Tissue damage from cortisone

I was given a cortisone injection in my buttock for a facial rash.  This has resulted in damaged tissue. The area of the injection site is now 1 1/2 to 2 inches deep and 3 to 4 inches wide.  I am missing tissue in the area.  What could have caused this?  Can the injection be administered improperly to case this? What can I do to fix it?  Thank you very much for your comments.

[Howard Rosenberg, MD]

Steroid injections are notorious for producing fat atrophy in the area injected.  Some physicians have suggested that this is caused by precipitation of steroid crystals in the area of injection and have recommended saline (salt water injections) in the same area to dissolve the steroids and reverse the atrophy.  I have tried this with limited or no success.  This may improve with time, but if not then fat injections would be the best option.