A steroid injection appointment is a short 5-10 minute appointment during which our nurses or Dr. Donovan will administer steroid into the scalp, eyebrows or other areas where patients may be losing hair. We perform steroid injections for a range of conditions including alopecia areata, lichen planopilaris, frontal fibrosing alopecia, folliculitis decalvans, central centrifugal cicatricial alopecia, discoid lupus and pseudopelade.
Injections are administered by our nurses or by Dr. Donovan (depending on the day). They are brief appointments designed to make things convenient for patients who needs these injections. Our goal is to help you get in and out of the appointment without delay. Most appointments take less than 5 minutes. When you arrive you will be taken immediately into the procedure room. Dr. Donovan will then ask you to either sit upright in a chair, or on a stool or to lie flat on an examining table to have your steroid injections. After the injections are done, we will assist you to book either another steroid injection appointment or help you book a follow up appointment.
When choosing a follow up appointment, be sure to take note of whether you wish a "steroid injection appointment" or a "follow up appointment"
If you have any questions about whether a steroid injection appointment or a follow up appointment is more appropriate for you, please let us know. In general, these principles are helpful in deciding which appointment is most suitable:
1. What is the name of the medication that is injected ?
The name of the medication is triamcinolone acetonide
2. How much is injected into the scalp ?
A concentration of 2.5 to 10 mg per mL is used of the triamcinolone acetonide. Between 1 mL and 9 mL is injected depending on the dose and area to cover. We do not exceed 20 mg in any visit.
3. How many injections are performed?
Anywhere from two to fifty injections may be performed depending on the size of the area of hair loss. For example, a small quarter-sized area of alopecia areata may be treated with 4 injections and a full eyebrow may be treated with 5-6 injections.
4. Are cortisone injections safe? Are there any side-effects from injections?
When it comes to cortisone mediations, it's important to remember that there are 3 main ways that cortisones can be used by physicians - 1) cortisone creams and lotions that are applied to the surface of the skin, 2) cortisone injections and 3) cortisone pills that are taken by mouth. Cortisone pills, by far, have the most potential side effects. Prednisone is the name of a common cortisone pill. Cortisone creams/lotions and injections have much fewer side effects - especially when used for short periods of time and under the care and direction of a physician. This last point can't be stated enough.
The most common side effect from injections is some discomfort at the time the medication is injected. Mostpatients rate this discomfort about 3 out of 10 and it lasts about 3-4 seconds. Manyindividuals with report that injections in the eyebrows are slightly more uncomfortable than injections in the scalp.
Other side effects are possible too so it's important to meet with your doctor to discuss the range of side effects with injections. For example, a small indentation or depression in the scalp can rarely occur in the area where the medicine is injected. This is a temporary indentation and goes away over time. However, it may take a few months to completely resolve. It's not possible to predict who will have this side effect and who will not, but it's not common and most individuals are not bothered by the side effect should it occur.
5. What types of hair loss conditions can cortisone injections be used for?
Dr. Donovan frequently uses steroid injections to stop or reduce inflammation under the scalp in many hair loss conditions, including:
• alopecia areata
• lichen planopilaris and frontal fibrosing alopecia
• central centrifigal cicatricial alopecia
• folliculitis decalvans
• some types of traction alopecia
6. What types of hair loss conditions are cortisone injections NOT used for?
Injections are not used for hair diseases that don't have much inflammation under the scalp. Therefore, Dr. Donovan does not use cortisone injections as part of the treatment plan for the following conditions:
• androgenetic alopecia (male and female genetic balding)
• telogen effluvium (hair shedding problems)
• tinea capitis (fungal infections)
• trichotillomania (hair pulling)
7. Can children receive cortisone injections too ?
Although it is safe for young children to receive cortisone injections, Dr. Donovan rarely perform injections in children with hair loss under the age of 8-10 years. This is simply to make sure the child is comfortable with the treatment. But it all depends on the child. There are some young children age 8 or 9 who feel comfortable with a few injections in the scalp, especially when I useda variety of distraction techniques. However, there are other children and adolescents who are not comfortable at all - and we choose not to inject but rather focus on other types of treatments.
8. What is the most important message to give about cortisone injections?
For many types of hair loss conditions, injections are a very important part of the treatment. When performed properly with the right concentration and amount these treatments are very safe.
9. What are the fees for steroid injections?
There is a fee of $ 200 for injections performed by our experienced nurses.
10. How far apart are my visits for injections ?
Visits range from every month to every 4 months depending on the specific diagnosis.
11. Is the appointment only for injections or will Dr. Donovan evaluate my scalp and progress?
The appointment is only for injections. Patients wishing to have a thorough review of their progress and whether or not any modifications to the treatment plan are needed should book a longer follow up appointment rather than a 5 minute injection appointment.