From the Guidelines
Yes, cortisone shots can cause facial flushing as a side effect, as evidenced by a case of facial flushing associated with a large intravenous methylprednisolone bolus in a trial 1. This reaction typically occurs within 24-48 hours after receiving the injection and usually resolves on its own within a few days. The flushing happens because corticosteroids can cause temporary vasodilation, where blood vessels in the face dilate, increasing blood flow to the area and creating a reddened appearance. Some key points to consider about cortisone shots and facial flushing include:
- The likelihood of experiencing facial flushing may increase with higher doses of cortisone.
- Other potential side effects that might accompany the flushing include a feeling of warmth, temporary insomnia, and increased energy.
- If the flushing is severe, persistent beyond several days, or accompanied by other concerning symptoms like difficulty breathing or severe swelling, medical attention should be sought immediately as this could indicate an allergic reaction rather than a typical side effect. It's also worth noting that while facial flushing is a potential side effect of corticosteroid use, other cosmetic changes such as facial rounding, dorsal hump formation, striae, weight gain, acne, alopecia, and facial hirsutism can occur with prolonged corticosteroid treatment 1. However, the question of facial flushing as a side effect of cortisone shots is most directly addressed by the evidence from the trial discussing the effects of a large intravenous methylprednisolone bolus 1.
From the Research
Cortisone Shots and Facial Flushing
- Corticosteroid injections can cause a range of potential side effects, including local and systemic effects 2.
- Systemic side effects of corticosteroid injections include facial flushing, hypertension, hyperglycemia, and osteoporosis 2.
- Sex-related side effects of corticosteroid injections, such as facial flushing, have been reported, particularly in female patients 3.
- Flushing is a known side effect of corticosteroid administration, and its occurrence has been studied in various epidural steroid injections 4, 5.
- The incidence of flushing after epidural steroid injections varies, with reports ranging from 9% to 28% 4, 5.
- Female participants are more likely to experience flushing after epidural steroid injections, with one study reporting a significant difference in the incidence of flushing between male and female participants 5.
- Flushing reactions after corticosteroid injections are generally self-limiting and resolve within 48 hours 5.
Studies on Cortisone Shots and Facial Flushing
- A study published in the American Journal of Roentgenology found that systemic side effects of corticosteroid injections include facial flushing 2.
- A review of sex-related side effects of corticosteroid injections published in Orthopedics reported that facial flushing is a potential side effect, particularly in female patients 3.
- A prospective database study published in the Pain Physician found that the incidence of flushing after epidural steroid injections was approximately 11% 4.
- A retrospective cohort study published in the Pain Physician found that the incidence of flushing after interlaminar lumbar epidural steroid injection with dexamethasone was 28% 5.