skin atrophy caused by cortisone shot

Please help!
On September 3, 2011, I got a kenelog injection in both of my scars located on my chin.  Both scars were keloid "raised" scars and over 20 years old. My dermatologist also gave me a topical steroid to use on the scars after my injections, that i used for about 3 weeks.  

4 weeks after the treatment i noticed both scars started to sink in causing a "Pitted" effect.  I dont know what to do now.  My dermatologist recommends doing a "Subcision" to both scars for "long term" fix, or for a "short term" fix do a temporary filler such as Restylane.  
My rush to get this fixed is important however, i do Not want to coplicate the healing process or make it worse.

Is it ok to do the Subcision?  Will it hurt anything later once the Kenelog subsides?

Or, should i do the Restylane for a temp fix and see how the Kenelog subsides once the Restylane disolves?

Please Help!!!    

[Bhupinder Kaur, MD]

Hello,
Kenalog is a steroid injection and should be used with caution. Steroids when used for a long period of time or high doses is notorious for causing unwanted side effects like thinning of skin , steroid induced rosacea, skin atrophy, telangiectasias etc. Injectibe steroids can cause collagen loss and indented scars.
These may take a long time to heal and fill in when collages in formed but sometimes it may take longer or less depending on the depth of the indentations and the response of the skin. If they persist then you can get collagen filling and laser resurfacing done.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.