Why Home Acne Injections Are a Terrible Idea

Thinking about trying at-home acne injections? Stop right there. Dr. Stefanie Williams tackles the emerging trend of self-administered steroid injections for acne spots, explaining exactly why this approach worries dermatologists worldwide. From permanent skin indentations and atrophy to potential infections and abscesses, she reveals the serious risks that come with injecting yourself at home in unsterile conditions. More importantly, she explains why these injections only mask symptoms temporarily without treating the underlying condition—clogged pores that start every acne lesion. Dr. Stefanie discusses the critical differences between how dermatologists perform these injections in controlled clinical settings versus what a standardized home device delivers, highlighting why customization and expertise are non-negotiable. She also addresses why UK and European dermatologists are particularly cautious about these treatments compared to other countries. This frank, detailed discussion will change how you think about acne treatment, why one-size-fits-all solutions fail, and why expertise matters when it comes to your skin health and safety.

Transcript

Setting The Agenda

SPEAKER_00 0:01

Dermatologist debriefs. Join no-nonsense dermatologist Dr. Stephanie Williams as she debunks myths and shares her professional insights. Separating facts from fiction in just a few minutes.

What The ClearPen Promises

How The Device Works

Why Technique And Tailoring Matter

When Steroid Shots Are Appropriate

Steroids Don’t Treat Root Causes

Safety And Misdiagnosis Risks

Complications And Antibiotic Cover

Practice Differences And Firm Stance

SPEAKER_01 0:16

Hello, this is Dr. Stephanie. A number of people, both journalists and patients, have asked me for my opinion on the so-called ClearPen, which are home injections for acne. And these are still being investigated, so they aren't actually available yet. I thought it would be important to share my views on that planned treatment because, frankly, from a dermatologist's point of view, I think this is a terrible idea. So, what exactly are those acne home injections? This is an automated self-injection device that patients would administer themselves into acne spots at home, as the name implies. So it's a little bit like an insulin injection, which often comes as an automated injection pen as well, or like an adrenaline injection for severe allergies. But of course, this one is very different. It contains a diluted form of triamsinolon acetonide, which is an anti-inflammatory corticosteroid. And this pen is designed to deliver a fixed dose of steroid directly into individual inflamed acne lesions such as cysts, papules, and pustules. So it essentially aims to replicate the intralesional steroid injections you would normally receive from your dermatologist in a clinic, but at a lower concentration and self-administered at home. When we do this in clinic, however, dermatologists tailor both the concentration as well as the volume injected to each individual patient and situation. And also there is a very precise control over injection depth, which is really important because if you inject this steroid too superficially, you may end up with a permanent dip in the skin. But this acne pen by contrast not only always injects the exact same volume of steroid, but also always injects in the same depth, regardless of how big or small, how superficial or deep your acne lesion is, and that's just not good enough. And that's one of one of the reasons why I feel a home device like this is a really bad idea because it cannot be tailored at all. When I perform steroid injections into an acne cyst in clinic, I would only ever inject a very small fraction of acne lesions with steroids, if at all. And then that's only used as a kind of emergency treatment which is symptomatic to bring down a very strongly inflamed acne cyst. So it's great, for example, if somebody comes with a major acne cyst a few days before their wedding or another major event. So that's a good indication for these acne injections. But that's a quite narrow scenario. And in this narrow scenario, steroids can be useful, intralesional steroids, but they are not, and they should never be a routine acne treatment. And that's why I don't think it's a good idea at all to give patients an injection pen to use at home. Also because they don't address the root cause of acne. They only basically paint over the cracks, and very temporarily, that is. You'll still get more spots coming up. It changes nothing really, because every acne lesion starts with a clogged pore, a so-called comedone. So this is either a white hat or a black hat or a microcomidone that's invisible to the naked eye. And steroid injections do absolutely nothing to tackle that, the beginning of acne. And that's really what we should be treating. And there are also practical and safety concerns. So injections should always be carried out under sterile controlled conditions by an expert and not by yourself in an uncontrolled, unclean home environment. In addition, there is also a real risk of misdiagnosis or injecting the wrong type of acne lesions. As I would only ever use intralesional steroids into very certain types of acne lesions, and at a very particular point in their development. So you can't just blindly inject all of the acne spots that you have. And there are other risks, of course, like skin atrophy, which is a skin thinning, or even a visible indentation in the skin surface, as well as irregular pigmentation, broken vessels, cautella and gectages, and even potential scarring if the treatment is not done correctly. And sometimes intralesional steroids, which locally suppress the immune system, can even make things worse. And acne lesions have the potential to progress into an abscess. So for that reason, I personally like to cover my acne patients who are here having these steroid injections with an appropriate acne antibiotic at the same time. This doesn't happen often, but it is a serious complication, and you really don't want to be causing that at home. Dermatologists in the UK and also in Germany, where I trained, are generally much more cautious and use steroid injections for acne far less frequently than in some other countries like the US. But even in the US, it is currently done by doctors, so that's good. We really don't want our patients to self-inject their acne lesions, it's just not safe. But most importantly, this approach does not treat the underlying disease or the underlying reason why you have acne, only a symptom, and only for a very short time until the next spot or the next acne cyst appears. Nothing changes. So I mentioned that this particular injection device is not approved yet, it's still under investigation, but for the avoidance of doubt, I very strongly discourage home steroid injections for acne. I think it's a really bad idea.