Saline injections symptoms and conditions

I had a severe cough for about 2-3 weeks when the doctor gave me an injection on Kenalog. I was not told any potential side effects. I now have a very large indentation at least the size of a gold ball on my right butt. My real concern is how to rectify this situation. Has anyone had any luck with saline injections or any other remedy? I am extremely frustrated and hate what my butt looks like now.

I am a physician. Kenalog is one of several injectable steroids that can cause subcutaneous atrophy or lipoatrophy as a side effect. For those who have this reaction, they will notice a dent or divot. This is not dangerous problem and most of the time the dent or divot will fill back in with time. How much time? The range is 3 to 24 months without treatment. However, for many patients this healing process can be speeded up with weekly saline injections that can be safely performed by almost any Doctor and need not be expensive.

The technique was well described in the Journal of Dermatological Surgery in 2006. If you do a google search for the name of the article as listed below you can find the Abstract and take a copy to your Doctor.

Best to all,

T.

Treatment of Local, Persistent Cutaneous Atrophy Following Corticosteroid Injection with Normal Saline Infiltration

Shumaker Peter R., MD*, Rao Jaggi, MD † , Goldman Mitchel P., MD †

Published in Dermatological Surgery, 21 Mar 2006

ABSTRACT
Background. Injections of corticosteroids are commonly used for a variety a dermatologic conditions but may cause local, persistent cutaneous atrophy, with few therapeutic options.

Objective. To determine the effectiveness of bacteriostatic normal saline infiltration on the improvement of corticosteroid-induced cutaneous atrophy.

Materials and Methods. Four patients with corticosteroid-induced atrophy of the skin, two caused by acneiform cysts and one from intramuscular steroid injection, were treated with weekly injections of normal saline directly into the atrophic site. The patients were seen on weekly follow-up visits, and improvement was documented.

Results. All four patients demonstrated complete resolution of skin atrophy and restoration of surface contour within 4 to 8 weeks of initial presentation. Injected volumes of normal saline ranged from 5 to 20 cm3 per treatment session and three to six weekly treatments. The patients were completely satisfied with these results.

Conclusion. Normal saline infiltration offers a safe, tolerable, relatively rapid, and effective treatment for local, persistent corticosteroid-induced atrophy.

Dermatologic Surgery, Volume 31 Issue 10, Pages 1340 - 1343,

Wow…I was doing so much research today and was so excited to find this website and seeing all the responses from everyone below. My daughter had a really bad allergy attack last 6/2008 when there was a lot of smoke in the Sacramento, CA Valley from surrounding fires. The smoke was so bad for a couple of months. I took my daughter into an urgent care Med 7 of Folsom per the advise nurse line provided by my health insurance co. Nothing had changed in my daughters diet or environment for the hives to occur, other than the smoke that was really bad outside. So the doctor came in and looked at my daughter and then he said they would be administering a Kenalog shot and that would help the hives disappear for what ever reaction she was having. I was a bit concerned because my daughter was only being 2 years old and there is steroids in this medication. Normally when we have ever got any type of injection from a doctors office they have always given you a side effects form for you to review and a form for you to sign an authorization to CYA. Unfortunately, due to me being so concerned with my daughter I didn’t realize it until I had to take my daughter an hour later after we got home the hives did not disappear they got even worst, so we rushed her Mercy of Folsom, CA and I gave my daughter benadryl only to settle the hives because she was so uncomfortable and itchy. Finally after waiting for about 2 ½ -3 hours in the emergency room the hives settled down for a short period of time. Finally we got in to see the doctor I explained everything and realized that the paperwork I had for my daughter didn’t have the side effects paperwork from Med 7 or the amount of the kenalog shot they administered to my daughter. The only thing the doctor could recommend was Zyrtec and to follow up with my daughters primary physician. So, we went to the store and purchased this over the counter medication for her allergies and it worked great for her. About a month after the kenalog injection in her upper left thigh I noticed she had these small white/purplish color marks on her leg and then it turned into a dime size indentation. Over the last 7 months that indentation has grown into the size of a quarter, maybe a bit bigger than that. We didn’t think anything of it until recently we called the advise nurse and she said to make an appointment with our primary physician to have him look at it. When we came into our appointment I explained the long story to him about the shot she received and why she received it, so he referred me to a dermatologist who really couldn’t give me any advise other than it was a lipoatrophy? He said he couldn’t recommend anything other than to watch it over time and if it gets bigger to go back to her primary physician. He stated that she could probably get surgery to have the muscle in her leg pulled together or add filler injections. He said I can’t really suggest anything if it is not effecting her general health. From what I see when I touch this area of my daughter softly she doesn’t even want it to be touched as if it is very sensitive? This is truly unacceptable and I plan on coming after the Med 7 clinic for not providing me any side effects paperwork before administering the shot and they have a rate us 1 - 10 website. I rated them a couple of days later and from what I heard from their Folsom, CA office is that they have the board of directors for these clinics and managers review what is sent on this rating website and someone would follow up with the client. Unfortunately, that was not the case because nobody ever called me back or was concerned. I will never go into a med 7 clinic for assistance again and I will continue my mission to make sure my daughter and others are aware of what could happen to them as well.

PS. To the writer slmgator Thank you!!! I will report my message to the FDA as well….

I had a kenalog injection to my right cheek to treat a cyst. It ended up dilating the blood vessels and it atrophied the fat cells under the skin's surface. Now I have a permanent indent in my cheek that looks terrible. There is no way to cover it up and people ask about it all the time. It is very upsetting and stressful. I went to a different dermatologist and was told the only thing to do is a filler injection that only lasts up to 6 months at a cost of $525

Kenalog needs to be sued! I had the flu back in November of 07' and my internist had her nurse give me a shot of Kenalog. Come to find out through my own research (not anything my doctor warned me about) that kenalog causes all kinds of hormonal irregularities. On top of that horrible feeling, I have a HUGE dent on my left butt cheek. It started out small and is now huge with lighter colored skin tissue deep (1.5 ") in the middle of it. I feel very embarrassed being nude, and very paranoid about clothing. I know it is very visible in a bikini and under A-line fitting clothing. I went to my doctor and asked her about it and she said "it is normal, and that was one of the side effects." BUT the nurse who injected the shot did not say a word about any side effects when she saw the dent nor did she admit to any error of the injection. The Dr. said I will now have this crater/dent for the rest of my life. It all smells fishy to me. My doctor didn't mention one single word about a possible side effect. I would NEVER have had the injection. We trust our doctors to tell us side effects that may cause us emotional stress, and possible disfigurement for the rest of our lives. Has anyone had any luck with getting a lawyer involved. I want compensation. I want to try the saline injections and don't want to pay for the treatment. AND I want to STOP this from happening to other women. This is not a vain issue. It is an outright disfigurement/deformaty.

my 11 y/o daughter has a chronic headache condition (NDPH), a non-stop headache since Oct.29,07. She had a supraorbital nerve block, occipital nerve block using Kenalog. Her first injection was only the occipital nerve block, then 2 weeks later, repeated the occipital nerve block and added the supraorbital (above eyebrow) nerve block. This was July 2nd. On July 10th, she started her first period...it lasted 19 days! Then, she had a week off, a week on, a week off, a week on, a week off........now, it's been 2 weeks since her last one. NOW.....I am seeing that the period was probably brought on by Kenalog and that the irregularity was too!
The other thing: She developed INDENTIONS across her forehead, they showed up on Aug.6th. One if very significant, the other 3 are smaller. There is some discoloration (greyish) and there is scarring at the injection site. We took her to the pain mgmt. doctor who did the procedure and she had researched it, after our call, and told us SALINE INJECTIONS would help to plump the indentions back up. She sent us to a Cosmetic Dermatologist b/c she'd not seen this or treated this before and he had. We saw him and he is waiting to talk to our pedi-neurologist to find out if she is a candidate for Saline Injections without effecting the nerves that are already messed up from the NDPH.
I am very upset about the side effects....we were NOT informed this could happen!!!!! The indentions are VERY TENDER! They are already at the site where her headache/nerve pain was severe..now you can't even touch across it! Hopefully her periods will regulate and stabilize! What a way to start your first one!!! UGGGHHH!!!! No one told us that could happen either! We had a doc fixing to put her on hormone therapy (BCP's) to regulate her! We are now waiting to see if it stabilizes.
My daughter has a great attitude about it, she has bangs and just said, "I'll just keep my bangs long enough to cover it up!!!"

I would NOT have taken the chance on this and do NOT recommend anyone with a child to take the chance with it! It wasn't worth what we ended up with!!!!

My daughter has Aloepecia Areata. Has anyone taken Kenalog to grow hair back. My doctors saying this may work and did mention about the dimpling effect. Not in the detail I read here, though. He made it sound like it would just be a dimple. I did not get the shot in his office, wanted to research some more. By the way, she is only a 11 yrs old. Not sure whether to try this stuff after reading all this.

I HATE Kenalog! I had the flu back in March of 08' and my doctor gave me a shot of Kenalog. Soon after I had a horrible period that was totally out of the blue which made my husband I think that I may have miscarried. Come to find out through my own research (not anything my doctor warned me about) that kenalog causes irregular periods, but for months I went through the pain of thinking my body had miscarried. On top of that horrible feeling, I have a HUGE dent on my left butt cheek. It started out small and is now huge with a blue bruise in the middle of it. I feel very embarrassed being nude, and very paranoid about clothing. I feel like everyone can see it. I went to my doctor and asked him about it and he said "it is normal, and will go away with time." BUT the nurse who injected the shot in the first place, came in after he left and asked to see the dent and then apologized with a look on her face that made me realize I will probably be sportin' this dent for the rest of my life. It all smells fishy to me. My doctor didn't mention one single word about a possible side effect. I would NEVER have had the injection. We trust our doctors to tell us side effects that may cause us emotional stress, and possible disfigurement for the rest of our lives. Has anyone had any luck with getting a lawyer involved. I want compensation. I want to try the saline injections and don't want to pay for the treatment. AND I want to STOP this from happening to other women. I know it might be vain and I know my husband loves me for who I am, but I am a woman and don't want the freakin' Grand Canyon on my butt cheek!!!!

I found this article on treating the dimpling/cutaneous atrophy effects of Kenalog with saline injections. Very good cosmetic effect.

1: Dermatol Surg. 2005 Oct;31(10):1340-3.
Treatment of local, persistent cutaneous atrophy following corticosteroid injection with normal saline infiltration.
Shumaker PR, Rao J, Goldman MP.

Dermatology Department, Naval Medical Center, San Diego, CA, USA.

BACKGROUND: Injections of corticosteroids are commonly used for a variety a dermatologic conditions but may cause local, persistent cutaneous atrophy, with few therapeutic options. OBJECTIVE: To determine the effectiveness of bacteriostatic normal saline infiltration on the improvement of corticosteroid-induced cutaneous atrophy. MATERIALS AND METHODS: Four patients with corticosteroid-induced atrophy of the skin, two caused by acneiform cysts and one from intramuscular steroid injection, were treated with weekly injections of normal saline directly into the atrophic site. The patients were seen on weekly follow-up visits, and improvement was documented. RESULTS: All four patients demonstrated complete resolution of skin atrophy and restoration of surface contour within 4 to 8 weeks of initial presentation. Injected volumes of normal saline ranged from 5 to 20 cm(3) per treatment session and three to six weekly treatments. The patients were completely satisfied with these results. CONCLUSION: Normal saline infiltration offers a safe, tolerable, relatively rapid, and effective treatment for local, persistent corticosteroid-induced atrophy.

I to have a huge dent in my right butt cheek. I would be interested in a class action suit. This is ridiculous! It has been about three months since I received the shot. Has anyone noticed their dents getting better with time?

I too experienced an indentation from a kenalog shot. My experience is a little different though, because I received the shots on my face for acne. I received four shots and two out of the four depressed / indented. I was EXTREMELY depressed and felt hopeless after reading it would take 6 months to a year (or more) to have my skin gash-free. I stayed up for two days straight searching for some sort of help on the internet and found a medical article about something called saline infiltration. It is a relatively new procedure and was created by "one of the best dermatologists in the country". I was so desperate, that the next morning I drove to see him in La Jolla, Ca (I live in LA). I received shots in the problem areas. It is now two days later and my indents are about 80% better!! He told me to give it another couple of days to see complete restoration, and if not, said that one more treatment should make everything 100% normal again. Needless to say, I am thrilled!! I do not know if this will work for any of your situations (being that the dr. is a dermatologist and the shot was initially given for acne), but I thought I would share my great news and hopefully help at least one person out there dealing with this mess.