Patients with cystic acne can find almost immediate relief of deep acne cysts from a steroid injection directly into the cyst. In my practice, I use a very dilute solution of Kenalog and place a very small amount of this steroid into a cyst. The amount of steroid is so small that there is essentially no systemic absorption. The main side effect of these injections is that fat atrophy can occur if too much steroid is injected resulting in a depression in the skin. However, this is not a permanent depression and eventually resolves. The underlying cause of a patient's cystic acne should be investigated and I recommend following up with a board certified dermatologist for diagnosis and treatment as each individual's condition is unique.
i used hydrocortisone butyrate on my face for about 2yrs. it was given to me for a patch under my face. i was told it would help my dry skin so every day i used it morning and night. this year i started getting patches on my face which the hydrocortisone did nothing to help. i was given a week of prednisone. my face cleared up beautifully until the last day of predisone. the next 3 days after finishing the pill my face blew up!! it was so red,literally like a thousand bumps under the skin and my face felt like sandpaper and was a bit swollen. i was given fluocinolone acetinide ointment to take till i "cleared up". noone at all mentioned over the past 2yrs the possibility of steroid rosacea. used that ointment till april. wasnt doing much cuz i would still get patchy and swollen. went to a new derm thats when i was put on doxycycline and elidel.
Oral corticosteroids ( Prednisone , Solu-Medrol ): Acne may be caused by systemic steroid use, but "steroid acne" is usually characterized by an acute eruption of tiny papules and pustules over the chest and back. Oral steroids may play a role in the treatment of cystic acne, not on their own, but as an adjunct to other antibiotic or isotretinoin therapy to try to suppress scarring inflammation in the skin as fast as possible. This may be especially important with the initiation of isotretinoin therapy, and many providers will start low-dose systemic steroids at the start of isotretinoin therapy in order to block the anticipated flare in disease that retinoids may trigger.