Another issue with usage of intra-lesional steroids is the size, length and thickness of the needle used to inject the keloid lesions. Some physicians falsely believe that a large and thick needle should be used to inject large keloid lesions. This belief comes from the fact that injecting some old and dense keloid lesions is a rather difficult task. In treating keloid lesions, the smaller and thinner the needle is, the less damage it causes to the keloid tissue. Dr. Tirgan only uses the smallest and thinnest needles, those that are used to inject insulin under the skin. With this method, Dr. Tirgan is able to inject any keloid.
High dosages of oral corticosteroids taken daily for prolonged periods of time can have serious systemic side effects including bone loss ( osteoporosis), increased risk of infections and diabetes and cataracts, thinning of skin, stretch marks, increased facial/body hair growth, acne, fluid retention, weight gain with redistribution of fat (fat deposits on back and face, thinning of limbs), muscle weakness, decreased resistance to infections, stomach ulcers, mood swings, insomnia, suppression of the body's own production of cortisol, etc.
Corticosteroid side effects may cause weight gain, water retention, flushing (hot flashes), mood swings or insomnia, and elevated blood sugar levels in people with diabetes. Any numbness or mild muscle weakness usually resolves within 8 hours in the affected arm or leg (similar to the facial numbness experienced after dental work). Patients who are being treated for chronic conditions (., heart disease, diabetes, rheumatoid arthritis) or those who cannot temporarily discontinue anti-clotting medications should consult their personal physician for a risk assessment.