The Science Behind a Steroid Shot and Cysts
Corticosteroids are powerful anti-inflammatory agents that mimic hormones produced naturally by the adrenal glands. When a dermatologist injects a small amount of diluted corticosteroid, such as cortisone, directly into a cyst, it works in a highly targeted way. This localized action suppresses the body's inflammatory response in that specific area, leading to a rapid reduction in redness, swelling, and pain. For inflammatory lesions like cystic acne, this can be a very effective way to provide quick relief and promote faster healing. The procedure typically takes just a few minutes in a doctor's office, and a local anesthetic may be used to minimize discomfort.
Healing of the deep-tissue area begins almost immediately, with most patients noticing a significant improvement within 24 to 48 hours. The effects of the anti-inflammatory action are long-lasting, though the underlying cause isn't addressed. This is why the effectiveness of a steroid shot can vary significantly depending on the type of cyst being treated.
Which Types of Cysts Respond to Steroid Shots?
The efficacy of a steroid injection depends heavily on the cyst's type and its underlying cause. Certain inflammatory cysts respond much better than others that are not defined by inflammation.
Cystic Acne
Steroid injections are most commonly and effectively used for cystic acne. For those large, painful, and deep-seated pimples that don't respond to topical treatments, a cortisone shot can provide rapid relief. By quickly shrinking the lesion, it helps prevent the cyst from rupturing and causing permanent scarring. This treatment is best used for isolated, severe breakouts, not as a long-term solution for widespread acne.
Epidermoid and Pilar Cysts
While a steroid shot can reduce the inflammation and swelling of an inflamed epidermoid or pilar cyst, it does not remove the cyst's sac or lining. This means that the cyst can (and often does) recur over time as the sac refills with keratin. For this reason, a steroid injection is considered a temporary solution for managing discomfort, with surgical excision being the more permanent fix.
Ganglion Cysts
Steroid injections, sometimes combined with aspiration to drain the fluid, are a treatment option for ganglion cysts. However, studies show that recurrence rates for ganglion cysts treated with injections can be high, with one study reporting a 73.2% recurrence rate. Surgical removal is often more effective for long-term resolution.
The Crucial Difference: Shrinking vs. Removing
One of the most important aspects to understand about steroid injections for cysts is that they do not remove the cyst sac. The lining of the cyst remains in the skin, which is why the cyst can return. In contrast, surgical excision, performed by a dermatologist or surgeon, involves removing the entire cyst and its surrounding wall, dramatically reducing the likelihood of recurrence.
Side Effects and Risks to Consider
While generally safe when administered correctly, steroid shots are not without potential side effects. These risks, while often temporary, should be discussed with a healthcare provider before treatment:
- Skin Atrophy: Too much cortisone can lead to a depression or thinning of the skin and fatty tissue at the injection site. This pitting, or indentation, is often temporary but can last for several months.
- Hypopigmentation: The injection can cause a lightening of the skin's color, which is more noticeable in individuals with darker skin tones. This usually resolves over time.
- Pain and Swelling: Temporary pain, redness, or swelling at the injection site is possible.
- Systemic Effects: In rare cases, if too much cortisone is injected, it can be absorbed into the bloodstream, leading to systemic side effects.
- Infection: As with any injection, there is a small risk of infection.
Comparison of Cyst Treatment Options
To help understand the pros and cons of different treatment approaches, here is a comparison of steroid injections versus other common cyst treatments.
| Feature | Steroid Injection (Cortisone Shot) | Incision and Drainage | Surgical Excision |
|---|---|---|---|
| Mechanism | Reduces inflammation to shrink the cyst | Drains the contents of the cyst | Removes the entire cyst sac |
| Effectiveness | Fast-acting; provides rapid symptom relief | Quick, temporary relief; high recurrence risk | Curative; removes the source of the cyst |
| Time to Results | 24-48 hours for noticeable improvement | Immediate relief from pressure | Requires healing time for the incision |
| Risk of Recurrence | High, as the sac is not removed | High, because the sac remains | Low, as the entire sac is removed |
| Scarring | Minimal risk of scarring if administered correctly; can prevent acne scars | Often leaves a small, potentially noticeable scar | May leave a scar, depending on size and location |
| Suitability | Best for inflamed, painful acne cysts or emergency management of a flare-up | For quick relief of an inflamed or infected cyst | Recommended for recurrent or persistent cysts |
Conclusion
Can a steroid shot make a cyst go away? The answer is that it depends on your definition of "go away." For an inflamed cystic pimple, it can make it disappear quickly and effectively by dramatically reducing the swelling and inflammation. However, for most types of true cysts, such as epidermoid or pilar cysts, the injection only addresses the symptoms, not the root cause. The cyst sac remains, meaning recurrence is a very real possibility. For those seeking a permanent solution, especially for recurring or bothersome cysts, surgical excision is often the most definitive treatment. It is crucial to consult a qualified dermatologist to determine the best approach for your specific situation and to ensure the correct diagnosis of the cyst type.
Learn more about epidermoid cysts and their treatment options from the authoritative resource at the Mayo Clinic.
