous injections in the same area. If an injection suits, the skin is cleaned, the area can be cooled, and a small dose of dilute corticosteroid is placed into the centre of the nodule with a fine needle. It takes a few minutes. Deep nodules are never squeezed or extracted.
Because one injection treats one spot, the visit also covers the acne behind it: skincare, any prescription medicine and its monitoring, and whether in-clinic support helps, such as the 675 nm Shaonu Guang (少女光) laser or R2 Glow for inflammation and redness, explained on acne laser treatment. The cost depends on how many lesions are injected, whether prescription treatment is started and any follow-up, and is explained at consultation. Marks and scars left by earlier spots are planned once acne is controlled; see acne scar treatment.
What Dr Sin Yong looks for
- Whether the lump is an inflamed acne nodule or a lookalike such as an epidermoid cyst, boil or fungal folliculitis.
- How deep and how old the lesion is, and whether it has already ruptured in the skin.
- Previous injections in the same area, and any dent or pale patch left by them.
- Your skin type and how readily it darkens or lightens after inflammation.
- The overall pattern of acne, and whether prescription treatment is needed to stop new nodules.
General clinical observations used at consultation; they describe what is checked, not any individual result.
Frequently asked questions
How much is a cortisone injection for acne in Singapore?
The cost depends on how many lesions are injected, whether the visit also starts prescription acne treatment, and whether a review is needed. It is explained at consultation before anything is done. At IN Eternity Clinic the consultation fee is waived if you go ahead with any medical treatment.
Can I get a cortisone shot for a pimple before an event?
Often, yes, if the spot is a deep, inflamed nodule or cyst. Most people notice it softening and easing within one to three days, so a visit a few days before the event is sensible. A spot with a yellow head or a blackhead will not benefit, and a lump that might be infected is treated differently.
Does a cyst injection hurt?
It stings for a second or two. The needle is very fine and the volume tiny, but an inflamed lump is tender, so cooling the skin beforehand helps; in one study cold anaesthesia lowered average pain scores from about 5.9 to 3.7 out of 10. Many people find the throbbing of the cyst worse than the injection.
Will a pimple injection leave a dent?
It can, though uncommonly. Too much steroid in one spot can thin the tissue and leave a small dent or a paler patch. These usually recover, but slowly, sometimes over many months. Keeping the dose low and avoiding repeated injections in one place keeps that risk small.
Can I pop a cystic pimple instead?
No. Deep nodules have no easy route to the surface, and squeezing ruptures the follicle further into the skin, which prolongs inflammation and raises the risk of scars and dark marks. A clean, cold compress can ease the pain while you arrange to have it seen.
How often can I have cortisone injections for acne?
Occasionally, for the spots that matter most. Repeated injections into the same area raise the risk of dents and pale patches, so if deep spots keep appearing, the focus moves to treating the acne itself with prescription treatment, which reduces how many nodules form in the first place.
Is a cortisone injection the same as putting steroid cream on a pimple?
No. The injection places a measured dose of a prescription corticosteroid into one inflamed lesion under medical supervision. Steroid creams bought without a prescription and spread on acne can calm redness briefly but cause a rebound rash, and should not be used on acne.
Book an assessment
IN Eternity Clinic, 9 Scotts Road, #12-01 Pacific Plaza, Singapore 228210. By appointment with Medical Director Dr Sin Yong. Monday to Saturday, 11am to 8pm. WhatsApp or call +65 8815 3008. At IN Eternity Clinic a consultation fee applies, and it is waived if you go ahead with any medical treatment; the fee is S$120.
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References
- Reynolds RV, Yeung H, Cheng CE, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol 2024;90(5):1006.e1-1006.e30. doi:10.1016/j.jaad.2023.12.017
- Levine RM, Rasmussen JE. Intralesional corticosteroids in the treatment of nodulocystic acne. Arch Dermatol 1983;119(6):480-481. doi:10.1001/archderm.1983.01650300034012
- Gallagher T, Taliercio M, Nia JK, Hashim PW, Zeichner JA. Dermatologist use of intralesional triamcinolone in the treatment of acne. J Clin Aesthet Dermatol 2020;13(12):41-43. PMID:33488919
- Olson LB, Roberts CM, Dhawan SS, et al. Intralesional triamcinolone for inflammatory acne: a comparative study of dose efficacy and investigation of a novel injection assistance device to enable self-administration of intralesional therapy. J Dermatolog Treat 2025;36(1):2504656. doi:10.1080/09546634.2025.2504656
- Park SJ, Shin SH, Koh YG, et al. Cold anesthesia for pain reduction during intralesional steroid injection for nodulocystic acne. J Cosmet Dermatol 2023;22(12):3375-3378. doi:10.1111/jocd.15829
- Layton AM, Henderson CA, Cunliffe WJ. A clinical evaluation of acne scarring and its incidence. Clin Exp Dermatol 1994;19(4):303-308. doi:10.1111/j.1365-2230.1994.tb01200.x
These sources describe mechanisms and general evidence. They are not a promise of any individual result; suitability is decided at an in-person assessment.