I wanted to share with you a recent procedure I had for a small bump, which doctors think is calcinosis, a small calcium deposition that can occur in the skin. I had it for over a year and recently saw a very well-trained plastic surgeon at Mass General Hospital. He suggested we either cut it out or inject something called Kenalog, a steroid injection, to shrink it. In this case, the surgeon used a mix of 20/40. The outcome was unexpected and taught me valuable lessons about the importance of caution and conservative dosing in dermatological treatments.
I presented with skin and fat atrophy at the injection site, a known but rare complication of intralesional corticosteroid injections. This side effect occurs when the steroid causes localized loss of subcutaneous fat, leading to a depression in the skin. In short, I had a reaction to the Kenalog, resulting in a vertical streak on my forehead of fat and skin loss.
To address the complication, I utilized hydrocolloid pimple patches, a treatment typically used for acne. These patches help by creating a moist environment that promotes skin healing and regeneration. After a few days, this method showed promising results, with noticeable improvement in the atrophy. The healing process was further supported by a regimen that included salicylic acid, glycolic acid and retinol, all known for their skin-renewing properties.
Salicylic acid, a beta-hydroxy acid, aids in exfoliating the skin, reducing inflammation, and promoting cell turnover. Retinol, a vitamin A derivative, enhances collagen production and accelerates skin renewal. This combination helped to improve the texture and appearance of the affected area, demonstrating the effectiveness of integrating these agents into the treatment plan.
The reason I’ve chosen to share this experience is to help you understand that not all procedures are safe, even in the best-trained hands. Even when you have done everything right and taken the proper steps, complications can arise in the most controlled settings. Regarding my practice, when my patients say, “Let’s do an extra filler or an extra thread,” if you don’t need it, take it from me and avoid the procedure if you can.
